SynthesisAddiction (Abingdon, England)2023
Biomarkers of potential harm in people switching from smoking tobacco to exclusive e-cigarette use, dual use or abstinence: secondary analysis of Cochrane systematic review of trials of e-cigarettes for smoking cessation.
Synthesis in Addiction (Abingdon, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2026Pooled it
- Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2025Pooled it
- Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2025Pooled it
- Population-Based Disease Odds for E-Cigarettes and Dual Use versus Cigarettes.NEJM evidence · 2024Pooled it
- Exposure to Tobacco-Specific Nitrosamines Among People Who Vape, Smoke, or do Neither: A Systematic Review and Meta-Analysis.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Pooled it
- Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2024Pooled it
- Biomarkers of potential harm in people switching from smoking tobacco to exclusive e-cigarette use, dual use or abstinence: secondary analysis of Cochrane systematic review of trials of e-cigarettes for smoking cessation.Addiction (Abingdon, England) · 2023Pooled it
- Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2022Pooled it
- Comparison of e-Cigarette and Cigarette Use and Dual Use Associations With Disease: Updated Systematic Review and Meta-Analysis.Public health reports (Washington, D.C. : 1974)Pooled it
- Patterns of e-Cigarette Use and Smoking Cessation Outcomes: Secondary Analysis of a Large Randomised Controlled Trial to Inform Clinical Advice.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Trial
- Restricting choice of e-cigarette flavor and device type increases choices to use combusted cigarettes among adults who dual use both products: Results from a within-subjects randomized trial.Addictive behaviors · 2026Trial
- Sustained effects of reduced nicotine cigarettes and co-use of non-combusted alternative nicotine delivery systems: A one-month follow-up to a randomized clinical trial.Drug and alcohol dependence · 2026Trial
- Carcinogen reduction in a randomized controlled study comparing e-cigarette provision to assessment only among people with serious mental illness who smoke.Drug and alcohol dependence · 2025Trial
- Evaluation of Dual Use: Real Time Reductions in Combustible Cigarette Smoking During Co-Occurring Use of E-Cigarettes.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Trial
- Augmented Doses of Nicotine Replacement Therapy: Feasibility for Dual Cigarette and E-Cigarette Cessation.American journal of preventive medicine · 2025Trial
- Use of e-Cigarettes in Cigarette Smoking Cessation: Secondary Analysis of a Randomized Controlled Trial.JMIR mHealth and uHealth · 2023Trial
- Change in E-cigarette risk perception and smoking behavior of Black and Latinx individuals who smoke.Drug and alcohol dependence · 2023Trial
- A Preconception Cohort Study of Nicotine Vaping and Incidence of Spontaneous Abortion.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Trends in adult exclusive and dual use of combustible and non-combustible tobacco products in the United States.JNCI cancer spectrum · 2026Article
- Does media channel matter? exploring the disparities of online and offline anti-tobacco messages and their impacts on e-cigarette harm perception and use.Substance abuse treatment, prevention, and policy · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
aimsThis study aims to compare biomarkers of potential harm between people switching from smoking combustible cigarettes (CC) completely to electronic cigarettes (EC), continuing to smoke CC, using both EC and CC (dual users) and using neither (abstainers), based on behaviour during EC intervention studies.
designSecondary analysis following systematic review, incorporating inverse variance random-effects meta-analysis and effect direction plots.
settingThis study was conducted in Greece, Italy, Poland, the United Kingdom and the United States.
participantsA total of 1299 adults smoking CC (nine studies) and provided EC. MEASUREMENTS: Measurements were conducted using carbon monoxide (CO) and 26 other biomarkers.
findingsIn pooled analyses, exhaled CO (eCO) was lower in EC versus EC + CC [mean difference (MD) = -4.40 parts per million (p.p.m.), 95% confidence interval (CI) = -12.04 to 3.24, two studies] and CC (MD = -9.57 p.p.m., 95% CI = -17.30 to -1.83, three studies). eCO was lower in dual users versus CC only (MD = -1.91 p.p.m., 95% CI = -3.38 to -0.45, two studies). Magnitude rather than direction of effect drove substantial statistical heterogeneity. Effect direction plots were used for other biomarkers. Comparing EC with CC, 12 of 13 biomarkers were significantly lower in EC users, with no difference for the 13th. Comparing EC with dual users, 12 of the 25 biomarkers were lower for EC, and five were lower for dual use. For the remaining eight measures, single studies did not detect statistically significant differences, or the multiple studies contributing to the outcome had inconsistent results. Only one study provided data comparing dual use with CC; of the 13 biomarkers measured, 12 were significantly lower in the dual use group, with no statistically significant difference detected for the 13th. Only one study provided data on abstainers.
conclusionsSwitching from smoking to vaping or dual use appears to reduce levels of biomarkers of potential harm significantly.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.