ArticleTobacco control2022
Risk and safety profile of electronic nicotine delivery systems (ENDS): an umbrella review to inform ENDS health communication strategies.
Article in Tobacco control, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 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
27 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Health impacts of electronic nicotine delivery systems: an umbrella review of systematic reviews.BMJ open · 2025Pooled it
- Pooled it
- Association of electronic cigarette use and suicidal behaviors: a systematic review and meta-analysis.BMC psychiatry · 2024Pooled it
- Sharing Antivaping Social Media Messages.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2025Trial
- Electronic cigarette use, related health outcomes and policy interventions in the USA: a call for research to fill evidence gaps.Tobacco control · 2026Review
- Applying a mixed-methods approach to evaluate and tailor electronic cigarette pictorial health warning labels for young adults in the United States.BMC public health · 2026Article
- Electronic Cigarette Usage and Psychological Distress: Insights from University Students Amidst the Armed Conflict in Southern Thailand.Healthcare (Basel, Switzerland) · 2026Article
- Nicotine e-cigarettes in Peru: analysis of law 32159 against international evidence and gaps for adolescent protection.Revista peruana de medicina experimental y salud publica · 2026Article
- Development of Survey Measures of Uncontrolled Vaping and Vaping Restraint.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- Interactions between ENDS and cigarette use: evidence from a 2022 national telephone survey in South Africa.Tobacco control · 2025Article
- Novel nicotine and tobacco products in pediatric age: a joint position paper.Italian journal of pediatrics · 2025Review
- Tobacco and asthma: presenting the world health organization (WHO) tobacco knowledge summary.Substance abuse treatment, prevention, and policy · 2025Review
- Nicotine and Toxicant Exposure among Individuals using both Combustible Cigarettes and E-cigarettes Based on Level of Product Use.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025Article
- The Future of e-Cigarette Health Warnings.JAMA internal medicine · 2025Article
- Building consensus on a set of ENDS-specific pictorial health warnings: a Delphi study among a tobacco control expert panel.Tobacco control · 2025Article
- Article
- Evaluating the human abuse potential of concurrent use of electronic cigarettes and low nicotine cigarettes among adults who smoke.Experimental and clinical psychopharmacology · 2025Article
- Applied statistical methods for identifying features of heart rate that are associated with nicotine vaping.The American journal of drug and alcohol abuse · 2025Article
- Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
objectivesThis umbrella review aims to summarise the evidence about electronic nicotine delivery systems' (ENDS) risk and safety health profile to inform ENDS health communication strategies. DATA SOURCES AND STUDY SELECTION: Six databases were searched for systematic reviews presenting evidence on ENDS-related health effects. Ninety reviews divided into five categories were included: toxicity=20, health effects=40, role in smoking cessation=24, role in transition to combustible cigarettes (CCs)=13 and industry marketing claims=4. DATA EXTRACTION: Findings were synthesised in narrative summaries. Meta-analyses were conducted by study type when appropriate. Quality assessment was conducted using the Measurement Tool to Assess Systematic Reviews. The Institute of Medicine's Levels of Evidence Framework was used to classify the evidence into high-level, moderate, limited-suggestive and limited-not-conclusive. DATA SYNTHESIS: We found high-level evidence that ENDS exposes users to toxic substances; increases the risk of respiratory disease; leads to nicotine dependence; causes serious injuries due to explosion or poisoning; increases smoking cessation in clinical trials but not in observational studies; increases CC initiation; and exposure to ENDS marketing increases its use/intention to use. Evidence was moderate for ENDS association with mental health and substance use, limited-suggestive for cardiovascular, and limited-not-conclusive for cancer, ear, ocular and oral diseases, and pregnancy outcomes.
conclusionsAs evidence is accumulating, ENDS communication can focus on high-level evidence on ENDS association with toxicity, nicotine addiction, respiratory disease, ENDS-specific harm (explosion, poisoning) and anti-ENDS industry sentiment. Direct comparison between the harm of CCs and ENDS should be avoided. PROSPERO REGISTRATION NUMBER: CRD42021241630.
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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.