SynthesisHarm reduction journal2023
Respiratory health effects of e-cigarette substitution for tobacco cigarettes: a systematic review.
Synthesis in Harm reduction journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers, 1 of them a synthesis 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
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Health impacts of electronic nicotine delivery systems: an umbrella review of systematic reviews.BMJ open · 2025Pooled it
- Trial
- Prevalence and correlates of ever and current dual use of cigarettes and e-cigarettes among adolescents in Saudi Arabia.Internal and emergency medicine · 2026Article
- Differences in respiratory wheezing between current exclusive e-cigarette users, current exclusive cigarette smokers, and never users of either product: findings from a population-based study.Harm reduction journal · 2025Article
- Electronic Nicotine Delivery Systems (ENDS): Implications for the Clinician.Pulmonary therapy · 2025Review
- Self-rated health differences between exclusive e-cigarette users and exclusive cigarette smokers: evidence from the 2017-2019 Scottish Health Survey.Internal and emergency medicine · 2025Article
- Comparative effects of cigarette smoking, e-cigarette use, and dual use on pulmonary function, exercise capacity, and quality of life in young adults: a cross-sectional study.Frontiers in public health · 2025Article
- Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella Review.Tobacco use insights · 2025Review
- Delphi consensus methodology to gauge expert perspectives on smoking prevention, cessation and harm reduction in Italy.Frontiers in psychiatry · 2025Review
- Respiratory symptoms among e-cigarette users without an established smoking history in the VERITAS cohort.Scientific reports · 2024Article
- Patterns of Use of e-Cigarettes and Their Respiratory Effects: Protocol for an Umbrella Review.JMIR research protocols · 2024Article
- A Global Health Survey of People Who Vape but Never Smoked: Protocol for the VERITAS (Vaping Effects: Real-World International Surveillance) Study.JMIR research protocols · 2024Article
- Correction to: Respiratory health efects of e-cigarette substitution for tobacco cigarettes: a systematic review.Harm reduction journal · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundE-cigarettes (electronic nicotine delivery system, ENDS) have been presented as a harm reduction strategy for people who smoke tobacco cigarettes but who cannot achieve abstinence, or for those who wish to continue to enjoy nicotine and the habit of smoking. What are the health effects of the substitution of ENDS for tobacco cigarettes? This systematic review evaluates the evidence of human clinical tests on the respiratory effects of ENDS use in participants who smoke tobacco cigarettes.
methodsA registered and published protocol was developed conforming to PRISMA 2020 and AMSTAR2 standards. The literature search was conducted in PubMed, Scopus, and the CENTRAL Cochrane Library and updated to May 2022. Three supplementary searches and a grey literature search were performed. Studies were evaluated with the JBI quality tools and the Oxford Catalogue of Bias. Due to the heterogeneity (diversity) of the studies, a narrative data synthesis was performed on the test findings plus three sub-group analyses.
resultsThe review consists of sixteen studies and twenty publications. Spirometry tests comprised the majority of the data. In total, 66 respiratory test measurements were reported, out of which 43 (65%) were not significant. Statistically significant findings were mixed, with 9 tests showing improvements and 14 measuring declines, none of which was clinically relevant. Ten studies were rated at a high risk of bias, and six had some concerns primarily due to inadequate research designs and the conduct of the studies. Reporting bias was documented in thirteen studies.
conclusionsMost of the studies showed no difference in respiratory parameters. This indicates that ENDS substitution for smoking likely does not result in additional harm to respiratory health. Due to the low quality of the studies, confidence in the conclusions is rated as low. Robust studies with a longer duration and sufficient power are required to validate any potential benefits or possible harms of ENDS substitution. Registration PROSPERO #CRD42021239094, International Registered Report Identifier (IRRID): DERR1-10.2196/29084.
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What OpenQuestion holds
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.