Evidence map›Paper›PMID 38411454›Full record

SynthesisNEJM evidence2024

Population-Based Disease Odds for E-Cigarettes and Dual Use versus Cigarettes.

Stanton A Glantz, Nhung Nguyen, Andre Luiz Oliveira da Silva

Abstract readMeta-Analysis
In one paragraph

Synthesis in NEJM evidence, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

101 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Pooled it
  6. Trial
  7. Trial
  8. Trial
  9. Article
  10. Article
  11. Article
  12. The triple-hit hypothesis: exploring pulmonary e-cigarette, PMEuropean respiratory review : an official journal of the European Respiratory Society · 2026
    Review
  13. Article
  14. Article
  15. Article
  16. Article
  17. Efforts to Secure Nicotine and Cannabis Product Placements in Popular Media by Ploom, Pax, and Juul: An Analysis of Tobacco Industry Documents.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026
    Article
  18. Review
  19. Review
  20. Toxicity and Appeal of Flavoured E-Cigarettes and Flavour Ban Outcomes: A Narrative Review.International journal of environmental research and public health · 2026
    Review

41 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Stanton A GlantzSan Francisco.
Nhung NguyenCenter for Tobacco Control Research and Education, University of California, San Francisco, San Francisco.
Andre Luiz Oliveira da SilvaCenter for Tobacco Control Research and Education, University of California, San Francisco, San Francisco.

Funding

Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
PROJECT 5: IMPACT OF CHANGING TOBACCO PRODUCT USE ON HEALTHCARE COSTS FOR GENERAL AND VULNERABLE POPULATIONSU54HL147127 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LING, PAMELA MAY · 2018 to 2022
$20.4M
NCATS NIH HHS UL1 TR001872NHLBI NIH HHS U54 HL147127
6 · The paper itself

Abstract

backgroundE-cigarettes are promoted as less harmful than cigarettes. There has not been a direct comparison of health effects of e-cigarettes or dual use (concurrently using e-cigarettes and cigarettes) with those of cigarettes in the general population.

methodsStudies in PubMed, EMBASE, Web of Science, and PsychINFO published through October 1, 2023, were pooled in a random-effects meta-analysis if five or more studies were identified with a disease outcome. We assessed risk of bias with Risk Of Bias In Non-randomized Studies of Exposure and certainty with Grading of Recommendations, Assessment, Development, and Evaluations. Outcomes with fewer studies were summarized but not pooled.

resultsWe identified 124 odds ratios (94 cross-sectional and 30 longitudinal) from 107 studies. Pooled odds ratios for current e-cigarette versus cigarette use were not different for cardiovascular disease (odds ratio, 0.81; 95% confidence interval, 0.58 to 1.14), stroke (0.73; 0.47 to 1.13), or metabolic dysfunction (0.99; 0.91 to 1.09) but were lower for asthma (0.84; 0.74 to 0.95), chronic obstructive pulmonary disease (0.53; 0.38 to 0.74), and oral disease (0.87; 0.76 to 1.00). Pooled odds ratios for dual use versus cigarettes were increased for all outcomes (range, 1.20 to 1.41). Pooled odds ratios for e-cigarettes and dual use compared with nonuse of either product were increased (e-cigarette range, 1.24 to 1.47; dual use, 1.49 to 3.29). All included studies were assessed as having a low risk of bias. Results were generally not sensitive to study characteristics. Limited studies of other outcomes suggest that e-cigarette use is associated with additional diseases.

conclusionsThere is a need to reassess the assumption that e-cigarette use provides substantial harm reduction across all cigarette-caused diseases, particularly accounting for dual use.

Indexed as

Electronic Nicotine Delivery SystemsTobacco ProductsSmokingTobacco Smoking

Identifiers

PMID38411454
PMCPMC11562742

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.