Evidence map›Paper›PMID 40917139›Full record

ReviewTobacco induced diseases2025

Electronic cigarettes and cardiovascular diseases: An updated systematic review and network meta-analysis.

Amarit Tansawet, Thunyarat Anothaisintawee, Suparee W Boonmanunt, Prapaporn Pornsuriyasak, Kanokporn Sukhato, Natasha Chawala, Patcharanat Inpithuk, Chatuthanai Savigamin, Saharat Liampeng, John Attia and 2 more

Abstract readReview
In one paragraph

Review in Tobacco induced diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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

6 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Amarit TansawetDepartment of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Thunyarat AnothaisintaweeDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Suparee W BoonmanuntDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Prapaporn PornsuriyasakDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Kanokporn SukhatoDepartment of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Natasha ChawalaDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Patcharanat InpithukDepartment of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Chatuthanai SavigaminJohns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States.
Saharat LiampengDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
John AttiaCentre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, The University of Newcastle, Australia, Newcastle, Australia.
Gareth J McKayCentre for Public Health, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom.
Ammarin ThakkinstianDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe association between electronic cigarettes (e-cigarettes) and the risk of cardiovascular disease (CVD) remains inconclusive. This study aims to compare CVD risk from the use of e-cigarettes, cigarettes, combined cigarette and e-cigarette use, and non-use.

methodsThis study is a systematic review and network meta-analysis (NMA). MEDLINE and Scopus databases (through February 2024) were used to identify eligible studies. Observational studies that investigated the effect of e-cigarettes on the risk of composite CVD, myocardial infarction (MI), or stroke, compared to cigarette, dual use, or non-use, were included. NMA was applied to estimate relative effects (i.e. adjusted odds ratio, AOR) of e-cigarette, cigarette, and dual use, on composite CVD, MI, and stroke outcomes. Risk of bias was assessed using the Joanna Briggs Institute tool for surveys and the Newcastle-Ottawa scale for cohort studies.

resultsEleven adult population studies were eligible for review. E-cigarette, cigarette, and dual use were significantly associated with composite CVD outcomes. Pooled AORs (95% CI) were 1.31 (1.05-1.62) for e-cigarette, 1.57 (1.30-1.88) for cigarette, and 1.67 (1.37-2.03) for dual use. Additionally, former cigarette and former dual use significantly increased the risk of composite CVD outcomes, compared to non-use. The pooled AORs (95% CI) were 1.29 (1.05-1.59) for former cigarette, and 1.46 (1.03-2.08) for former dual use, while former e-cigarette use was not significantly associated with composite CVD endpoints. For MI and stroke outcomes, only cigarette and dual use were significantly associated with these events.

conclusionsCurrent e-cigarette, cigarette, and dual use were significantly associated with increased risk of composite CVD outcomes, while only cigarette and dual use significantly increased the risk of MI and stroke, compared to non-use. However, these findings were primarily based on cross-sectional data limiting the temporality of effect; additional prospective cohort studies are needed to confirm our findings.

Indexed as

cardiovascular diseaseelectronic cigarettemyocardial infarctionnetwork meta-analysisstroke

Identifiers

PMID40917139
PMCPMC12412302

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.