Evidence map›Paper›PMID 41887411›Full record

ReviewAddiction (Abingdon, England)2026

Electronic cigarettes for smoking cessation: An overview of systematic reviews and evidence and gap map.

Angela Difeng Wu, Monserrat Conde, Ailsa R Butler, Ethan Knight, Nicola Lindson, Jonathan Livingstone-Banks, Peter Hajek, Hayden McRobbie, Rachna Begh, Annika Theodoulou and 4 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Electronic cigarettes for smoking cessation.The Cochrane database of systematic reviews · 2025
    Pooled it
  3. Article
  4. Review
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

14 authors.

Angela Difeng WuNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0001-9726-8975
Monserrat CondeNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-9669-9180
Ailsa R ButlerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-8577-6574
Ethan KnightNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Nicola LindsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0003-2539-9268
Jonathan Livingstone-BanksNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-3757-5591
Peter HajekWolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID https://orcid.org/0000-0001-9160-4296
Hayden McRobbieWolfson Institute of Population Health, Queen Mary University of London, London, UK.ORCID https://orcid.org/0000-0002-7777-1845
Rachna BeghNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Annika TheodoulouNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0002-8942-2167
Caitlin NotleyNorwich Medical School, University of East Anglia, Norwich, UK.ORCID https://orcid.org/0000-0003-0876-3304
Tari TurnerCochrane Australia, School of Public Health & Preventive Medicine, Melbourne, Australia.
Eliza ZhitnikDepartment of Health Promotion and Policy, University of Massachusetts, Amherst, MA, USA.
Jamie Hartmann-BoyceDepartment of Health Promotion and Policy, University of Massachusetts, Amherst, MA, USA.ORCID https://orcid.org/0000-0001-9898-3049

Funding

Cancer Research UK PRCPJT-Nov22/100012
6 · The paper itself

Abstract

BACKGROUND AND

aimsElectronic cigarettes (EC) are considered a smoking cessation tool in some countries, such as the United Kingdom, but uncertainty remains internationally over whether their benefits outweigh potential harms when used for this purpose. This overview (1) synthesised existing evidence from systematic reviews (SR) on the effectiveness and safety of ECs to explore and address these uncertainties and disagreements and (2) mapped primary intervention studies to identify priorities for further research.

methodsOverview of SRs published from 1 January 2015 and meeting the inclusion criteria of the Cochrane review of EC for smoking cessation. We searched seven databases to April 2024. We followed Cochrane screening and data extraction methods. We adapted Campbell Collaboration and 3ie methods for the Evidence and Gap Map (EGM). We assessed review quality using AMSTAR-2.

resultsWe included 14 reviews of intervention studies (7 high quality; 7 low quality), with search dates from 2014 to 2023, in adult populations including the general population, people at risk of lung cancer, with comorbid health conditions and pregnant people. Eighteen studies were included across multiple reviews, some of which included multiple meta-analyses. Across 21 meta-analytic comparisons of nicotine EC versus other interventions, all reported point estimates favouring nicotine EC for smoking cessation, with relative risks/odds ratios typically in the range 1.17-1.67 versus nicotine replacement therapy and 1.46-2.09 versus non-nicotine EC, with higher-quality reviews giving more consistent estimates. Of 13 reviews that meta-analysed serious adverse events (SAEs), two reported point estimates suggesting increased SAEs with nicotine EC; other estimates included the possibility of no difference. For adverse events, pooled estimates generally indicated little or no difference between groups. Our EGM mapped 90 primary, complete studies and identified absolute gaps in evidence comparing the effects of nicotine EC to cytisine, bupropion and nicotine pouches. Most studies used collected data from high-income countries.

conclusionMeta-analyses of electronic cigarettes (EC) for smoking cessation report point estimates favouring higher ≥6-month smoking cessation rates with nicotine EC compared with nicotine replacement therapy, non-nicotine EC/placebo, behavioural or no support and mixed support. Evidence on serious adverse events (SAEs) remains inconclusive. Evidence gaps were identified in SAE data and in studies from low- and middle-income countries.

Indexed as

Electronic Nicotine Delivery SystemsSmoking CessationEvidence GapsHumansNicotine Replacement TherapySystematic Reviews as Topicelectronic cigarettesevidence and gap mapevidence synthesisoverview of reviewsmokingsmoking cessationtobaccovapes

Identifiers

PMID41887411
PMCPMC13357930

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.