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Review
. 2023 Dec 14:21:168.
doi: 10.18332/tid/174660. eCollection 2023.

E-cigarette use and respiratory symptoms in adults: A systematic review and meta-analysis

Mohammed M Alqahtani  1   2   3 , Faraj K Alenezi  4   5 , Mohammed A Almeshari  6 , Abdullah M Alanazi  1   2 , Ziyad Ben Taleb  7 , Mohammad E Ebrahimi Kalan  8 , Mary P Martinasek  9 , Rheese J McNab  9 , Rachel Culbreth  10 , Mansour Alotaibi  11 , Hassan Aljohani  1   2 , Lynda T Goodfellow  12 , Taha T Ismaeil  1   2 , Saleh S Algarni  1   2 , Tareq F Alotaibi  1   2 , Mobarak K Alqahtani  1   2 , Hamoud Al-Ajel  13   14 , Khalid S Alwadeai  6 , Nafea S Almutairi  15 , Eric Ford  16
Affiliations
Review

E-cigarette use and respiratory symptoms in adults: A systematic review and meta-analysis

Mohammed M Alqahtani et al. Tob Induc Dis. .

Abstract

Introduction: Electronic cigarette (e-cigarette) use is gaining popularity among adults. Monitoring e-cigarette-induced respiratory symptoms is crucial for both clinical and regulatory purposes. We systematically reviewed the current literature to understand the prevalence of respiratory symptoms among exclusive e-cigarette users, dual users, and former smokers.

Methods: Databases searched included PubMed, CINAHL, Cochrane Library, Embase, and Scopus. We included all English-language, empirical quantitative articles that explored the prevalence of e-cigarette-related respiratory symptoms. Random-effects models were utilized in conducting the meta-analyses. The quality of identified studies was evaluated using the NIH Study Quality Assessment Tools. This study is registered with PROSPERO(#CRD42020165973).

Results: The literature search identified 1240 references. After removing duplicates and screening for eligibility, 168 studies were included in the final review. The majority of included studies reported a wide range of adverse respiratory symptoms. The respiratory symptoms were prevalent among the exclusive e-cigarette users, dual users, and those who switched from combustible cigarettes to e-cigarettes. Further, out of the RCT studies, 5 were rated as good quality, while 3 were rated as fair. Among the observational studies, 24 were rated as good quality, and 9 were rated as fair. The two experimental studies were both rated as fair quality.

Conclusions: Continued monitoring of respiratory symptoms among e-cigarette users is warranted. Due to the heterogeneity and inconsistencies among studies, which limit result interpretation and highlight the need for studies assessing causal inference, further research using robust study designs is essential. This will provide clinicians with comprehensive knowledge about the potential respiratory risks of e-cigarette use.

Keywords: e-cigarette; respiratory symptoms; systematic review.

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Conflict of interest statement

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.

Figures

Figure 1
Figure 1
Forest plot of respiratory symptom prevalence among exclusive, dual, and transitioning e-cigarette users
Figure 2
Figure 2
Forest plot of cough prevalence among exclusive, dual, and transitioning e-cigarette user
Figure 3
Figure 3
Forest plot of phlegm prevalence among exclusive, dual, and transitioning e-cigarette users
Figure 4
Figure 4
Forest plot of shortness of breath prevalence among dual, exclusive, and transitioning e-cigarette users
See this image and copyright information in PMC

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