Electronic cigarettes for smoking cessation
- PMID: 38189560
- PMCID: PMC10772980
- DOI: 10.1002/14651858.CD010216.pub8
Electronic cigarettes for smoking cessation
Update in
-
Electronic cigarettes for smoking cessation.Cochrane Database Syst Rev. 2025 Jan 29;1(1):CD010216. doi: 10.1002/14651858.CD010216.pub9. Cochrane Database Syst Rev. 2025. PMID: 39878158 Free PMC article.
Abstract
Background: Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol by heating an e-liquid. People who smoke, healthcare providers and regulators want to know if ECs can help people quit smoking, and if they are safe to use for this purpose. This is a review update conducted as part of a living systematic review.
Objectives: To examine the safety, tolerability and effectiveness of using electronic cigarettes (ECs) to help people who smoke tobacco achieve long-term smoking abstinence, in comparison to non-nicotine EC, other smoking cessation treatments and no treatment.
Search methods: We searched the Cochrane Tobacco Addiction Group's Specialized Register to 1 February 2023, and Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO to 1 July 2023, and reference-checked and contacted study authors.
Selection criteria: We included trials in which people who smoke were randomized to an EC or control condition. We also included uncontrolled intervention studies in which all participants received an EC intervention as these studies have the potential to provide further information on harms and longer-term use. Studies had to report an eligible outcome.
Data collection and analysis: We followed standard Cochrane methods for screening and data extraction. Critical outcomes were abstinence from smoking after at least six months, adverse events (AEs), and serious adverse events (SAEs). We used a fixed-effect Mantel-Haenszel model to calculate risk ratios (RRs) with a 95% confidence interval (CI) for dichotomous outcomes. For continuous outcomes, we calculated mean differences. Where appropriate, we pooled data in pairwise and network meta-analyses (NMA).
Main results: We included 88 completed studies (10 new to this update), representing 27,235 participants, of which 47 were randomized controlled trials (RCTs). Of the included studies, we rated ten (all but one contributing to our main comparisons) at low risk of bias overall, 58 at high risk overall (including all non-randomized studies), and the remainder at unclear risk. There is high certainty that nicotine EC increases quit rates compared to nicotine replacement therapy (NRT) (RR 1.59, 95% CI 1.29 to 1.93; I2 = 0%; 7 studies, 2544 participants). In absolute terms, this might translate to an additional four quitters per 100 (95% CI 2 to 6 more). There is moderate-certainty evidence (limited by imprecision) that the rate of occurrence of AEs is similar between groups (RR 1.03, 95% CI 0.91 to 1.17; I2 = 0%; 5 studies, 2052 participants). SAEs were rare, and there is insufficient evidence to determine whether rates differ between groups due to very serious imprecision (RR 1.20, 95% CI 0.90 to 1.60; I2 = 32%; 6 studies, 2761 participants; low-certainty evidence). There is moderate-certainty evidence, limited by imprecision, that nicotine EC increases quit rates compared to non-nicotine EC (RR 1.46, 95% CI 1.09 to 1.96; I2 = 4%; 6 studies, 1613 participants). In absolute terms, this might lead to an additional three quitters per 100 (95% CI 1 to 7 more). There is moderate-certainty evidence of no difference in the rate of AEs between these groups (RR 1.01, 95% CI 0.91 to 1.11; I2 = 0%; 5 studies, 1840 participants). There is insufficient evidence to determine whether rates of SAEs differ between groups, due to very serious imprecision (RR 1.00, 95% CI 0.56 to 1.79; I2 = 0%; 9 studies, 1412 participants; low-certainty evidence). Due to issues with risk of bias, there is low-certainty evidence that, compared to behavioural support only/no support, quit rates may be higher for participants randomized to nicotine EC (RR 1.88, 95% CI 1.56 to 2.25; I2 = 0%; 9 studies, 5024 participants). In absolute terms, this represents an additional four quitters per 100 (95% CI 2 to 5 more). There was some evidence that (non-serious) AEs may be more common in people randomized to nicotine EC (RR 1.22, 95% CI 1.12 to 1.32; I2 = 41%, low-certainty evidence; 4 studies, 765 participants) and, again, insufficient evidence to determine whether rates of SAEs differed between groups (RR 0.89, 95% CI 0.59 to 1.34; I2 = 23%; 10 studies, 3263 participants; very low-certainty evidence). Results from the NMA were consistent with those from pairwise meta-analyses for all critical outcomes, and there was no indication of inconsistency within the networks. Data from non-randomized studies were consistent with RCT data. The most commonly reported AEs were throat/mouth irritation, headache, cough, and nausea, which tended to dissipate with continued EC use. Very few studies reported data on other outcomes or comparisons, hence, evidence for these is limited, with CIs often encompassing both clinically significant harm and benefit.
Authors' conclusions: There is high-certainty evidence that ECs with nicotine increase quit rates compared to NRT and moderate-certainty evidence that they increase quit rates compared to ECs without nicotine. Evidence comparing nicotine EC with usual care/no treatment also suggests benefit, but is less certain due to risk of bias inherent in the study design. Confidence intervals were for the most part wide for data on AEs, SAEs and other safety markers, with no difference in AEs between nicotine and non-nicotine ECs nor between nicotine ECs and NRT. Overall incidence of SAEs was low across all study arms. We did not detect evidence of serious harm from nicotine EC, but the longest follow-up was two years and the number of studies was small. The main limitation of the evidence base remains imprecision due to the small number of RCTs, often with low event rates. Further RCTs are underway. To ensure the review continues to provide up-to-date information to decision-makers, this review is a living systematic review. We run searches monthly, with the review updated when relevant new evidence becomes available. Please refer to the Cochrane Database of Systematic Reviews for the review's current status.
Copyright © 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Conflict of interest statement
RB holds a National Institiute for Health Research (NIHR) grant, but this did not directly fund this current work. RB is also supported by Cancer Research UK. She is principal investigator of an ongoing study listed in this review.
CB was principal investigator on the ASCEND e‐cigarette trial reported in the Cochrane Review and a co‐investigator on the ASCEND II trial and several other studies included in the review. CB reports research grants from the Health Research Council of NZ, the Heart Foundation of NZ and the NZ Ministry of Health (Monitoring the Illicit Tobacco Trade in NZ), the NZ Ministry of Foreign Affairs and Trade (estimating the numbers of tobacco and vaping retailers in NZ) and Auckland Council (Evaluation of the Smokefree Auckland Project). CB reports research grants from: Wellcome Trust UK, REFLECT Cool roofing trial; Health Research Council of NZ, Cess@tion trial, FASD studies; The University of Auckland Transdisciplinary Ideation Fund for The Collective website; Putahi Manawa Centre for Research Excellence in Heart Health Integrated Research Module grant; US NIH (via Wake Forest University): CENIC study; Education NZ Smoking cessation in China; Marsden Fund (NZ): Respiratory effects of vaping. He has recently led a project funded by Pfizer (NZ) on chronic disease management. CB is President of the Society for Research on Nicotine & Tobacco; Member of the Expert Working Group on Tobacco, Health Coalition Aotearoa; Member of the Scientific Advisory Committee of the Cancer Society of NZ; Member of the Scientific Advisory Committee of the RESPIRE research programme, University of Edinburgh; Member of the CREATE Tobacco Endgame Centre of Research Excellence, Australia. CB has carried out independent contractor consultancy for Johnson and Johnson in 2020 on NRT and to Kervue Inc. regarding setting up an ASEAN regional smoking cessation networking board.
ARB's work on this review has been supported by Cancer Research UK Project Award funding. This is not deemed a conflict of interest.
PH was principal investigator on three of the trials included in this review two funded by NIHR and one by CRUK and co‐investigator on other relevant studies.
JHB has received support for this work from the Cochrane Review Support Programme and the University of Oxford's Returning Carer's Fund. JHB been an applicant and pricipal investigator on project grants to carry out research in the area of tobacco control from National Institute for Health Research and Cancer Research UK. None of these are deemed conflicts of interest.
NL has received payment for lectures on systematic review methodology (Oxford University Hospitals NHS Foundation Trust), and has been an applicant and pricipal investigator on project funding to carry out research in the area of tobacco control from the NIHR Evidence Synthesis programme, Cancer Research UK (charity), Clarion Futures (charity), Oxfordshire County Council and the NIHR Oxfordshire and Thames Valley ARC, and Greater Manchester NHS Integrated Care. None of this is deemed a conflict of interest.
JLB was employed by the University of Oxford to work as a Managing Editor and Information Specialist for the Cochrane Tobacco Addiction Review Group before becoming an author on this review. During this time, he was involved in the editorial processing of the review. He is now an Editor for Cochrane. Since becoming an author, he has not been involved in the editorial process for this review. Core infrastructure funding for the Cochrane Tobacco Addiction Group was provided by the NIHR to the University of Oxford.
HM is an employee of Te Whatu Ora‐Health New Zealand. HM holds fellowships with New Zealand College of Public Health Medicine (NZCPHM represents public health medicine specialists); and the Society of Lifestyle Medicine. HM is a Professor in Public Health Interventions, University of New South Wales, National Drug and Alcohol Research Centre and provide mentorship and advice for the Tobacco Research Group. He is currently a named investigator on three smoking cessation trials that are all funded by the Australian National Health and Medical Research Council (NHMRC). HM is a named investigator of a smoking cessation trial at Queen Mary University of London, funded by the National Institute of Health Research. HM is a named investigator of a study that examines an approach to prevent e‐cigarette use among adolescents at University of Sydney, funded by the Australian National Health and Medical Research Council (NHMRC). HM is a co‐investigator on a number of studies included in this review. HM is a board Member, Rotorua Community Youth Centre Trust.
CN has received an honorarium from Vox Media for filming a 'nicotine explainer' on the role of nicotine in addiction. This is not deemed a conflict of interest. CN is a member of the advisory council for 'Action on Smoking and Health (ASH)'. CN is co‐PI on an ongoing trial (protocol) Cessation of Smoking Trial in the Emergency Department (CoSTED) ‐ National Institute for Health Research ‐ Health Technology Assessment. NIHR129438.
TM is funded by the National Institute for Health Research (NIHR) Complex Reviews Support Unit (CRSU) and supported by the NIHR Applied Research Collaboration East Midlands (ARC EM) and Leicester Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
NAR has received royalties from UpToDate, Inc. for chapters on electronic cigarettes and occasional fees from academic hospitals or professional medical societies for lectures on smoking cessation that include discussion of electronic cigarettes. NAR was a member of the committee that produced the 2018 National Academies of Science, Engineering, and Medicine's Consensus Study Report on the Public Health Benefits of E‐cigarettes. She was unpaid for this work. NAR is employed by Massachusetts General Hospital (MGH). Outside the topic of e‐cigarettes, NAR is a consultant for Achieve LifeSciences, which is developing an investigational smoking cessation medication for FDA approval (cytisine) and her institution (MGH) receives a grant from the company as a site for a clinical trial testing the safety and efficacy of cytisine. NAR holds grants from NIH for research work.
AT's work on this review has been supported by the Nuffield Department of Primary Care Health Sciences at the University of Oxford. This is not deemed a conflict of interest
TT has no known conflicts of interest.
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Update of
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Electronic cigarettes for smoking cessation.Cochrane Database Syst Rev. 2022 Nov 17;11(11):CD010216. doi: 10.1002/14651858.CD010216.pub7. Cochrane Database Syst Rev. 2022. Update in: Cochrane Database Syst Rev. 2024 Jan 8;1:CD010216. doi: 10.1002/14651858.CD010216.pub8. PMID: 36384212 Free PMC article. Updated.
References
References to studies included in this review
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Hatsukami 2020 {published and unpublished data}
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Hickling 2019 {published data only}
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- Hickling LM, Perez-Iglesias R, McNeill A, Dawkins L, Moxham J, Ruffell T, et al. A pre-post pilot study of electronic cigarettes to reduce smoking in people with severe mental illness. Psychological Medicine 2019;49(6):1033-40. - PubMed
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- NCT02212041. Acceptability, patterns of use and safety of electronic cigarette in people with mental illness: a pilot study. clinicaltrials.gov/show/NCT02212041 (accessed 17 February 2016).
Holliday 2019 {published data only}
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- Holliday et al. E-cigarettes for smoking cessation in patients with periodontitis: pilot RCT. In: IADR International Association for Dental Research. 2019.
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- ISRCTN17731903. Feasibility study of e-cigarettes in periodontitis. www.isrctn.com/ISRCTN17731903 (first received 27 September 2016).
Humair 2014 {published data only}
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Ikonomidis 2018 {published data only}
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Ikonomidis 2020a {published data only}
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Kerr 2020 {published and unpublished data}
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- Kerr D. Chapter 5: A randomised controlled trial investigating the cardiovascular effects of e-cigaretttes in comparison to nicotine replacement patches [personal communication]. Studies into the Cardiovascular and Respiratory Effects of Electronic Cigarettes (PhD thesis), emailed to: A Butler 27 September 2020.
-
- NCT03358953. The cardiovascular impacts of electronic cigarettes in comparison to the use of nicotine replacement patches (VAPOUR). clinicaltrials.gov/ct2/show/NCT03358953 (first received December 2 2017 ).
Kimber 2021 {published data only}
Klonizakis 2022 {published data only}
-
- Jones G, McIntosh E, Brose LS, Klonizakis M. Participant experiences of a quit smoking attempt through either Nicotine Replacement Therapy (NRT) methods or the use of an e-cigarette. Journal of Addiction Medicine 2022;16(3):272-7. - PubMed
-
- NCT03061253. E-cigarettes and cardiovascular function (ISME-NRT). clinicaltrials.gov/ct2/show/NCT03061253 (first received 23 February 2017).
Kumral 2016 {published data only}
-
- Kumral TL, Saltürk Z, Yildirim G, Uyar Y, Berkiten G, Atar Y, et al. How does electronic cigarette smoking affect sinonasal symptoms and nasal mucociliary clearance? B-ENT 2016;12(1):17-21. - PubMed
Lee 2018 {published data only}
-
- Lee SM, Tenney R, Wallace A, Arjojmandi M. The end perioperative smoking pilot study: a randomized trial comparing e-cigarettes versus nicotine patch. Canadian Journal of Anesthesia 2017;64(1 Supplement 1):S48-S49.
-
- Lee SM, Tenney R, Wallace A, Arjomandi M. Exploring the teachable moment: facilitators and barriers to perioperative smoking cessation, a qualitative study,. Canadian Journal of Anesthesia 2017; Conference: 2017 Annual Meeting of the Canadian Anesthesiologists' Society, Canada. 61;1 Supplement:S46-S47.
-
- NCT02482233. A pilot randomized controlled clinical trial - "Electronic nicotine delivery device (e-cigarette) for perioperative smoking cessation in veterans". clinicaltrials.gov/show/NCT02482233 (accessed 17 February 2016).
Lee 2019 {published data only}
-
- KCT0001277. Effect of an electronic cigarette for smoking reduction and cessation in Korean male smokers: a randomized, controlled study. KCT0001277 2014 (accessed 15 August 2016). - PubMed
-
- Lee SH, Ahn SH, Cheong YS. Effect of electronic cigarettes on smoking reduction and cessation in Korean male smokers: a randomized controlled study. Journal of the American Board of Family Medicine 2019;32(4):567-74. - PubMed
Lucchiari 2022 {published data only}
-
- Lucchiari C, Masiero M, Mazzocco K, Veronesi G, Maisonneauve P, Jemos C, et al. Benefits of e-cigarettes in smoking reduction and in pulmonary health among chronic smokers undergoing a lung cancer screening program at 6 months. Addictive Behaviours 2020;103:106222. - PubMed
-
- Lucchiari C, Masiero M, Mazzocco K, Veronesi G, Maisonneuve P, Jemos C et al. Nicotine-Free E-Cigarettes Might Promote Tobacco Smoking Reduction Better Than Nicotine Delivery Devices: Results of a Double-Blind Randomized Controlled Trial at 1 Year. Current Oncology (Toronto, Ont.) 2022;29(11):8579-90. - PMC - PubMed
-
- Lucchiari C, Masiero M, Mazzocco K, Veronesi G, Maisonneuve P, Jemos C, et al. Nicotine-free e-cigarettes might promote tobacco smoking reduction better than nicotine delivery devices: results of a double-blind randomized controlled trial at 1 year. Current Oncology 2022;29(11):8579-90. [DOI: 10.3390/curroncol29110676] - DOI - PMC - PubMed
-
- Masiero M, Lucchiari C, Mazzocco K, Veronesi G, Maisonneuve P Jemos C, et al. Corrigendum: E-cigarettes may support smokers with high smoking-related risk awareness to stop smoking in the short run: preliminary results by randomized controlled trial. Nicotine and Tobacco Research 2020;22(4):594-5. [NCT02422914] - PubMed
Martinez 2021 {published data only}
-
- Byrne M, Simmons V, Martinez U, Sutton S, Brandon K, Brandon T. Cost effectiveness of a smoking cessation intervention for dual users of combustible and electronic cigarettes. In: Society for Research on Nicotine and Tobacco, Annual Meeting, Baltimore USA. March 2022.
-
- Gore LR, Sutton SK, Martinez U, Brandon KO, Simmons VN, Brandon TH. Mediators of initial abstinence for an extended self help smoking cessation intervention with dual users of combustible and electronic cigarettes. In: Society for Research on Nicotine and Tobacco, Annual Meeting, Baltimore USA. Vol. PS3-7. March 2022.
-
- Meltzer LR, Simmons VN, Sutton SK, Drobes DJ, Quinn GP, Meade CD, et al. A randomized controlled trial of a smoking cessation self-help intervention for dual users of tobacco cigarettes and e-cigarettes: intervention development and research design. Contemporary Clinical Trials 2017;60:56-62. - PMC - PubMed
Martner 2019 {published data only (unpublished sought but not used)}
McRobbie 2015 {published data only}
-
- McRobbie H, Goniewicz M, Phillips A, Myers-Smith K, West O, Hajek P. Effects of the use of electronic cigarettes with and without concurrent smoking on acrolein delivery POS4-33. In: Society for Research on Nicotine and Tobacco, 20th Annual Meeting, Seattle, Washington. 2014:13. [www.srnt.org/conferences/2014/pdf/SRNT_2014_Rapids_C.pdf]
-
- McRobbie H, Phillips A, Goniewicz ML, Smith KM, Knight-West O, Przulj D, et al. Effects of switching to electronic cigarettes with and without concurrent smoking on exposure to nicotine, carbon monoxide, and acrolein. Cancer Prevention Research (Philadelphia, Pa.) 2015;8(9):873-8. - PubMed
-
- NCT01714778. Toxins and Delivery in E-cigarette USers (TADEUS). clinicaltrials.gov/ct2/show/NCT01714778 (first received 26 October 2012).
Meier 2017 {published data only}
Morphett 2022a {unpublished data only}
-
- ACTRN12612001210864. Can using nicotine as a long-term substitute enhance smoking cessation over using it only as a cessation aid? [An open-label randomised pragmatic policy trial examining effectiveness of short-term use of Nicotine Replacement Therapy (NRT) vs short- or long-term use of NRT vs short- or long-term use of NRT or electronic nicotine delivery systems for smoking cessation in cigarette smokers.]. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=1261... (first received November 15 2012).
-
- Morphett K, Fraser D, Borland R, Hall W, Walker N, Bullen C, et al. A pragmatic randomized comparative trial of e-cigarettes and other nicotine products for quitting or long-term substitution in smokers. Nicotine & Tobacco Research 2022;24(7):1079-88. [DOI: doi: 10.1093/ntr/ntab266] - PubMed
Morphett 2022b {published and unpublished data}
-
- ACTRN12618000408280. Cessation And Relapse Prevention (CARP) trial: nicotine vaporisers compared to standard nicotine replacement therapy for smoking cessation among people with co-morbidities. www.anzctr.org.au/ACTRN12618000408280.aspx (first received 21 March 2018).
-
- Morphett K, Boyd M, Puljevic C, Gilks C, Bonevski B, Borland R, et al. Do nicotine vaping products increase quitting among priority population groups over standard smoking cessation therapy? A pragmatic randomised partial cross-over trial. In: Society for Research on Nicotine and Tobacco (SRNT), Annual Meeting 2022. Vol. SYM17-4. 2022.
Morris 2022 {published data only}
-
- Morris P, McDermott S, Chapman F, Verron T, Cahours X, Stevenson M, et al. Reductions in biomarkers of exposure to selected harmful and potentially harmful constituents following exclusive and partial switching from combustible cigarettes to myblu TM electronic nicotine delivery systems (ENDS). Internal & Emergency Medicine 2022;17(2):397-410. [DOI: 10.1007/s11739-021-02813-w] - DOI - PMC - PubMed
-
- NCT04429932. A study to evaluate nicotine uptake and biomarkers in adult smokers using mybluTM electronic cigarettes. clinicaltrials.gov/ct2/show/NCT04429932 (first received June 7 2021).
-
- NCT04430634. A study to evaluate nicotine uptake and biomarkers in smokers using mybluTM electronic cigarettes [An open-label, randomized, crossover study to assess nicotine uptake, tobacco-related biomarkers of exposure, biomarkers of potential harm, and puff topography with use of mybluTM electronic cigarettes in adult smokers]. clinicaltrials.gov/ct2/show/NCT04430634 (first received June 7 2021).
Myers‐Smith 2022 {published data only}
-
- ISRCTN13288677. Can electronic cigarettes and nicotine replacement treatment help reduce smoking in smokers who struggle to quit? www.isrctn.com/ISRCTN13288677 (first received 17 March 2017).
-
- Myers Smith K, Phillips-Waller A, Pesola F, McRobbie H, Przulj D, Orzol M, et al. E-cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult: randomised controlled trial. Addiction 2022;117(1):224-33. [DOI: ] - PubMed
NCT02648178 {published data only}
-
- NCT02648178. Evaluation of appeal and impact of e-cigarettes among chronic smokers with smoking-related cancers. clinicaltrials.gov/show/NCT02648178 (accessed 17 February 2016).
NCT02918630 {published data only}
-
- NCT02918630. E-cigarettes to promote smoking reduction among individuals with schizophrenia. clinicaltrials.gov/ct2/show/NCT02918630 (first received 5 July 2018).
NCT03492463 {published data only}
-
- NCT03492463. The role of nicotine dose and route of delivery in affecting adoption of e-cigarettes and reducing exposure to toxic combustion products (ENDS-Switch). clinicaltrials.gov/ct2/show/study/NCT03492463 (first received April 10 2018).
NCT04084210 {published data only}
-
- NCT04084210. Impact of alternative nicotine-delivery products on combustible cigarette use [Understanding the real-world impact of the use of three alternate nicotine-delivery products on combustible cigarette use]. clinicaltrials.gov/ct2/show/NCT04084210 (first received September 10, 2019).
-
- Piper M, Schlam T, Donny E, Jorenby D. The real-world impact of three alternative nicotine delivery products on combustible cigarette use. In: Society for Research on Nicotine and Tobacco (SRNT) 29th Annual Meeting 1-4 March 2023. Vol. SYM17-2. 2023:p 22.
Nides 2014 {published data only}
-
- NCT01898169. Evaluation of short-term safety and use patterns of an electronic nicotine delivery system. clinicaltrials.gov/ct2/show/NCT01898169 (first received 12 July 2013).
-
- Nides MA, Leischow SJ, Bhatter M, Simmons M. Nicotine blood levels and short-term smoking reduction with an electronic nicotine delivery system. American Journal of Health Behavior 2014;38(2):265-74. - PubMed
Okuyemi 2022 {published data only}
-
- NCT03084315. Changes in biomarkers associated with use of electronic cigarettes [Changes in biomarkers associated with use of electronic cigarettes among African American menthol and non-menthol smokers]. clinicaltrials.gov/ct2/show/NCT03084315 (first received March 20 2017).
-
- Okuyemi KS, Ojo-Fati O, Aremu TO, Friedrichsen CS, Grude L, Oyenuga M, et al. A randomized trial of nicotine vs. no-nicotine e-cigarettes among African American smokers: changes in smoking and tobacco biomarkers. Nicotine & Tobacco Research 2022;24(4):555-63. [DOI: ] - PubMed
Oncken 2015 {published data only}
-
- NCT01775787. Effects of Electronic Cigarettes on Nicotine Concentrations (ECIG). clinicaltrials.gov/ct2/show/NCT01775787 (first received 25 January 2013).
-
- Oncken CA, Litt MD, McLaughlin LD, Burki NA. Nicotine concentrations with electronic cigarette use: effects of sex and flavor. Nicotine & Tobacco Research 2015;17(4):473-8. - PubMed
-
- Swedeh MA, Oncken C, Burki NK. Acute effects of electronic cigarettes on airway function in human subjects. In: American Thoracic Society International Conference Abstracts. Vol. 189. 2014:A4089.
Ozga‐Hess 2019 {published data only}
Pacifici 2015 {published data only}
Polosa 2011 {published data only}
-
- NCT01195597. Smoking cessation and reduction with an electronic nicotine delivery device (ENDD). clinicaltrials.gov/ct2/show/NCT01195597 (first received 6 September 2010).
-
- Polosa R, Morjaria JB, Caponnetto P, Campagna D, Russo C, Alamo A, et al. Effectiveness and tolerability of electronic cigarette in real-life: a 24-month prospective observational study. Internal and Emergency Medicine 2014;9(5):537-46. - PubMed
Polosa 2014b {published data only}
-
- NCT02124200. High cessation rates in smokers using personal vaporizers (VAPECIG). clinicaltrials.gov/ct2/show/NCT02124200 (first received 28 April 2014).
Polosa 2015 {published data only}
Pratt 2016 {published data only}
-
- Pratt SI, Sargent J, Daniels L, Santos MM, Brunette M. Appeal of electronic cigarettes in smokers with serious mental illness. Addictive Behaviors 2016;59:30-4. - PubMed
Pratt 2022 {published and unpublished data}
-
- NCT03050853. The appeal and impact of e-cigarettes in smokers with SMI. clinicaltrials.gov/ct2/show/NCT03050853 (first received February 13 2017).
-
- Pratt S, Ferron J, Sargent J, Brunette M. Assessing the effect of e-cigarettes versus usual smoking on NNAL among chronic smokers with serious mental illness. In: Society for Research on Nicotine and Tobacco (SRNT) 29th Annual Meeting 1-4 March 2023 . Vol. PPS22-5. 2023:p73.
Price 2022 {published data only}
Pulvers 2018 {published data only}
Pulvers 2020 {published and unpublished data}
-
- Arnold M, Nollen N, Mayo M, Ahluwalia J, Leavens E, Zhang G et al. Dual use of cigarettes and e-cigarettes in African American and LatinX smokers: Secondary analyses from a randomised controlled e-cigarettes switching trial. In: Society for Research on Nicotine and Tobacco (SRNT) 2021 Annual Meeting. February 24-27 2021 virtual:POD4-2 p31. - PMC - PubMed
-
- Arnold MJ, Nollen NL, Mayo MS, Ahluwalia JS, Leavens EL, Zhang G, Rice M, et al. Harm reduction associated with dual use of cigarettes and e-cigarettes in Black and Latino smokers: secondary analyses from a randomized controlled e-cigarette switching trial. Nicotine & Tobacco Research 2021;23(11 2021 Oct 7;23(11):192-1876. [DOI: 10.1093/ntr/ntab069] - DOI - PMC - PubMed
-
- Leavens ELS, Nollen N, Ahluwalia J, Mayo M, Rice M, Brett E, et al. Changes in dependence, withdrawal, and craving among adult smokers who switch to nicotine salt pod-based e-cigarettes. In: Society for Research on Nicotine and Tobacco (SRNT) 2021 Annual Meeting. February 24-27 2021 virtual:POD53-1 p96, C-6 p116. - PMC - PubMed
Russell 2021 {published and unpublished data}
-
- Russell C, McKeganey N, Katsampouris E, Satchwell A, Haseen F. A randomised community-based trial of a closed-system pod e-vapour product and nicotine replacement therapy for cigarette abstinence and reduction. Society for Research on Nicotine and Tobacco (SRNT) 2021 Annual Meeting February 24-27 2021 virtual:PH-353 p230.
Scheibein 2020 {published and unpublished data}
-
- Scheibein F, McGirr K, Morrison A, Roche, Wells JS. An exploratory non-randomized study of a 3-month electronic nicotine delivery system (ENDS) intervention with people accessing a homeless supported temporary accommodation service (STA) in Ireland. Harm Reduction Journal 2020;17(1):73. - PMC - PubMed
Skelton 2022 {published data only}
-
- ACTRN12617000905369. Smoking reduction interventions for smoking cessation. ncbi.nlm.nih.gov/pmc/articles/PMC6953262/ (first received 9 June 2017). [DOI: 10.1002/14651858.CD013183.pub2] - DOI
-
- Lum A, Skelton E, Robinson M, Guillaumier A, Wynne O, Gartner C, et al. Barriers and facilitators to using vaporised nicotine products as smoking cessation aids among people receiving treatment for substance use disorder. Addictive Behaviors 2021;124:107097. [DOI: 10.1016/j.addbeh.2021.107097] - DOI - PubMed
-
- Skelton E, Lum A, Robinson M, Dunlop A, Guillaumier A, Baker A, et al. A pilot randomised controlled trial of abrupt versus gradual smoking cessation in combination with vaporised nicotine products for people receiving alcohol and other drug treatment. Addictive Behaviors 2022;131:107328. [DOI: doi: 10.1016/j.addbeh.2022.107328] - PubMed
Smith 2020 {published and unpublished data}
Stein 2016 {published data only}
Strasser 2016 {published data only}
Tattan‐Birch 2023 {published data only}
-
- ISRCTN16931827. A trial to assess the benefit of offering an e-cigarette starter kit to smokers attempting to stop smoking with varenicline. isrctn.com/ISRCTN16931827 (first received 23 August 2018).
-
- Tattan-Birch H, Kock L, Brown J, Beard E, Bauld L, West R, et al. E-cigarettes to augment stop smoking in-person support and treatment with varenicline (E-ASSIST): a pragmatic randomised controlled trial. Nicotine & Tobacco Research 2023;25(3):395-403. [DOI: 10.1093/ntr/ntac149] - DOI - PMC - PubMed
Tseng 2016 {published data only}
-
- Guttentag A, Tuo-Yen T, Shelley D, Thomas K. Analyzing trajectories of acute cigarette reduction post-introduction of an e-cigarette using ecological momentary assessment data. International Journal of Environmental Research and Public Health 2022;19(12):7452. [DOI: 10.3390/ijerph19127452] - DOI - PMC - PubMed
-
- Guttentag A. Do e-cigarettes "Work" for smokers as a step on the way to cessation? An analysis of the temporal and spatial correlates of switching in a harm reduction trial among adult smokers. Dissertation Abstracts International: Section B: The Sciences and Engineering 2021;82:8-B.
-
- NCT02628964. Assessing the use of electronic cigarettes (e-cigarettes) as a harm reduction strategy. clinicaltrials.gov/show/NCT02628964 (accessed 17 February 2016).
Valentine 2018 {published data only}
Van Staden 2013 {published data only}
-
- Van Staden SR, Groenewald M, Engelbrecht R, Becker PJ, Hazelhurst LT. Carboxyhaemoglobin levels, health and lifestyle perceptions in smokers converting from tobacco cigarettes to electronic cigarettes. South African Medical Journal 2013;103(11):865-8. - PubMed
Vickerman 2022 {published data only}
-
- NCT03575468. Enhanced e-cigarette coaching intervention for dual users of cigarettes and e-cigarettes. clinicaltrials.gov/ct2/show/NCT03575468 (first received 2 July 2018).
-
- Vickerman KA, Carpenter KM, Watt K, Miles L, Hsu J, Brandon T, et al. A behavioral smoking cessation intervention for Quitline callers who also use e-cigarettes. In: Society for Research on Nicotine and Tobacco (SRNT) 2021 Annual Meeting; February 24-27 2021 (virtual). 2021:POD14-1 p50.
Wadia 2016 {published data only}
-
- Wadia R, Booth V, Yap HF, Moyes DL. A pilot study of the gingival response when smokers switch from smoking to vaping. British Dental Journal 2016;221(11):722-6. - PubMed
Wagener 2023 {published data only}
-
- Wagener T, Beebe L, Businelle M, Carpenter M, Hinton A, Hart J, et al. E-cigarette versus combination nicotine replacement therapy delivered through state quitlines on smoking abstinence following a recent failed quit attempt: a randomized trial. In: Society for Research on Nicotine and Tobacco (SRNT) 29th Annual Meeting; 2023 Mar 1-4; San Antonio (TX), USA. SYM5-2. 2023.
Walele 2018 {published data only}
-
- Cravo AS, Bush J, Sharma G, Savioz R, Martin C, Craige S, et al. A randomised, parallel group study to evaluate the safety profile of an electronic vapour product over 12 weeks. Regulatory Toxicology and Pharmacology 2016;81:S1-S14. - PubMed
-
- NCT02029196. A randomised, parallel group, multi-centre study to evaluate the safety profile of the ITG EVP G1 product. clinicaltrials.gov/show/NCT02029196 (accessed 16 July 2014).
-
- NCT02143310. A multi-centre study to evaluate the safety of use of electronic vapour products for two years. clinicaltrials.gov/show/NCT02143310 (accessed 16 July 2014).
-
- Walele T, Bush J, Koch A, Savioz R, Martin C, O'Connell G. Evaluation of the safety profile of an electronic vapour product used for two years by smokers in a real-life setting. Regulatory Toxicology and Pharmacology 2018;92:226-38. - PubMed
Walker 2020 {published data only}
-
- NCT02521662. A randomised-controlled clinical trial to evaluate the effectiveness and safety of combining nicotine patches with e-cigarettes (with and without nicotine) plus behavioural support, on smoking abstinence. clinicaltrials.gov/show/NCT02521662 (accessed 17 February 2016).
-
- Walker N, Parag V, Verbiest M, Laking G, Laugesen M, Bullen C. Nicotine patches used in combination with e-cigarettes (with and without nicotine) for smoking cessation: a pragmatic, randomised trial. Lancet. Respiratory Medicine 2020;8(1):54-64. - PubMed
White 2021 {published and unpublished data}
-
- NCT03185546. Project 2 cigarette and e-cigarette nicotine content and e-liquid flavors. clinicaltrials.gov/ct2/show/NCT03185546 (first received May 14 2021).
-
- White CM, Denlinger-Apte RL, Tessier KM, Koopmeiners JS, Hatsukami DK, Strasser AA. Cigarette nicotine reduction in the presence of an alternative: investigating how cigarette nicotine content and e-liquid content affect smoking. In: Society for Research on Nicotine and Tobacco (SRNT) 2021 Annual Meeting February 24-27 2021 (virtual). 2021:SYM2C p2-3.
-
- White CM, Tessier KM, Koopmeiners JS, Denlinger-Apte RL, Cobb CO, Lane T, et al. Preliminary evidence on cigarette nicotine reduction with concurrent access to an e-cigarette: manipulating cigarette nicotine content, e-liquid nicotine content, and e-liquid flavor availability. Preventive Medicine 2022;Dec; 165(Pt B):107213:Epub. [DOI: ] - PMC - PubMed
References to studies excluded from this review
Adkison 2013 {published data only}
Al‐Delaimy 2015 {published data only}
Bianco 2019 {published data only}
-
- Bianco CL, Pratt SI, Ferron JC, Brunette MF. Electronic cigarette use during a randomized trial of interventions for smoking cessation among Medicaid beneficiaries with mental illness. Journal of Dual Diagnosis 2019;15(3):184-91. - PubMed
Caponnetto 2019 {published data only}
Chaumont 2019 {published data only}
-
- Chaumont M, El Channan M, Bernard A, Lesage A, Deprez G, Van Muylem A, et al. Short-term high wattage e-cigarette cessation improves cardiorespiratory outcomes in regular users: a randomized crossover trial. Journal of Hypertension 2019;Conference: 29th European Meeting on Hypertension and Cardiovascular Protection, ESH 2019. Italy. 37(Supplement 1):e8-9.
ChiCTR2100044062 {published data only}
-
- ChiCTR2100044062. Study on the kinetics of nicotine metabolism of cigarettes/e-cigarettes in Chinese healthy subjects and the effect of complete/partial replacement of cigarettes with e-cigarettes on human biomarkers, tolerance and satisfaction survey of e-cigaret [传统卷烟/电子烟在中国健康受试者中尼古丁代谢动力学研究及用电子烟完全/部分替代香烟后对人体生物标志物的影响、对电子烟的耐受性及满意度调查]. Chinese Clinical Trial Registry 2021.
Collins 2019 {published data only}
-
- Collins SE, Nelson LA, Stanton J, Mayberry N, Ubay T, Taylor EM, et al. Harm reduction treatment for smoking (HaRT-S): findings from a single-arm pilot study with smokers experiencing chronic homelessness. Substance Abuse 2019;40(2):229-39. - PubMed
Cox 2019a {published data only}
Douptcheva 2013 {published data only}
-
- Douptcheva N, Gmel G, Studer J, Deline S, Etter JF. Use of electronic cigarettes among young Swiss men. Journal of Epidemiology & Community Health 2013;67(12):1075-6. - PubMed
Dyer 2023 {published data only}
Farsalinos 2013a {published data only}
Grana 2014b {published data only}
ISRCTN54776958 {published data only}
James 2016 {published data only}
-
- James SA, Meier EM, Wagener TL, Smith KM, Neas BR, Beebe LA. E-Cigarettes for immediate smoking substitution in women diagnosed with cervical dysplasia and associated disorders. International Journal of Environmental Health Research 2016;13(3):E288. [DOI: 10.3390/ijerph13030288] - DOI - PMC - PubMed
-
- NCT01989923. Smoking Cessation in Women With Gynecological Conditions. https://clinicaltrials.gov/ct2/show/NCT01989923 (Accessed 9 September 2022).
Kasza 2013 {published data only}
Kotlyar 2022 {published data only}
Manzoli 2015 {published data only}
-
- NCT01785537. The efficacy and safety of electronic cigarettes: a 5-year follow-up study. clinicaltrials.gov/ct2/show/NCT01785537 (first received 7 February 2013).
Miura 2015 {published data only}
-
- Miura N, Yuki D, Minami N, Kakehi A, Futama Y. A study to investigate changes in the levels of biomarkers of exposure to selected cigarette smoke constituents in Japanese adult male smokers who switched to a non-combustion inhaler type of tobacco product. Regulatory Toxicology and Pharmacology 2015;71(3):498-506. - PubMed
NCT03575468 {published data only}
-
- NCT03575468. Enhanced E-cigarette Coaching Intervention for Dual Users of Cigarettes and E-cigarettes. https://clinicaltrials.gov/ct2/show/NCT03575468 (first received 2 July 2018).
NCT05658471 {published data only}
-
- NCT05658471. Pharmacokinetics and Pharmacodynamics of Nicotine With Use of Standardized Research Electronic Cigarette (SREC). Clinicaltrials.gov 2022;(first received 24 August 2023). [https://classic.clinicaltrials.gov/ct2/show/NCT05658471]
Nolan 2016 {published data only}
Palamidas 2014 {published data only}
-
- Palamidas A, Gennimata SA, Kaltsakas G, Tsikrika S, Vakali S, Gratziou C, et al. Acute effect of an e-cigarette with and without nicotine on lung function. Tobacco Induced Diseases 2014;12(Suppl 1):A34.
Pearson 2012 {published data only}
Song 2020 {published data only}
-
- NCT02596685. Effects of Electronic Cigarette Use on the Lungs. https://www.clinicaltrials.gov/ct2/show/NCT02596685 (Accessed 8 September 2022).
St.Helen 2020 {published data only}
Tucker 2018 {published data only}
-
- Tucker MR, Laugesen M, Bullen C, Grace RC. Predicting short-term uptake of electronic cigarettes: effects of nicotine, subjective effects, and simulated demand. Nicotine & Tobacco Research 2018;20(10):1265-71. - PubMed
Wagener 2014 {published data only}
-
- Wagener TL, Meier E, Hale JJ, Oliver ER, Warner ML, Driskill LM, et al. Pilot investigation of changes in readiness and confidence to quit smoking after e-cigarette experimentation and 1 week of use. Nicotine & Tobacco Research 2014;16(1):108-14. - PubMed
Walele 2016a {published data only}
-
- Walele T, Sharma G, Savioz R, Martin C, Williams J. A randomised, crossover study on an electronic vapour product, a nicotine inhalator and a conventional cigarette. Part A: Pharmacokinetics. Regulatory Toxicity 2016;74:187-92. - PubMed
Walele 2016b {published data only}
-
- Walele T, Sharma G, Savioz R, Martin C, Williams J. A randomised, crossover study on an electronic vapour product, a nicotine inhalator and a conventional cigarette. Part B: Safety and subjective effects. Regulatory Toxicity 2016;74:193-9. - PubMed
References to ongoing studies
ACTRN12619001787178 {published data only}
-
- ACTRN12619001787178. Project NEAT: nicotinE as treatment for tobacco smoking following discharge from residential withdrawal services. www.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12619001787178 (first received 18 November 2019).
-
- Bonevski B, Trigg J, Rich J, Williams E, Baker AL, Walker N, et al. Perceptions of nicotine products for tobacco smoking cessation following discharge from alcohol and other drug residential withdrawal services: a qualitative analysis. In: SRNT (Society for Research on Nicotine and Tobacco) 29th Annual Meeting 2023 Mar 1-4; San Antonio (TX), USA. SYM13-2. 2023:p 17.
ACTRN12621000148875 {published data only}
-
- ACTRN12621000148875. HARMONY: harm reduction for opiates, nicotine and you. www.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12621000148875 (first received February 12 2021). [CENTRAL: www.cochranelibrary.com/central/doi/10.1002/central/CN-02240640/full]
Berlin 2019 {published data only}
-
- Berlin I, Dautzenberg B, Lehmann B, Palmyre J, Liégey E, De Rycke Y, et al. Randomised, placebo-controlled, double-blind, double-dummy, multicentre trial comparing electronic cigarettes with nicotine to varenicline and to electronic cigarettes without nicotine: the ECSMOKE trial protocol. BMJ Open 2019;9(5):e028832. - PMC - PubMed
-
- NCT03630614. Randomized trial of electronic cigarettes with or without nicotine in smoking cessation (ECSMOKE). clinicaltrials.gov/ct2/show/NCT03630614 (first received 15 August 2018).
Caponnetto 2014 {published data only}
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- ISRCTN63825779. Yorkshire Enhanced Stop Smoking (YESS). isrctn.com 2018.
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NCT01989923 {published data only}
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- NCT01989923. Immediate smoking cessation for patients at risk for cervical dysplasia, cervical cancer and lower genital tract dysplasia and cancer - a feasibility study comparing nicotine replacement therapy with the electronic nicotine delivery system. clinicaltrials.gov/show/NCT01989923 (first received November 21 2013).
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- NCT02590393. The role of nicotine and non-nicotine alkaloids in e-cigarette use and dependence. clinicaltrials.gov/show/NCT02590393 (first received 17 February 2016).
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NCT03625986 {published data only}
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- NCT03962660. Harm Reduction for Tobacco Smoking with support of Tobacco-Replacing Electronic Nicotine Delivery Systems (HaRTS-TRENDS). clinicaltrials.gov/ct2/show/record/NCT03962660 (first received 24 May 2019).
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NCT04063267 {published data only}
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- NCT05023096. Potential effects of electronic nicotine delivery system flavor regulations on African American menthol smokers (RVA flavors) [Effects of electronic nicotine delivery system flavor regulations on tobacco behavior, toxicity, and abuse liability among African American menthol smokers]. clinicaltrials.gov/ct2/show/NCT05023096 (first received August 26 2021).
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- NCT05144542. Risk and benefits of electronic cigarettes to older smokers at high risk for lung cancer. www.clinicaltrials.gov/ct2/show/NCT05144542 (first received December 3 2021).
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- NCT05199480. Understanding the impact of cartridge-based electronic cigarettes and generated aerosols on cardiopulmonary health. clinicaltrials.gov/ct2/show/NCT05199480 (first received January 20 2022).
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- NCT05205811. The effects of combination zonisamide and bupropion on switching to an electronic cigarette [A randomized controlled trial to determine the effects of combination zonisamide and bupropion on switching to an electronic cigarette]. clinicaltrials.gov/ct2/show/NCT05205811 (first received January 25 2022).
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- NCT05311085. Cytisine and e-cigarettes with supportive text-messaging for smoking cessation (Cess@Tion). clinicaltrials.gov/ct2/show/NCT05311085 (first received April 5 2022).
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NCT05525078 {published and unpublished data}
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