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Cited by 895Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesPrenatal Substance Exposure Effects

E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis

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Kalkhoran, Sara, Glantz, Stanton A·2016·The Lancet Respiratory Medicine
DOI 10.1016/s2213-2600(15)00521-4PMC PMC4752870
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Abstract

Background Smokers increasingly use e-cigarettes for many reasons, including attempts to quit combustible cigarettes and to use nicotine where smoking is prohibited. We aimed to assess the association between e-cigarette use and cigarette smoking cessation among adult cigarette smokers, irrespective of their motivation for using e-cigarettes. Methods PubMed and Web of Science were searched between April 27, 2015, and June 17, 2015. Data extracted included study location, design, population, definition and prevalence of e-cigarette use, comparison group (if applicable), cigarette consumption, level of nicotine dependence, other confounders, definition of quitting smoking, and odds of quitting smoking. The primary endpoint was cigarette smoking cessation. Odds of smoking cessation among smokers using e-cigarettes compared with smokers not using e-cigarettes were assessed using a random effects meta-analysis. A modification of the ACROBAT-NRSI tool and the Cochrane Risk of Bias Tool were used to assess bias. This meta-analysis is registered with PROSPERO (number CRD42015020382). Findings 38 studies (of 577 studies identified) were included in the systematic review; all 20 studies with control groups (15 cohort studies, three cross-sectional studies, and two clinical trials) were included in random effects meta-analysis and sensitivity analyses. Odds of quitting cigarettes were 28% lower in those who used e-cigarettes compared with those who did not use e-cigarettes (odds ratio [OR] 0·72, 95% CI 0·57-0·91). Association of e-cigarette use with quitting did not significantly differ among studies of all smokers using e-cigarettes (irrespective of interest in quitting cigarettes) compared with studies of only smokers interested in cigarette cessation (OR 0·63, 95% CI 0·45-0·86 vs 0·86, 0·60-1·23; p=0·94). Other study characteristics (design, population, comparison group, control variables, time of exposure assessment, biochemical verification of abstinence, and definition of e-cigarette use) were also not associated with the overall effect size (p≥0·77 in all cases). Interpretation As currently being used, e-cigarettes are associated with significantly less quitting among smokers. Funding National Institutes of Health, National Cancer Institute, FDA Center for Tobacco Products.

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  • Use of e-cigarettes has increased over time, their safety especially with regard to CVD has been questioned, and their effects on kidney disease are unknown.

    “Although use of e-cigarettes has increased over time, their safety, especially with regard to CVD, has been questioned, and their effects on kidney disease are unknown.”

    From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [186]

    The Introduction (page unavailable) says e-cigarette use is increasing in many countries, and the Discussion likewise says use is increasing. Our copy focuses on smoking cessation; it does not address cardiovascular safety or state that the effects on kidney disease are unknown (searched: cardiovascular safety, CVD, kidney, renal). (LLM, conf=0.88)

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Authors
Kalkhoran, S., & Glantz, S. A.
Affiliations
University of California, San Francisco (US)
Corresponding author
Glantz, Stanton A
ORCID
Venue
The Lancet Respiratory Medicine
Publisher
Elsevier BV
Published
2016-02
Volume
4
Issue
2
Pages
116-128
ISSN
2213-2600 (ISSN-L)
DOI
10.1016/s2213-2600(15)00521-4
PMC
PMC4752870
OpenAlex
W2239337157
Cited by
895
References
6
Citations by year
2026: 25 · 2025: 34 · 2024: 76 · 2023: 47 · 2022: 67 · 2021: 90 · 2020: 122 · 2019: 140 · 2018: 104 · 2017: 101 · 2016: 87 · 2013: 1
FWCI
16.89
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet Respiratory Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • U.S. Public Health Service (T32HP19025)
  • National Cancer Institute (P50CA180890)
  • Center for Tobacco Products
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords
electronic cigarettes, smoking cessation, cigarette smokers, nicotine dependence, tobacco harm reduction, nicotine replacement therapy, smoking abstinence, real-world evidence
MeSH terms
Humans, Motivation, Smoking, Prevalence, Odds Ratio, Smoking Cessation, Electronic Nicotine Delivery Systems

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