Abstract
ObjectivesThis umbrella review aims to summarise the evidence about electronic nicotine delivery systems’ (ENDS) risk and safety health profile to inform ENDS health communication strategies.Data sources and study selectionSix databases were searched for systematic reviews presenting evidence on ENDS-related health effects. Ninety reviews divided into five categories were included: toxicity=20, health effects=40, role in smoking cessation=24, role in transition to combustible cigarettes (CCs)=13 and industry marketing claims=4.Data extractionFindings were synthesised in narrative summaries. Meta-analyses were conducted by study type when appropriate. Quality assessment was conducted using the Measurement Tool to Assess Systematic Reviews. The Institute of Medicine’s Levels of Evidence Framework was used to classify the evidence into high-level, moderate, limited-suggestive and limited-not-conclusive.Data synthesisWe found high-level evidence that ENDS exposes users to toxic substances; increases the risk of respiratory disease; leads to nicotine dependence; causes serious injuries due to explosion or poisoning; increases smoking cessation in clinical trials but not in observational studies; increases CC initiation; and exposure to ENDS marketing increases its use/intention to use. Evidence was moderate for ENDS association with mental health and substance use, limited-suggestive for cardiovascular, and limited-not-conclusive for cancer, ear, ocular and oral diseases, and pregnancy outcomes.ConclusionsAs evidence is accumulating, ENDS communication can focus on high-level evidence on ENDS association with toxicity, nicotine addiction, respiratory disease, ENDS-specific harm (explosion, poisoning) and anti-ENDS industry sentiment. Direct comparison between the harm of CCs and ENDS should be avoided.PROSPERO registration numberCRD42021241630.
Funder
National Institute on Drug Abuse (NIDA) of the National Institutes of Health
Subject
Public Health, Environmental and Occupational Health,Health (social science)
Reference148 articles.
1. Health UDo , Services H . E-Cigarette use among youth and young adults: a report of the surgeon General, 2016.
2. US Food FDA , Administration D . Statement from FDA commissioner Scott Gottlieb, M.D., on new steps to address epidemic of youth e-cigarette use, 2018. https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-new-steps-address-epidemic-youth-e-cigarette-use
3. E-cigarette Use Among Middle and High School Students — United States, 2020
4. Electronic cigarette and JUUL use among adolescents and young adults;Vallone;JAMA Pediatr,2020
5. Young adult perceptions of JUUL and other pod electronic cigarette devices in California: a qualitative study
Cited by
9 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献