{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:42:54Z","timestamp":1791916974568,"version":"4.3.4"},"reference-count":47,"publisher":"European Respiratory Society (ERS)","issue":"163","license":[{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ersjournals.com"],"crossmark-restriction":true},"short-container-title":["Eur Respir Rev"],"published-print":{"date-parts":[[2022,3,31]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the effects of electronic cigarettes (e-cigarettes) as a therapeutic intervention compared to nicotine replacement therapy (NRT) on nicotine abstinence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two authors independently searched the PubMed, Embase, PsycInfo and Cochrane Central Register of Controlled Trials databases for articles published up to and including 10 July 2021. We included randomised controlled trials (RCTs) in which nicotine e-cigarettes were compared to NRT among current cigarette users. The primary outcome was abstaining from all nicotine-delivery devices. Secondary outcomes were 1) allocated product use (e-cigarettes or NRT) among successful cigarette quitters and 2) quitting cigarettes at the end of the trial using fixed-effect Mantel\u2013Haenszel models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included four RCTs representing 1598 adult participants (51.0% females). The mean age of participants in these studies ranged from 41 to 54\u2005years, while average baseline smoking ranged from 14 to 21 cigarettes per day. Compared to NRT, e-cigarette use was associated with lower nicotine abstinence rates at the longest follow-up (risk ratio 0.50 (95% CI 0.32\u20130.77)). Among successful cigarette quitters, the risk of allocated product use by the end of the observational time was higher for e-cigarette users compared to NRT (risk ratio 8.94 (95% CI 3.98\u201320.07)). E-cigarette users had higher cigarette smoking cessation rates compared to NRT users (risk ratio 1.58 (95% CI 1.20\u20132.08)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of e-cigarettes as a therapeutic intervention for smoking cessation may lead to permanent nicotine dependence.<\/jats:p><\/jats:sec>","DOI":"10.1183\/16000617.0215-2021","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T09:50:10Z","timestamp":1648029010000},"page":"210215","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":69,"title":["E-cigarettes and nicotine abstinence: a meta-analysis of randomised controlled trials"],"prefix":"10.1183","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7163-5738","authenticated-orcid":false,"given":"Reiner","family":"Hanewinkel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Niederberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5346-4234","authenticated-orcid":false,"given":"Anya","family":"Pedersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9064-6603","authenticated-orcid":false,"given":"Jennifer B.","family":"Unger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9718-439X","authenticated-orcid":false,"given":"Artur","family":"Galimov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"2022032302500461000_31.163.210215.1","unstructured":"National Academies of Sciences, Engineering, and Medicine . Public Health Consequences of E-Cigarettes. Washington, DC, The National Academies Press, 2018."},{"key":"2022032302500461000_31.163.210215.2","doi-asserted-by":"crossref","first-page":"106243","DOI":"10.1016\/j.addbeh.2019.106243","article-title":"Electronic cigarette advertising and teen smoking initiation","volume":"103","author":"Hansen","year":"2020","journal-title":"Addict Behav"},{"key":"2022032302500461000_31.163.210215.3","doi-asserted-by":"crossref","first-page":"230","DOI":"10.2105\/AJPH.2020.305999","article-title":"E-cigarette use and adult cigarette smoking cessation: a meta-analysis","volume":"111","author":"Wang","year":"2021","journal-title":"Am J Public Health"},{"key":"2022032302500461000_31.163.210215.4","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010216.pub2"},{"key":"2022032302500461000_31.163.210215.5"},{"key":"2022032302500461000_31.163.210215.6","first-page":"CD010216","article-title":"Electronic cigarettes for smoking cessation","volume":"9","author":"Hartmann-Boyce","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"2022032302500461000_31.163.210215.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-044222"},{"key":"2022032302500461000_31.163.210215.8","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.04083-2020"},{"key":"2022032302500461000_31.163.210215.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"2022032302500461000_31.163.210215.10","unstructured":"Siemieniuk R , Guyatt G . What is GRADE? 2019. https:\/\/bestpractice.bmj.com\/info\/toolkit\/learn-ebm\/what-is-grade\/"},{"key":"2022032302500461000_31.163.210215.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"2022032302500461000_31.163.210215.12","doi-asserted-by":"crossref","unstructured":"Higgins JP , Thomas J , Chandler J , et al. Cochrane handbook for systematic reviews of interventions. Hoboken, John Wiley & Sons, 2019.","DOI":"10.1002\/9781119536604"},{"key":"2022032302500461000_31.163.210215.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"2022032302500461000_31.163.210215.14","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1093\/ntr\/ntaa143","article-title":"QuitNic: a pilot randomized controlled trial comparing nicotine vaping products with nicotine replacement therapy for smoking cessation following residential detoxification","volume":"23","author":"Bonevski","year":"2021","journal-title":"Nicotine Tob Res"},{"key":"2022032302500461000_31.163.210215.15","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1093\/ntr\/ntz233","article-title":"A randomized clinical trial examining the effects of instructions for electronic cigarette use on smoking-related behaviors and biomarkers of exposure","volume":"22","author":"Hatsukami","year":"2020","journal-title":"Nicotine Tob Res"},{"key":"2022032302500461000_31.163.210215.16","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/add.15628","article-title":"E-cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult: randomized controlled trial","volume":"117","author":"Myers Smith","year":"2022","journal-title":"Addiction"},{"key":"2022032302500461000_31.163.210215.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61842-5"},{"key":"2022032302500461000_31.163.210215.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1808779"},{"key":"2022032302500461000_31.163.210215.19","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2019.04.180384"},{"key":"2022032302500461000_31.163.210215.20","doi-asserted-by":"crossref","first-page":"e5609","DOI":"10.7717\/peerj.5609","article-title":"E-cigarettes versus nicotine patches for perioperative smoking cessation: a pilot randomized trial","volume":"6","author":"Lee","year":"2018","journal-title":"PeerJ"},{"key":"2022032302500461000_31.163.210215.21","doi-asserted-by":"crossref","first-page":"106912","DOI":"10.1016\/j.addbeh.2021.106912","article-title":"A systematic review of randomized controlled trials and network meta-analysis of e-cigarettes for smoking cessation","volume":"119","author":"Chan","year":"2021","journal-title":"Addict Behav"},{"key":"2022032302500461000_31.163.210215.22","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1093\/ntr\/ntab050","article-title":"Validating e-cigarette dependence scales based on dynamic patterns of vaping behaviors","volume":"23","author":"Buu","year":"2021","journal-title":"Nicotine Tob Res"},{"key":"2022032302500461000_31.163.210215.23","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1017\/jsc.2014.27","article-title":"Nicotine: pharmacology, toxicity and therapeutic use","volume":"9","author":"Fagerstr\u00f6m","year":"2014","journal-title":"J Smok Cessat"},{"key":"2022032302500461000_31.163.210215.24","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1021\/acs.chemrestox.1c00253","article-title":"Characterizing the chemical landscape in commercial e-cigarette liquids and aerosols by liquid chromatography\u2013high-resolution mass spectrometry","volume":"34","author":"Tehrani","year":"2021","journal-title":"Chem Res Toxicol"},{"key":"2022032302500461000_31.163.210215.25","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1080\/15592294.2020.1724401","article-title":"Hypomethylation of LINE-1 repeat elements and global loss of DNA hydroxymethylation in vapers and smokers","volume":"15","author":"Caliri","year":"2020","journal-title":"Epigenetics"},{"key":"2022032302500461000_31.163.210215.26","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s13181-020-00772-w","article-title":"Review of health consequences of electronic cigarettes and the outbreak of electronic cigarette, or vaping, product use-associated lung injury","volume":"16","author":"Cao","year":"2020","journal-title":"J Med Toxicol"},{"key":"2022032302500461000_31.163.210215.27","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1080\/15376516.2016.1196282","article-title":"Reductions in biomarkers of exposure (BoE) to harmful or potentially harmful constituents (HPHCs) following partial or complete substitution of cigarettes with electronic cigarettes in adult smokers","volume":"26","author":"O'Connell","year":"2016","journal-title":"Toxicol Mech Methods"},{"key":"2022032302500461000_31.163.210215.28","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1165\/rcmb.2019-0200OC","article-title":"Electronic nicotine delivery system aerosol-induced cell death and dysfunction in macrophages and lung epithelial cells","volume":"63","author":"Serpa","year":"2020","journal-title":"Am J Respir Cell Mol Biol"},{"key":"2022032302500461000_31.163.210215.29","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1111\/odi.12652","article-title":"Recent updates on electronic cigarette aerosol and inhaled nicotine effects on periodontal and pulmonary tissues","volume":"23","author":"Javed","year":"2017","journal-title":"Oral Dis"},{"key":"2022032302500461000_31.163.210215.30","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01815-2019"},{"key":"2022032302500461000_31.163.210215.31","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00278-2018"},{"key":"2022032302500461000_31.163.210215.32","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01151-2018"},{"key":"2022032302500461000_31.163.210215.33","doi-asserted-by":"crossref","first-page":"e0256044","DOI":"10.1371\/journal.pone.0256044","article-title":"Association between electronic nicotine delivery systems and electronic non-nicotine delivery systems with initiation of tobacco use in individuals aged <20 years. A systematic review and meta-analysis","volume":"16","author":"Yoong","year":"2021","journal-title":"PLoS One"},{"key":"2022032302500461000_31.163.210215.34","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2019-055433"},{"key":"2022032302500461000_31.163.210215.35","first-page":"CD000146","article-title":"Nicotine replacement therapy versus control for smoking cessation","volume":"5","author":"Hartmann-Boyce","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2022032302500461000_31.163.210215.36","doi-asserted-by":"publisher","DOI":"10.1378\/chest.109.2.438"},{"key":"2022032302500461000_31.163.210215.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2010.12.003"},{"key":"2022032302500461000_31.163.210215.38","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-045603"},{"key":"2022032302500461000_31.163.210215.39","doi-asserted-by":"crossref","first-page":"29","DOI":"10.18332\/tpc\/132964","article-title":"Risk of smoking relapse with the use of electronic cigarettes: a systematic review with meta-analysis of longitudinal studies","volume":"7","author":"Barufaldi","year":"2021","journal-title":"Tob Prev Cessat"},{"key":"2022032302500461000_31.163.210215.40","doi-asserted-by":"crossref","first-page":"101009","DOI":"10.1016\/j.pmedr.2019.101009","article-title":"Patterns and trends of dual use of e-cigarettes and cigarettes among US adults, 2015\u20132018","volume":"16","author":"Owusu","year":"2019","journal-title":"Prev Med Rep"},{"key":"2022032302500461000_31.163.210215.41","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.amepre.2019.07.028","article-title":"Association of e-cigarette use with respiratory disease among adults: a longitudinal analysis","volume":"58","author":"Bhatta","year":"2020","journal-title":"Am J Prev Med"},{"key":"2022032302500461000_31.163.210215.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2018.12.011"},{"key":"2022032302500461000_31.163.210215.43","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1177\/2047487320941993","article-title":"Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC)","volume":"28","author":"Kavousi","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2022032302500461000_31.163.210215.44","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02009-2019"},{"key":"2022032302500461000_31.163.210215.45","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1164\/rccm.202012-4441LE","article-title":"Respiratory symptom incidence among people using electronic cigarettes, combustible tobacco, or both","volume":"204","author":"Reddy","year":"2021","journal-title":"Am J Respir Crit Care Med"},{"key":"2022032302500461000_31.163.210215.46","doi-asserted-by":"crossref","first-page":"5612","DOI":"10.1038\/s41598-020-62545-3","article-title":"Dual use of electronic and conventional cigarettes is associated with higher cardiovascular risk factors in Korean men","volume":"10","author":"Kim","year":"2020","journal-title":"Sci Rep"},{"key":"2022032302500461000_31.163.210215.47","doi-asserted-by":"crossref","first-page":"e55","DOI":"10.1016\/j.japh.2021.05.001","article-title":"Evidence against e-cigarettes for smoking cessation","volume":"61","author":"Teriba","year":"2021","journal-title":"J Am Pharm Assoc"}],"container-title":["European Respiratory Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1183\/16000617.0215-2021","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T05:04:59Z","timestamp":1740373499000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.ersnet.org\/lookup\/doi\/10.1183\/16000617.0215-2021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,23]]},"references-count":47,"journal-issue":{"issue":"163","published-online":{"date-parts":[[2022,3,23]]},"published-print":{"date-parts":[[2022,3,31]]}},"alternative-id":["10.1183\/16000617.0215-2021"],"URL":"https:\/\/doi.org\/10.1183\/16000617.0215-2021","relation":{},"ISSN":["0905-9180","1600-0617"],"issn-type":[{"value":"0905-9180","type":"print"},{"value":"1600-0617","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,23]]}}}