E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis

Objective To review and summarise the current evidence on the uptake of combustible cigarette smoking following e-cigarette use in non-smokers—including never-smokers, people not currently smoking and past smokers—through an umbrella review, systematic review and meta-analysis.Design Umbrella review...

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Main Authors: Emily Banks, Grace Joshy, Laura Ford, Olivia Nina Baenziger, Amelia Yazidjoglou
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/3/e045603.full
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author Emily Banks
Grace Joshy
Laura Ford
Olivia Nina Baenziger
Amelia Yazidjoglou
author_facet Emily Banks
Grace Joshy
Laura Ford
Olivia Nina Baenziger
Amelia Yazidjoglou
author_sort Emily Banks
collection DOAJ
description Objective To review and summarise the current evidence on the uptake of combustible cigarette smoking following e-cigarette use in non-smokers—including never-smokers, people not currently smoking and past smokers—through an umbrella review, systematic review and meta-analysis.Design Umbrella review, systematic review and meta-analysis.Data sources PubMed, Scopus, Web of Science, PsychINFO (Ovid), Medline (Ovid) and Wiley Cochrane Library up to April 2020.Results Of 6225 results, 25 studies of non-smokers—never, not current and former smokers—with a baseline measure of e-cigarette use and an outcome measure of combustible smoking uptake were included. All 25 studies found increased risk of smoking uptake with e-cigarette exposure, although magnitude varied substantially. Using a random-effects model, comparing e-cigarette users versus non-e-cigarette users, among never-smokers at baseline the OR for smoking initiation was 3.19 (95% CI 2.44 to 4.16, I2 85.7%) and among non-smokers at baseline the OR for current smoking was 3.14 (95% CI 1.93 to 5.11, I2 91.0%). Among former smokers, smoking relapse was higher in e-cigarette users versus non-users (OR=2.40, 95% CI 1.50 to 3.83, I2 12.3%).Conclusions Across multiple settings, non-smokers who use e-cigarettes are consistently more likely than those avoiding e-cigarettes to initiate combustible cigarette smoking and become current smokers. The magnitude of this risk varied, with an average of around three times the odds. Former smokers using e-cigarettes have over twice the odds of relapse as non-e-cigarettes users. This study is the first to our knowledge to review and pool data on the latter topic.PROSPERO registration number CRD42020168596.
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spelling doaj-art-0e10913e1aeb48afb53c2737329b72f32024-11-21T00:30:08ZengBMJ Publishing GroupBMJ Open2044-60552021-03-0111310.1136/bmjopen-2020-045603E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysisEmily Banks0Grace Joshy1Laura Ford2Olivia Nina Baenziger3Amelia Yazidjoglou4The National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, AustraliaResearch School of Population Health, Australian National University, Canberra, Australian Capital Territory, AustraliaThe National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, AustraliaThe University of Melbourne School of Population and Global Health, Melbourne, Victoria, AustraliaThe National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, AustraliaObjective To review and summarise the current evidence on the uptake of combustible cigarette smoking following e-cigarette use in non-smokers—including never-smokers, people not currently smoking and past smokers—through an umbrella review, systematic review and meta-analysis.Design Umbrella review, systematic review and meta-analysis.Data sources PubMed, Scopus, Web of Science, PsychINFO (Ovid), Medline (Ovid) and Wiley Cochrane Library up to April 2020.Results Of 6225 results, 25 studies of non-smokers—never, not current and former smokers—with a baseline measure of e-cigarette use and an outcome measure of combustible smoking uptake were included. All 25 studies found increased risk of smoking uptake with e-cigarette exposure, although magnitude varied substantially. Using a random-effects model, comparing e-cigarette users versus non-e-cigarette users, among never-smokers at baseline the OR for smoking initiation was 3.19 (95% CI 2.44 to 4.16, I2 85.7%) and among non-smokers at baseline the OR for current smoking was 3.14 (95% CI 1.93 to 5.11, I2 91.0%). Among former smokers, smoking relapse was higher in e-cigarette users versus non-users (OR=2.40, 95% CI 1.50 to 3.83, I2 12.3%).Conclusions Across multiple settings, non-smokers who use e-cigarettes are consistently more likely than those avoiding e-cigarettes to initiate combustible cigarette smoking and become current smokers. The magnitude of this risk varied, with an average of around three times the odds. Former smokers using e-cigarettes have over twice the odds of relapse as non-e-cigarettes users. This study is the first to our knowledge to review and pool data on the latter topic.PROSPERO registration number CRD42020168596.https://bmjopen.bmj.com/content/11/3/e045603.full
spellingShingle Emily Banks
Grace Joshy
Laura Ford
Olivia Nina Baenziger
Amelia Yazidjoglou
E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis
BMJ Open
title E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis
title_full E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis
title_fullStr E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis
title_full_unstemmed E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis
title_short E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis
title_sort e cigarette use and combustible tobacco cigarette smoking uptake among non smokers including relapse in former smokers umbrella review systematic review and meta analysis
url https://bmjopen.bmj.com/content/11/3/e045603.full
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