Health Effects of Electronic Cigarettes: An Umbrella Review and Methodological Considerations

Nargiz Travis, Marie Knoll, Christopher J. Cadham, Steven Cook, Kenneth E. Warner, Nancy L. Fleischer, Clifford E. Douglas, Luz María Sánchez-Romero, Ritesh Mistry, Rafael Meza, Jana L. Hirschtick and David T. Levy
Additional contact information
Nargiz Travis: Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA
Marie Knoll: Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA
Christopher J. Cadham: Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Steven Cook: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Kenneth E. Warner: Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Nancy L. Fleischer: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Clifford E. Douglas: Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Luz María Sánchez-Romero: Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA
Ritesh Mistry: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Rafael Meza: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Jana L. Hirschtick: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
David T. Levy: Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA

IJERPH, 2022, vol. 19, issue 15, 1-23

Abstract: E-cigarettes are often marketed as a safer alternative to combustible cigarettes. However, their health effects, especially those associated with long-term use, remain largely uncertain. We conducted an umbrella review of the cardiopulmonary and carcinogenic risks of e-cigarette use, distinguishing between short-term and long-term health effects. The search for systematic reviews was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. Seventeen systematic reviews, including five meta-analyses, were included in our umbrella review. There was a clear underreporting of e-cigarette devices and e-liquid types, e-cigarette and cigarette exposure, and the health and smoking status of study participants. Overall, the findings suggest that short-term use of e-cigarettes may be associated with acute cardiopulmonary risks, although to a lesser extent than cigarette use. Long-term e-cigarette use may have pulmonary/respiratory benefits in those who switch from chronic cigarette smoking, particularly in individuals with asthma and chronic obstructive pulmonary disease (COPD). Evidence on intermediate and long-term carcinogenic effects is lacking. This umbrella review underscores the urgent need for systematic reviews with better adherence to established reporting guidelines, consistent definitions of duration of e-cigarette use, a focus on newer devices, and accounting for the impacts of former or current smoking.

Keywords: umbrella review; health effects; electronic cigarettes; vaping; tobacco products (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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