Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella Review

E-cigarettes (ECs) are a well-established consumer product. To study their respiratory health effects, there is the issue of heterogenous patterns of use: concurrently with cigarette smoking (dual use), exclusive use after smoking cessation (exclusive use), or use initiated without any prior or curr...

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Main Authors: Giusy Rita Maria La Rosa, Riccardo Polosa, Renée O'Leary
Format: Article
Language:English
Published: SAGE Publishing 2025-02-01
Series:Tobacco Use Insights
Online Access:https://doi.org/10.1177/1179173X251325421
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author Giusy Rita Maria La Rosa
Riccardo Polosa
Renée O'Leary
author_facet Giusy Rita Maria La Rosa
Riccardo Polosa
Renée O'Leary
author_sort Giusy Rita Maria La Rosa
collection DOAJ
description E-cigarettes (ECs) are a well-established consumer product. To study their respiratory health effects, there is the issue of heterogenous patterns of use: concurrently with cigarette smoking (dual use), exclusive use after smoking cessation (exclusive use), or use initiated without any prior or current use of cigarettes (naïve use). Our primary goal was to synthesize the evidence on the respiratory effects of ECs use in adults, categorized by their pattern of use. Additionally, we identified the highest quality systematic reviews and critically evaluated the current literature on this topic. The review was developed with published umbrella review guidelines. The database searches were Medline, Scopus, Cochrane, Epistemonikos, LILACS, and grey literature databases. The criterion for inclusion of systematic reviews was analyses of respiratory tests from randomized controlled trials or cohort studies. Quality assessments were performed with AMSTAR2 and a checklist of reporting biases. A narrative analysis was synthesized by test method: spirometry, impulse oscillometry, breath gasses, biomarkers, and clinical serious adverse events. Twelve systematic reviews were included. The findings on respiratory functioning were statistically non-significant across all patterns of use. Reporting bias was frequently observed. Based on the current research, there is no evidence of significant change in the short or medium term in respiratory function with any pattern of ECs use. We attribute the null findings to the weaknesses of acute studies, the participants’ smoking history masking testing, and the inclusion of participants with a low frequency of use.
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spelling doaj-art-41964d4bab6e4986ac33a9c12eb8d14d2025-08-20T01:57:21ZengSAGE PublishingTobacco Use Insights1179-173X2025-02-011810.1177/1179173X251325421Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella ReviewGiusy Rita Maria La RosaRiccardo PolosaRenée O'LearyE-cigarettes (ECs) are a well-established consumer product. To study their respiratory health effects, there is the issue of heterogenous patterns of use: concurrently with cigarette smoking (dual use), exclusive use after smoking cessation (exclusive use), or use initiated without any prior or current use of cigarettes (naïve use). Our primary goal was to synthesize the evidence on the respiratory effects of ECs use in adults, categorized by their pattern of use. Additionally, we identified the highest quality systematic reviews and critically evaluated the current literature on this topic. The review was developed with published umbrella review guidelines. The database searches were Medline, Scopus, Cochrane, Epistemonikos, LILACS, and grey literature databases. The criterion for inclusion of systematic reviews was analyses of respiratory tests from randomized controlled trials or cohort studies. Quality assessments were performed with AMSTAR2 and a checklist of reporting biases. A narrative analysis was synthesized by test method: spirometry, impulse oscillometry, breath gasses, biomarkers, and clinical serious adverse events. Twelve systematic reviews were included. The findings on respiratory functioning were statistically non-significant across all patterns of use. Reporting bias was frequently observed. Based on the current research, there is no evidence of significant change in the short or medium term in respiratory function with any pattern of ECs use. We attribute the null findings to the weaknesses of acute studies, the participants’ smoking history masking testing, and the inclusion of participants with a low frequency of use.https://doi.org/10.1177/1179173X251325421
spellingShingle Giusy Rita Maria La Rosa
Riccardo Polosa
Renée O'Leary
Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella Review
Tobacco Use Insights
title Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella Review
title_full Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella Review
title_fullStr Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella Review
title_full_unstemmed Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella Review
title_short Patterns of Use of e-Cigarettes and Their Respiratory Effects: A Critical Umbrella Review
title_sort patterns of use of e cigarettes and their respiratory effects a critical umbrella review
url https://doi.org/10.1177/1179173X251325421
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