Abstract
BackgroundDespite the clear risks of tobacco use, millions of people continue to smoke. Electronic nicotine delivery systems (ENDS), commonly called e-cigarettes, have been proposed as a substitute for those who are unwilling or unable to quit. Current systematic and narrative reviews on the health effects of ENDS use, particularly respiratory and cardiovascular effects, have come to differing conclusions.ObjectiveWe conducted two systematic reviews to critically assess and synthesize available human studies on the respiratory and cardiovascular health effects of ENDS substitution for people who smoke. The primary goal is to provide clinicians with evidence on the health effects of ENDS substitution to inform their treatment recommendations and plans. The twin goal of the reviews is to promote health literacy in ENDS users with facts on the health effects of ENDS.MethodsThese two reviews will be living systematic reviews. The systematic reviews will be initiated through a baseline review. Studies will be evaluated using the JBI quality assessment tools and a checklist of biases drawn from the Centre for Evidence Based Medicine Catalogue of Bias. A narrative synthesis is planned because of the heterogeneity of data. A search for recently published studies will be conducted every 3 months, and an updated review will be published every 6 months for the duration of the project or possibly longer.ResultsThe baseline and updated reviews will be published in a peer-reviewed journal. The findings of the reviews will be reported in a white paper for clinicians and a fact sheet for people who use ENDS.ConclusionsThe substitution of ENDS for cigarettes is one way to potentially reduce the risks of smoking. Clinicians and their patients need to understand the potential benefits and possible risks of substituting ENDS for cigarettes. Our living systematic reviews seek to highlight the best and most up-to-date evidence in this highly contentious and fast-moving field of research.Trial RegistrationPROSPERO CRD42021239094; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=239094International Registered Report Identifier (IRRID)DERR1-10.2196/29084
Highlights
BackgroundThere are 1.3 billion people worldwide who use tobacco, and more than 7 million of them die annually from its use [1]
The twin goals of the reviews include promoting health literacy in Electronic nicotine delivery systems (ENDS) users with facts on the health effects of ENDS with a white paper drawn from the review
The protocol conforms to the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols) requirements [30]; the completed checklist is provided in Multimedia Appendix 1
Summary
BackgroundThere are 1.3 billion people worldwide who use tobacco, and more than 7 million of them die annually from its use [1]. Despite the clear risks of tobacco use, millions of people continue to smoke. Current systematic and narrative reviews on the health effects of ENDS use, respiratory and cardiovascular effects, have come to differing conclusions. Objective: We conducted two systematic reviews to critically assess and synthesize available human studies on the respiratory and cardiovascular health effects of ENDS substitution for people who smoke. The primary goal is to provide clinicians with evidence on the health effects of ENDS substitution to inform their treatment recommendations and plans. The findings of the reviews will be reported in a white paper for clinicians and a fact sheet for people who use ENDS. Conclusions: The substitution of ENDS for cigarettes is one way to potentially reduce the risks of smoking. Trial Registration: PROSPERO CRD42021239094; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=239094 International Registered Report Identifier (IRRID): DERR1-10.2196/29084
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