Adermark Louise, Galanti Maria Rosaria, Ryk Charlotta, Gilljam Hans, Hedman Linnea
Dept of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Dept of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
ERJ Open Res. 2021 Jul 12;7(3). doi: 10.1183/23120541.00976-2020. eCollection 2021 Jul.
The aim of this systematic review and meta-analysis was to assess the association between e-cigarette use and subsequent initiation or recurrence of cigarette smoking.
A systematic literature search was finalised on 11 November 2019 using PubMed (including MEDLINE), EMBASE, Cochrane Library, Scopus, PubMed Health, NICE Evidence Search, PROSPERO, CRD and PsycInfo.
Studies were included if meeting the following criteria: reporting empirical results; longitudinal observational design with a minimum of 3 months of follow-up; including general population samples; allowing for the comparison between users and nonusers of e-cigarettes. Studies rated as having high risk of bias were excluded. Studies were independently assessed by at least two authors. The procedures described by PRISMA were followed, and the quality of evidence was rated using GRADE.
30 longitudinal studies from 22 different cohorts assessing e-cigarette use among nonsmokers or never-smokers at baseline, and subsequent use of cigarette smoking at follow-up, were included in this review. A random-effects meta-analysis based on 89 076 participants showed a pooled unadjusted odds ratio (OR) of cigarette smoking among baseline nonsmoker e-cigarette users compared with nonusers of 4.68 (CI 3.64-6.02), while the adjusted OR was 3.37 (CI 2.68-4.24). These results were consistent irrespective of whether the outcome was measured as ever-smoking or as past 30-day smoking. The evidence was graded as moderate.
Use of e-cigarettes may predict the initiation or recurrence of cigarette smoking.
本系统评价和荟萃分析旨在评估使用电子烟与随后开始吸烟或复吸之间的关联。
2019年11月11日完成了一项系统文献检索，使用了PubMed（包括MEDLINE）、EMBASE、Cochrane图书馆、Scopus、PubMed Health、NICE证据检索、PROSPERO、CRD和PsycInfo。
符合以下标准的研究纳入：报告实证结果；纵向观察性设计，随访至少3个月；包括一般人群样本；允许比较电子烟使用者和非使用者。被评为具有高偏倚风险的研究被排除。研究由至少两名作者独立评估。遵循PRISMA描述的程序，并使用GRADE对证据质量进行评级。
本评价纳入了22个不同队列的30项纵向研究，这些研究评估了基线时非吸烟者或从不吸烟者使用电子烟的情况，以及随访时随后吸烟的情况。基于89076名参与者的随机效应荟萃分析显示，与非使用者相比，基线非吸烟电子烟使用者吸烟的合并未调整优势比（OR）为4.68（95%CI 3.64-6.02），而调整后的OR为3.37（95%CI 2.68-4.24）。无论结果是测量为曾经吸烟还是过去30天吸烟，这些结果都是一致的。证据等级为中等。
使用电子烟可能预示着开始吸烟或复吸。
