La Rosa Giusy Rita Maria, Del Giovane Cinzia, Pedullà Eugenio, Kowalski Jan, Chapple Iain, Minozzi Silvia, Amaliya Amaliya, Polosa Riccardo
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
Syst Rev. 2025 Apr 17;14(1):90. doi: 10.1186/s13643-025-02839-7.
Tobacco use is a global issue, and non-combustible nicotine products (NCNPs) like electronic nicotine delivery systems, nicotine pouches, snus, and nicotine replacement therapies offer potential risk/harm reduction for smokers unable or unwilling to quit. Although NCNPs are less harmful than tobacco smoking, their impact on oral health remains unclear. A systematic review and network meta-analysis will be conducted to answer the research question: What are the oral signs and symptoms associated with NCNPs as both monotherapies and combination therapies compared to each other, placebo, standard care, no drug treatment, and combustible cigarette smoking?
We will search PubMed and Scopus databases, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to August 2024. This review will focus on randomized controlled trials (RCTs) with a minimum follow-up period of 1 month, comparing any NCNPs versus placebo, standard care, no drug treatment, combustible cigarette smoking or to each other in adult smokers. Our primary outcomes will be the number of participants reporting any oral side effect, aphthous ulcers, dry mouth and mouth irritation. Studies will be excluded if they involve: non-smokers, pregnant women, individuals with mental health or neurological disorders, participants consuming alcohol or other substances. Data will be analyzed using a network meta-analysis framework, estimating odds ratios with 95% confidence intervals. Risk of bias will be determined using the Cochrane risk of bias tool-version 2.0 for included RCTs and the Confidence In Network Meta-Analysis tool will be employed to assess the confidence of evidence contributing to each network estimate.
Our findings will provide critical insights into the oral health implications of NCNPs, informing clinical and public health decisions. Results are expected by May 2025 and will be disseminated through publications and presentations to guide tobacco harm reduction strategies.
PROSPERO CRD42024565118.
烟草使用是一个全球性问题，像电子尼古丁传送系统、尼古丁袋、口含烟和尼古丁替代疗法等非燃烧性尼古丁产品，为无法或不愿戒烟的吸烟者提供了潜在的降低风险/危害的方法。尽管非燃烧性尼古丁产品的危害低于吸烟，但其对口腔健康的影响仍不明确。将进行一项系统评价和网状荟萃分析，以回答以下研究问题：与彼此、安慰剂、标准护理、无药物治疗和燃烧性香烟吸烟相比，作为单一疗法和联合疗法的非燃烧性尼古丁产品会导致哪些口腔体征和症状？
我们将检索PubMed和Scopus数据库，以及截至2024年8月的Cochrane对照试验中央注册库（CENTRAL）。本评价将聚焦于至少随访1个月的随机对照试验（RCT），比较任何非燃烧性尼古丁产品与安慰剂、标准护理、无药物治疗、燃烧性香烟吸烟或在成年吸烟者中相互比较。我们的主要结局将是报告任何口腔副作用、复发性阿弗他溃疡、口干和口腔刺激的参与者数量。如果研究涉及：非吸烟者、孕妇、有心理健康或神经疾病的个体、饮酒或使用其他物质的参与者，则将其排除。将使用网状荟萃分析框架分析数据，估计比值比及95%置信区间。将使用Cochrane偏倚风险工具2.0确定纳入RCT的偏倚风险，并将使用网状荟萃分析证据置信度工具评估有助于每个网状估计的证据的置信度。
我们的研究结果将为非燃烧性尼古丁产品对口腔健康的影响提供关键见解，为临床和公共卫生决策提供信息。预计2025年5月得出结果，并将通过出版物和报告进行传播，以指导烟草危害降低策略。
PROSPERO CRD42024565118。
