Overview of Electronic Nicotine Delivery Systems: A Systematic Review

Abstract

Context Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. Evidence acquisition The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. Evidence synthesis There were 686 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. Conclusions Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.

E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys

“…13 Intensive use of e-cigarettes is key to their potential effect as a smoking cessation aid. 14 15 34 Our study, based on the largest representative sample of e-cigarette users in the US in 2014-15, found that more than 70% of recent quitters who used e-cigarettes were still using e-cigarettes daily. The daily use might have been critical in preventing relapse.…”

Prevalence and correlates of electronic cigarette use among Canadian students: cross-sectional findings from the 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey

“…We selected these covariables because other studies have shown that they are significant predictors of e-cigarette use and smoking onset in adolescents. 25,26 The calculation of tolerances and variance inflation factors indicated no problems of multicollinearity among explanatory variables. We report our results as unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs).…”

Electronic Cigarette Use Prevalence, Associated Factors, and Pattern by Cigarette Smoking Status in the United States From NHANES (National Health and Nutrition Examination Survey) 2013–2014

“…Consequently, initial growth in the prevalence of use of these products was noted among cigarette smokers 3. Over time, however, extensive marketing,4 improvements in design, extensive flavor options,5 and a widespread perception that e‐cigarettes were safer than cigarettes led to their increased popularity, especially among youth6, 7, 8, 9, 10 and those who never smoked tobacco 9, 10. This increasing popularity has raised public health concerns, given the paucity of high‐quality longitudinal evidence on the health effects of e‐cigarette exposure and uncertainly about the data supporting their use as smoking‐cessation devices 1…”