World No Tobacco Day – created in 1987 by the World Health Organization (WHO) – gives us the opportunity to reflect on and celebrate the achievements of the Cochrane Living Systematic Review for Electronic Cigarettes for Smoking Cessation, developed by members of the Nuffield Department of Primary Care Health Sciences, the Centre for Evidence-Based Medicine, and the Cochrane Tobacco Addiction Group. The review examines the effectiveness, tolerability, and safety of using electronic cigarettes (ECs) to help people who smoke tobacco achieve long‐term smoking abstinence.
Since coming on the market over a decade ago, electronic cigarettes have caused a considerable stir in the public health community, and there has been a large amount of misinformation circulating about their use.
With funding from Cancer Research UK and the National Institute for Health Research, our team of experts strive to inform the debate around this issue by bringing together all the relevant and up-to-date scientific data using gold-standard methods to facilitate informed, evidence-based choices about health interventions for tobacco control. And they are proving successful in their mission.
When discussing this review, study lead and Editor of the Cochrane Tobacco Addiction Group, Jamie Hartmann-Boyce, said: “I’m incredibly proud of the work our team has done in this area, and the influence it’s had. Smoking remains the leading cause of preventable disease and death worldwide, and it is essential that the best available evidence on new technologies, like e-cigarettes, inform decisions about tobacco control moving forward.”
Dr Nicola Lindson, University Research Lecturer and co-lead on the living systematic review, said: “One of the exciting things about this project is thinking about how we can best share our findings with different audiences. We’ve developed briefings aimed at policymakers, members of the public, and healthcare professionals, and given talks to various audiences – but perhaps for us the most rewarding has been starting up our monthly podcast – Let’s Talk E-cigarettes."
Since its first publication in 2014, this review has contributed to national and international guidelines. With support from Cancer Research UK, it became a living systematic review in April 2021, meaning research is ongoing and updated regularly, in this case, on a monthly basis.
The most recent version of the Cochrane review was published in September 2021 and includes data from 61 studies and 16,759 participants. 34 of these studies were randomised controlled trials (RCTs), aimed to effectively reduce bias and provide immediate comparative results.
- The review showed more people probably stop smoking for at least 6 months using nicotine e‐cigarettes than using nicotine replacement therapy, or nicotine‐free e-cigarettes.
- Nicotine e-cigarettes may work better than no support for quitting smoking, or than behavioural support alone.
- Nicotine e-cigarettes may not be associated with serious unwanted effects when used for quitting smoking.
- The unwanted effects reported most often with nicotine e‐cigarettes were throat or mouth irritation, headaches, coughs and feeling sick. These effects reduced over time as people continued using nicotine e‐cigarettes.
The team reveal, “There is still work to be done. More reliable evidence is needed to be confident about the effects of e‐cigarettes, particularly the effects of newer types of e‐cigarettes that have better nicotine delivery”.
Thank you to all our team members involved in this review.
Visit our webpage to find out more about this study, including reviews, briefing documents, press coverage, publications and podcasts.