Evidence mapPaperPMID 36294263Full record

SynthesisInternational journal of environmental research and public health2022

The Health Effects of Real-World Dual Use of Electronic and Conventional Cigarettes versus the Health Effects of Exclusive Smoking of Conventional Cigarettes: A Systematic Review.

Charlotta Pisinger, Sofie K Bergman Rasmussen

Abstract readSystematic Review
In one paragraph

Synthesis in International journal of environmental research and public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Vaping-related lung disease: a narrative review.Journal of thoracic disease · 2026
    Review
  7. Identifying Latent Classes of Dual Cigarette/ENDS Users Based on Motivations for ENDS Use: Product Substitution Versus Complementary Use.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026
    Article
  8. Article
  9. Article
  10. Article
  11. Waterpipe and Co-Use of Inhaled Nicotine and Tobacco Products: Findings from a Population-Based Cross-Sectional Household Survey in Germany.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025
    Article
  12. Article
  13. The respiratory epithelium in the era of vaping: insights fromEuropean respiratory review : an official journal of the European Respiratory Society · 2025
    Review
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Charlotta PisingerCenter for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark.ORCID 0000-0002-7970-3168
Sofie K Bergman RasmussenCenter for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA high prevalence of dual use of e-cigarettes and conventional cigarettes has been reported across the world.

methodsA systematic search was carried out. We included original articles on any topic relevant to health, excluding mental health, in all languages. The PRISMA guidelines were followed. Both reviewers independently screened and read all publications. We compared dual use with exclusive smoking of conventional cigarettes (ESCC).

resultsFifty-two publications (49 studies) were included. Thirteen papers/10 studies were prospective. There was great heterogeneity across studies. Many methodological weaknesses, such as inaccurate exposure measurement, lack of adjustment for former tobacco consumption, and lack of significance testing were identified. Most prospective studies found dual use to be at least as harmful as ESCC. The longest follow-up was six years. Most of the best available cross-sectional studies found dual use associated with the same and, in several studies, significantly higher risk of self-reported symptoms/disease than in ESCC. The intensity of cigarette smoking seems associated with worse health.

conclusionExisting studies indicate that dual use is at least as, or probably even more, harmful than ESCC. Due to the predominance of cross-sectional studies and the methodological weaknesses we judged the overall certainty of the evidence as "low certainty".

Indexed as

Electronic Nicotine Delivery SystemsTobacco ProductsVapingCross-Sectional StudiesElectronicsHumansProspective Studiesbiomarkercigarettesdual usee-cigaretteselectronic cigarettesENDShealthpublic healthsmokingvaping

Identifiers

PMID36294263
PMCPMC9603628

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.