JMIR Publications

ABSTRACT

Background:

Electronic nicotine delivery systems (ENDS), commonly called e-cigarettes, have been tested as a treatment for tobacco cession (primarily cigarettes) for over a decade. A plethora of systematic reviews published in the past two years have synthesized the evidence on the efficacy of ENDS for cessation but have come to differing conclusions.

Objective:

The purpose of our umbrella review is to provide a quality assessment of the current systematic reviews, catalog the available studies, and conduct secondary meta-analyses of the effectiveness of ENDS for tobacco cessation. The research questions are: 1. Are ENDS more, less, or equally effective compared to other cessation methods? 2. In absolute numbers, what is the range of success rates for cessation with ENDS use? 3. How weak or strong is the evidence base on the cessation effectiveness of ENDS? 4. Is reporting bias occurring in systematic reviews of ENDS for smoking cessation?

Methods:

A search will be conducted by two independent dual reviewers in EMBASE, SCOPUS, and PubMed for systematic reviews of clinical trials on ENDS for cessation. Secondary searches will citation chase the included systematic reviews and check the retrieval with two consultations from topic experts. Systematic reviews will be assessed by dual independent reviewers for methodological quality with AMSTAR2 and examined for reporting bias with categories from the Centre for Evidence Based Medicine’s Catalogue of Bias.

Results:

A vote counting of the direction of effect for each cessation method will display the relative effectiveness of ENDS for cessation compared to other interventions (including no treatment). A second order meta-analysis will compute a cessation success rate for ENDS. The primary studies will be listed in a citation matrix that will include the bias ratings given by the systematic reviews. The strength or weakness of the evidence will be assessed with a stratification of evidence. Reporting bias will be presented as a tabulation of bias indicators.

Conclusions:

The use of ENDS for cessation is a highly controversial subject. By an exhaustive synthesis of the available data and a critical assessment of current systematic reviews we hope to clarify the effectiveness of ENDS for cigarette smoking cessation. Our purpose is to explain to clinicians, policy makers, and people who smoke what evidence has been published so that they can make evidence-informed decisions. Clinical Trial: PROSPERO Registration: CRD42023406165