An update of a systematic review and meta‐analyses exploring flavours in intervention studies of e‐cigarettes for smoking cessation
Abstract
Abstract Aims To determine patterns of e‐cigarette flavour use (sweet, tobacco, menthol/mint) in interventional studies of e‐cigarettes for stopping smoking, and to estimate associations between flavours and smoking/vaping outcomes. Methods Update of secondary data analyses, including meta‐analyses subgrouped by flavour provision and narrative syntheses, incorporating data from January 2004 to February 2024. Eligible studies were identified from a Cochrane review. Studies provided adults who smoked cigarettes with nicotine‐containing e‐cigarettes for smoking cessation and provided data on e‐cigarette e‐liquid flavour use. Outcomes included participants' flavour use measured at any time, plus smoking abstinence, abstinence from all tobacco or commercial nicotine products and allocated product use at 6 months or longer, reported as risk ratios with 95% confidence intervals. We assessed risk of bias using the Cochrane Risk of Bias 1 tool. Results We included 25 studies (n = 16 748); 21 contributed to subgroup meta‐analyses and 18 provided flavour choices. We judged 15 studies at high, seven at low and three at unclear risk of bias. In studies where participants had a choice of flavours, some switching between flavours occurred (five studies). A preference for sweet (including fruit) flavours over tobacco and menthol was indicated (in 6 of 11 studies); however, there were differences across studies. Subgroup meta‐analyses showed no clear associations between e‐liquid flavours…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 16 participants or records.
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