PDF(Pubmed)
Abstract：
E-cigarettes (electronic nicotine delivery system, ENDS) have been presented as a harm reduction strategy for people who smoke tobacco cigarettes but who cannot achieve abstinence, or for those who wish to continue to enjoy nicotine and the habit of smoking. What are the health effects of the substitution of ENDS for tobacco cigarettes? This systematic review evaluates the evidence of human clinical tests on the respiratory effects of ENDS use in participants who smoke tobacco cigarettes.
A registered and published protocol was developed conforming to PRISMA 2020 and AMSTAR2 standards. The literature search was conducted in PubMed, Scopus, and the CENTRAL Cochrane Library and updated to May 2022. Three supplementary searches and a grey literature search were performed. Studies were evaluated with the JBI quality tools and the Oxford Catalogue of Bias. Due to the heterogeneity (diversity) of the studies, a narrative data synthesis was performed on the test findings plus three sub-group analyses.
The review consists of sixteen studies and twenty publications. Spirometry tests comprised the majority of the data. In total, 66 respiratory test measurements were reported, out of which 43 (65%) were not significant. Statistically significant findings were mixed, with 9 tests showing improvements and 14 measuring declines, none of which was clinically relevant. Ten studies were rated at a high risk of bias, and six had some concerns primarily due to inadequate research designs and the conduct of the studies. Reporting bias was documented in thirteen studies.
Most of the studies showed no difference in respiratory parameters. This indicates that ENDS substitution for smoking likely does not result in additional harm to respiratory health. Due to the low quality of the studies, confidence in the conclusions is rated as low. Robust studies with a longer duration and sufficient power are required to validate any potential benefits or possible harms of ENDS substitution. Registration PROSPERO #CRD42021239094, International Registered Report Identifier (IRRID): DERR1-10.2196/29084.
A registered and published protocol was developed conforming to PRISMA 2020 and AMSTAR2 standards. The literature search was conducted in PubMed, Scopus, and the CENTRAL Cochrane Library and updated to May 2022. Three supplementary searches and a grey literature search were performed. Studies were evaluated with the JBI quality tools and the Oxford Catalogue of Bias. Due to the heterogeneity (diversity) of the studies, a narrative data synthesis was performed on the test findings plus three sub-group analyses.
The review consists of sixteen studies and twenty publications. Spirometry tests comprised the majority of the data. In total, 66 respiratory test measurements were reported, out of which 43 (65%) were not significant. Statistically significant findings were mixed, with 9 tests showing improvements and 14 measuring declines, none of which was clinically relevant. Ten studies were rated at a high risk of bias, and six had some concerns primarily due to inadequate research designs and the conduct of the studies. Reporting bias was documented in thirteen studies.
Most of the studies showed no difference in respiratory parameters. This indicates that ENDS substitution for smoking likely does not result in additional harm to respiratory health. Due to the low quality of the studies, confidence in the conclusions is rated as low. Robust studies with a longer duration and sufficient power are required to validate any potential benefits or possible harms of ENDS substitution. Registration PROSPERO #CRD42021239094, International Registered Report Identifier (IRRID): DERR1-10.2196/29084.
摘要：
背景：电子烟（电子尼古丁输送系统，ENDS）已被提出作为一种减少危害的策略，适用于吸烟但无法实现禁欲的人，或那些希望继续享受尼古丁和吸烟习惯的人。用ENDS代替烟草香烟对健康有什么影响？本系统综述评估了吸烟参与者使用ENDS对呼吸的影响的人体临床试验的证据。
方法：开发了符合PRISMA2020和AMSTAR2标准的注册和发布方案。文献检索在PubMed进行，Scopus,和CENTRALCochrane图书馆，并更新至2022年5月。进行了三次补充搜索和灰色文献检索。使用JBI质量工具和牛津偏见目录对研究进行了评估。由于研究的异质性(多样性)，我们对试验结果进行了叙述性数据合成,并进行了3个亚组分析.
结果：这篇综述包括16项研究和20篇出版物。肺活量测定测试包括大部分数据。总的来说,报告了66项呼吸测试测量结果，其中43（65%）不显著。具有统计学意义的发现好坏参半，有9项测试显示改善，14项测量下降，这些都不是临床相关的。十项研究被评为偏倚高风险，六人有一些担忧，主要是由于研究设计和研究的进行不足。在13项研究中记录了报告偏倚。
结论：大多数研究显示呼吸参数没有差异。这表明ENDS替代吸烟可能不会对呼吸道健康造成额外伤害。由于研究质量低，对结论的信心被评为低。需要具有较长持续时间和足够功率的稳健研究来验证ENDS替代的任何潜在益处或可能的危害。注册PROSPERO#CRD42021239094，国际注册报告标识符(IRRID)：DERR1-10.2196/29084。
方法：开发了符合PRISMA2020和AMSTAR2标准的注册和发布方案。文献检索在PubMed进行，Scopus,和CENTRALCochrane图书馆，并更新至2022年5月。进行了三次补充搜索和灰色文献检索。使用JBI质量工具和牛津偏见目录对研究进行了评估。由于研究的异质性(多样性)，我们对试验结果进行了叙述性数据合成,并进行了3个亚组分析.
结果：这篇综述包括16项研究和20篇出版物。肺活量测定测试包括大部分数据。总的来说,报告了66项呼吸测试测量结果，其中43（65%）不显著。具有统计学意义的发现好坏参半，有9项测试显示改善，14项测量下降，这些都不是临床相关的。十项研究被评为偏倚高风险，六人有一些担忧，主要是由于研究设计和研究的进行不足。在13项研究中记录了报告偏倚。
结论：大多数研究显示呼吸参数没有差异。这表明ENDS替代吸烟可能不会对呼吸道健康造成额外伤害。由于研究质量低，对结论的信心被评为低。需要具有较长持续时间和足够功率的稳健研究来验证ENDS替代的任何潜在益处或可能的危害。注册PROSPERO#CRD42021239094，国际注册报告标识符(IRRID)：DERR1-10.2196/29084。
