Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

107 questions · 114 findings · 15 reviews

No studies found 7 · 6.1%GRADE not reported 18 · 15.8%Very low 24 · 21.1%Low 42 · 36.8%Moderate 13 · 11.4%High 10 · 8.8%

Electronic cigarette use vs Non-smokers (non-users)

Periodontitis / periodontal disease and periodontal parameters · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users appear more likely to develop periodontal disease and worse periodontal parameters than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine) vs Unexposed controls / unflavored e-liquid / conventional cigarette smoke

Enamel/dental hard-tissue changes and e-liquid cariogenic properties (demineralization, colour change, pH, sugar content, metals) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome…

In vitro evidence suggests e-liquids are often acidic and sugar-containing and can alter enamel/dentin colour and properties, supporting a plausible cariogenic effect, but findings are heterogeneous and not pooled (ungraded, narrative).

1 finding from 1 review

E-cigarette aerosol / e-liquid exposure (flavored and unflavored; nicotine and non-nicotine) vs Unexposed controls / unflavored e-liquid / conventional cigarette smoke

Cariogenic and commensal oral bacteria (S. mutans and commensal streptococci growth, adhesion, biofilm) · Oral bacteria (streptococci), dental hard tissue (enamel/dentin) and e-liquids studied in vitro/ex vivo (with a few clinical microbiome…

Most in vitro studies indicate e-cigarette aerosol/e-liquid (especially flavored/high-concentration) disrupts normal oral flora and favors cariogenic S. mutans growth and biofilm, plausibly increasing caries risk; not pooled (ungraded, narrative).

1 finding from 1 review

Intervention not reported

Nicotine tapering · adults (aged ≥ 18 years) who smoked cigarettes Components: components of pharmacological and e‐cigarette (EC) interventions for smoking…

The intervention showed no clear difference in nicotine tapering (low certainty).

1 finding from 1 review

Intervention not reported

Nicotine patch · adults (aged ≥ 18 years) who smoked cigarettes Components: components of pharmacological and e‐cigarette (EC) interventions for smoking…

The intervention showed no clear difference in nicotine patch (low certainty).

1 finding from 1 review

Intervention not reported

Fast‐acting NRT (nicotine other) · adults (aged ≥ 18 years) who smoked cigarettes Components: components of pharmacological and e‐cigarette (EC) interventions for smoking…

The intervention showed no clear difference in fast‐acting NRT (nicotine other) (low certainty).

1 finding from 1 review

Intervention not reported

Fast‐acting NRT (nicotine other) · adults (aged ≥ 18 years) who smoked cigarettes Components: components of pharmacological and e‐cigarette (EC) interventions for smoking…

The intervention leads to higher fast‐acting NRT (nicotine other) (high certainty).

1 finding from 1 review

Intervention not reported

Non‐nicotine/placebo EC · adults (aged ≥ 18 years) who smoked cigarettes Components: components of pharmacological and e‐cigarette (EC) interventions for smoking…

The intervention showed no clear difference in non‐nicotine/placebo EC (low certainty).

1 finding from 1 review

Intervention not reported

Cessation: Low‐nicotine cigarettes vs regular cigarettes · Smokers who cannot or do not want to quit smoking

It is very uncertain whether the intervention changes cessation: Low‐nicotine cigarettes vs regular cigarettes (very low certainty).

1 finding from 1 review

Intervention not reported

Number of smokers receiving nicotine gum/replacement therapy self‐report · Smokers treated by health professionals

The intervention showed no clear difference in number of smokers receiving nicotine gum/replacement therapy… (low certainty).

1 finding from 1 review