International Journal of Public Health

, Volume 61, Issue 2, pp 257–267 | Cite as

The efficacy and short-term effects of electronic cigarettes as a method for smoking cessation: a systematic review and a meta-analysis

  • S. KhoudigianEmail author
  • T. Devji
  • L. Lytvyn
  • K. Campbell
  • R. Hopkins
  • D. O’Reilly



E-cigarettes are increasingly popular as smoking cessation aids. This review assessed the efficacy of e-cigarettes for smoking cessation as well as desire to smoke, withdrawal symptoms, and adverse events in adult smokers.


A systematic review was conducted. Studies comparing e-cigarettes to other nicotine replacement therapies or placebo were included. Data were pooled using meta-analysis.


Of 569 articles, 5 were eligible. Study participants were more likely to stop smoking when using nicotine e-cigarettes (43/489, 9 %) versus placebo e-cigarettes (8/173, 5 %); however, this difference was not statistically significant (RR 2.02; 95 % CI 0.97, 4.22). The pooled effect estimates for the desire to smoke (RR −0.22; 95 % CI −0.80, 0.36), irritability (RR −0.03; 95% CI −0.38, 0.31), restlessness (RR −0.03; 95 % CI −0.42, 0.35), poor concentration (RR −0.01; 95 % CI −0.35, 0.32), depression (RR −0.01; 95 % CI −0.22, 0.20), hunger (RR −0.01; 95 % CI −0.32, 0.30), and average number of non-serious adverse events (RR −0.09; 95 % CI −0.28, 0.46) were not statistically significantly different. Only one study reported serious adverse events with no apparent association with e-cigarette use.


Limited low-quality evidence of a non-statistically significant trend toward smoking cessation in adults using nicotine e-cigarettes exists compared with other therapies or placebo. Larger, high-quality studies are needed to inform policy decisions.


Meta-analysis E-cigarettes Smoking cessation Withdrawal symptoms Public health 


Compliance with ethical standards

Conflict of interest

The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.


The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author contribution statement

SK and DO designed the systematic review and meta-analysis protocol. SK and KC created the search strategy. SK and TD searched for publications, and did the review and data extraction, and LL helped with the disagreements. SK, DO, and RΒ developed the analysis frame. SK and TD did the analysis, and SK and DO critically interpreted the results. SK drafted the article, and all authors provided critical revision of the article.

Supplementary material

38_2016_786_MOESM1_ESM.docx (48 kb)
Supplementary material 1 (DOCX 48 kb)
38_2016_786_MOESM2_ESM.docx (21 kb)
Supplementary material 2 (DOCX 21 kb)


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Copyright information

© Swiss School of Public Health (SSPH+) 2016

Authors and Affiliations

  • S. Khoudigian
    • 1
    Email author
  • T. Devji
    • 1
  • L. Lytvyn
    • 1
  • K. Campbell
    • 1
    • 2
    • 3
  • R. Hopkins
    • 1
    • 2
    • 3
  • D. O’Reilly
    • 1
    • 2
    • 3
  1. 1.Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada
  2. 2.PATH Research InstituteSt Joseph’s Healthcare HamiltonHamiltonCanada
  3. 3.Research Institute of St. Joseph’sHamiltonCanada

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