An update of a systematic review and meta-analyses exploring flavours in intervention studies of e-cigarettes for smoking cessation

Lindson, Nicola, Livingstone-Banks, Jonathan, Butley, Ailsa R., Levy, David T., Barnett, Phoebe, Theodoulou, Annika, Notley, Caitlin ORCID: https://orcid.org/0000-0003-0876-3304, Rigotti, Nancy A., Chen, Yixian and Hartmann-Boyce, Jamie (2024) An update of a systematic review and meta-analyses exploring flavours in intervention studies of e-cigarettes for smoking cessation. Addiction. ISSN 0965-2140

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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 provided and smoking cessation or study product use. One included study randomised participants to two different flavour conditions and found similar cessation rates and long-term e-cigarette use between arms at 12 months. Conclusions: Some people using e-cigarettes to quit smoking switch between e-cigarette flavours during a quit attempt. Sweet flavours may be preferred overall, but this may differ depending on context. Based on intervention studies there is no clear association between the use of e-cigarette flavours and smoking cessation or longer-term e-cigarette use, possibly due to a paucity of data.

Item Type:	Article
Additional Information:	Data Availability Statement: Data sharing not applicable to this article as no new datasets were generated.
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Depositing User:	LivePure Connector
Date Deposited:	29 Nov 2024 01:53
Last Modified:	06 Jan 2025 00:59
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97832
DOI:	10.1111/add.16736

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