Association between electronic nicotine delivery systems use and risk of stroke: a meta-analysis of 1,024,401 participants

Abstract

IntroductionTo evaluate the relationship between electronic nicotine delivery systems (ENDS) use and the risk of stroke when compared to non-smokers.Material and methodsA comprehensive search was conducted until June 15, 2023. We included observational studies that assessed association of current or former usage of ENDS with risk of stroke compared with non-smokers, reported the risk estimate as odds ratio (OR) or hazard ratio (HR) and were adjusted for possible confounders.Results6 studies with 1,024,401 participants were included in our analysis. ENDS use was associated with a significant increased risk of stroke (OR = 1.52; 95% CI: 1.17–1.97) compared with non-users. A non-significant association was found between former ENDS use and risk of stroke (OR = 1.03; 95% CI: 0.87–1.21).ConclusionsThe ENDS usage appears to be associated with a higher risk of stroke compared to non-use, whereas there was no association between former ENDS use and the risk of stroke.