A new study published in Public Health Reports, “Comparison of e-Cigarette and Cigarette Use and Dual Use Associations With Disease: Updated Systematic Review and Meta-Analysis“, finds that e-cigarette use is associated with disease risks that are similar to or approach those linked to combustible cigarette use. Conducted by researchers Stanton A. Glantz and Andre Luiz Oliveira da Silva, the updated review also found that dual use of e-cigarettes and cigarettes is associated with even greater harm across multiple health outcomes. The findings add to a growing body of evidence informing public health policy and tobacco prevention efforts.

The study updated a previous meta-analysis by reviewing population-based research published between 2005 and 2025. Researchers analyzed 142 odds ratios drawn from 124 articles examining associations between e-cigarette use, cigarette use, and dual use across a range of disease outcomes, including cardiovascular disease, stroke, asthma, chronic obstructive pulmonary disease, metabolic dysfunction, oral disease, and fetal growth outcomes.

The analysis found that e-cigarette use was associated with elevated odds of disease compared with nonuse, while dual use was consistently associated with higher risks than cigarette use alone. According to the authors, the evidence increasingly demonstrates that e-cigarettes should not be promoted as a safer alternative to combustible cigarettes.

The researchers also emphasized the importance of using the most current scientific evidence to guide clinical recommendations and public health policy as research on e-cigarette use and long-term health outcomes continues to expand rapidly.