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Article History

Received: 9 April 2026

Accepted: 3 June 2026

First Online: 13 June 2026

Declarations

Conflict of interests: Najim Z. Alshahrani, Davide Campagna, Antonio Ceriello, Anoop Misra, Anas Ali Alhur, Abdul Basit, Cristina Russo, Tadej Battelino, Noel Somasundaram, Muhammad Yazid Jalaludin, Yoshifumi Saisho, Venera Tomaselli, Dianna J. Magliano, Othmar Moser, Joanna Mitri, and Roger Chen declare no conflicts of interest relevant to this work. Magdalena Walicka has received honoraria for lectures from Sanofi, AstraZeneca, Teva, and Eli Lilly, and has received support for attending meetings from Sanofi, Novo Nordisk, and Berlin-Chemie. Yusuff Adebayo Adebisi has previously received funding through the Tobacco Harm Reduction Scholarship and the Kevin Molloy Fellowship, both awarded by Knowledge-Action-Change (KAC), an independent public health organisation based in the United Kingdom. KAC receives funding from Global Action to End Smoking (GA), an independent U.S. nonprofit 501(c)(3) grant-making organisation that supports health and science research, cessation education, and agricultural transformation initiatives. Riccardo Polosa is a full tenured Professor of Internal Medicine at the University of Catania (Italy) and Medical Director of the Institute for Internal Medicine at the same university. He has received EU and governmental competitive grants including U-BIOPRED, AIR-PROM, Integral Rheumatology & Immunology Specialists Network (IRIS), and several PNRR grants funded by NextGenerationEU of the European Commission. He has also received investigator-initiated grants from GA, Pfizer, GlaxoSmithKline, CV Therapeutics, NeuroSearch A/S, Sandoz, Merck Sharp & Dohme, Boehringer Ingelheim, Novartis, Arbi Group Srl., Duska Therapeutics, and Forest Laboratories. He is the founder of the Center for Tobacco Prevention and Treatment (CPCT) and the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) at the University of Catania. He has received consultancy fees from Pfizer, Boehringer Ingelheim, Duska Therapeutics, Forest Laboratories, CV Therapeutics, Sermo Inc., GRG Health, Clarivate Analytics, Guidepoint Expert Network, and GLG Group. He receives textbook royalties from Elsevier and EDRA. He is Chair of the European Technical Committee for Standardisation on “Requirements and test methods for emissions of electronic cigarettes” (CEN/TC 437; WG4) and scientific advisor of the non-profit Foundation RIDE2Med.

Ethics approval and consent to participate: This study was a systematic review and meta-analysis of previously published, publicly available studies. No new primary data were collected. Ethical approval was therefore not required.

Consent for publication: Not applicable.

Human and animal rights: This article does not contain any studies with humans or animals conducted by any of the authors.

Informed consent: For this type of study, formal consent is not required.