全球关于电子烟（电子烟，vape）健康影响的证据进行复审和综合分析。伞形综述（基于主要独立综述，包括2018年美国国家科学、工程和医学院[NASEM]报告）和对NASEM报告以后发表的关于电子烟使用与人类健康结果关系的发表和同行评审的研究的补充系统综述。伞形综述：2017-2021年发表的8个主要独立综述。系统综述：PubMed、MEDLINE、Scopus、Web of Science、Cochrane图书馆和PsycINFO（发表于2017年7月至2020年7月且未纳入NASEM综述的文章）。我们的综合包括400篇符合条件的出版物：112篇来自NASEM综述，189篇来自我们的补充综述搜索，另有99篇其他综述引用过的文献。有确凿证据表明，电子烟使用与中毒、即时吸入毒性（包括癫痫），以及与电子烟或蒸汽产品使用相关的肺损伤（EVALI; 它主要但不仅限于含有四氢大麻酚和维生素E醋酸盐的e-液体），以及导致伤害和烧伤的设备故障有着关联。环境效应包括废物、火灾以及产生室内空气微粒物（充分到确凿的证据）。有充分证据表明尼古丁电子烟可以在非吸烟者中引起依赖或成瘾，并且强有力的证据表明年轻非吸烟者使用电子烟比不使用者更可能开始吸烟并成为常吸烟者。有限的证据表明，结合临床支持使用自由基尼古丁电子烟是有效的戒烟辅助措施。关于电子烟对其他临床结果的影响，包括心血管疾病、癌症、发育和心理及生殖健康方面的影响，证据不充分或不可得。电子烟可能对健康有害，特别是对非吸烟者、儿童、青少年和年轻成年人。它们对许多重要的健康结果的影响不确定。电子烟可能对完全戒烟并迅速戒烟的吸烟者有益，但它们目前不是获批的戒烟辅助措施。需要更好的证据来了解电子烟使用对健康的影响、对戒烟的安全性和有效性以及有效的管理。系统综述：PROSPERO，CRD42020200673（前瞻性）。©2023年作者。由John Wiley＆Sons Australia，Ltd代表AMPCo Pty Ltd出版的《澳大利亚医学杂志》。

To review and synthesise the global evidence regarding the health effects of electronic cigarettes (e-cigarettes, vapes).Umbrella review (based on major independent reviews, including the 2018 United States National Academies of Sciences, Engineering, and Medicine [NASEM] report) and top-up systematic review of published, peer-reviewed studies in humans examining the relationship of e-cigarette use to health outcomes published since the NASEM report.Umbrella review: eight major independent reviews published 2017-2021. Systematic review: PubMed, MEDLINE, Scopus, Web of Science, the Cochrane Library, and PsycINFO (articles published July 2017 - July 2020 and not included in NASEM review).Four hundred eligible publications were included in our synthesis: 112 from the NASEM review, 189 from our top-up review search, and 99 further publications cited by other reviews. There is conclusive evidence linking e-cigarette use with poisoning, immediate inhalation toxicity (including seizures), and e-cigarette or vaping product use-associated lung injury (EVALI; largely but not exclusively for e-liquids containing tetrahydrocannabinol and vitamin E acetate), as well as for malfunctioning devices causing injuries and burns. Environmental effects include waste, fires, and generation of indoor airborne particulate matter (substantial to conclusive evidence). There is substantial evidence that nicotine e-cigarettes can cause dependence or addiction in non-smokers, and strong evidence that young non-smokers who use e-cigarettes are more likely than non-users to initiate smoking and to become regular smokers. There is limited evidence that freebase nicotine e-cigarettes used with clinical support are efficacious aids for smoking cessation. Evidence regarding effects on other clinical outcomes, including cardiovascular disease, cancer, development, and mental and reproductive health, is insufficient or unavailable.E-cigarettes can be harmful to health, particularly for non-smokers and children, adolescents, and young adults. Their effects on many important health outcomes are uncertain. E-cigarettes may be beneficial for smokers who use them to completely and promptly quit smoking, but they are not currently approved smoking cessation aids. Better quality evidence is needed regarding the health impact of e-cigarette use, their safety and efficacy for smoking cessation, and effective regulation.Systematic review: PROSPERO, CRD42020200673 (prospective).© 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.