Systematic ReviewResearchMedication SafetyPatient Education

Regulated nicotine e-cigarettes increased quit rates versus nicotine replacement therapy

The Cochrane database of systematic reviews (PubMed)Aug 26, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A living Cochrane review found high-certainty evidence that regulated nicotine e-cigarettes increased six-month-or-longer smoking cessation compared with nicotine replacement therapy, while long-term safety still requires larger, longer studies.

What NurseJet pulled from the source

Eighty randomized trials represented 29,861 participants. Across 11 trials with 4,114 participants, nicotine e-cigarettes increased quit rates versus nicotine replacement therapy, corresponding to about four additional quitters per 100. Serious adverse-event rates were probably similar in that comparison, but the review did not establish long-term safety.

Why this matters for nurses

Nurses routinely assess tobacco use and connect patients with cessation support. The update can inform neutral counseling about comparative trial evidence while preserving attention to product regulation, uncertain long-term harms, patient preference, and approved local cessation pathways.

Bedside takeaway

Discuss regulated nicotine e-cigarettes within a complete cessation pathway, clearly separating quit-rate evidence from unresolved long-term safety.

How This Applies in Practice

Use this when: Providing tobacco-use assessment or cessation education to an adult who smokes combustible cigarettes.

On your shift

Record cigarette, nicotine-vaping, and other inhaled-product use separately, including the patient's quit goals and prior attempts.
Offer the approved cessation counseling, medication, and referral options and explain the evidence in preference-sensitive language.
Clarify that the review studied regulated nicotine products and continue follow-up for abstinence, dual use, and adverse effects.

Keep in mind: Higher quit rates do not make vaping harmless or establish long-term safety. Follow facility policy, the approved cessation pathway, and provider orders.

Key takeaways

The living review included 80 completed randomized trials representing 29,861 participants.
High-certainty evidence showed higher quit rates with nicotine e-cigarettes than with nicotine replacement therapy.
The estimated absolute difference was about four additional quitters per 100 people compared with nicotine replacement therapy.
Trials tested regulated nicotine products; the findings do not apply to illicit products, THC products, or establish long-term safety.

Practice implications

Document combustible-tobacco and vaping use separately, assess readiness to quit, and offer the organization's approved counseling and medication pathway. Explain that the evidence concerns regulated nicotine products and does not mean vaping is risk free.

Limitations & cautions

Only 12 included studies were rated at low overall risk of bias, some safety comparisons were imprecise, and longer and larger trials are needed. Results do not apply to illicit products or products containing other active substances such as THC.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

Open source

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The Cochrane database of systematic reviews (PubMed)

The Cochrane database of systematic reviews (PubMed). Electronic cigarettes for smoking cessation.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42642048/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Renal failure (PubMed)Sep 7, 2026Research Article

A single-center retrospective cohort found that approximately one quarter of laboratory-defined acute kidney injury cases on internal medicine wards were not documented, particularly when maximal creatinine was lower.

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Research ArticleResearchQuality ImprovementAI summary · original source linked below

Among 161 adult hospitalizations meeting serum-creatinine criteria for acute kidney injury, 39 cases (24.2%) were undocumented. Length of stay and in-hospital mortality did not differ significantly by documentation status.

Key takeaways

In the 149 hospitalizations with a demonstrable creatinine change, 33 cases (22.1%) were undocumented.
Higher maximal creatinine was associated with lower adjusted odds of underdocumentation.
The study did not test whether a detection or documentation intervention improves care or outcomes.

Why this matters on shift

A smaller creatinine rise may receive less attention even when it meets the study's laboratory definition of acute kidney injury, which can affect how renal risk is communicated across the inpatient team.

Bedside takeaway

Trend ordered renal-function results and communicate clinically important changes through local escalation and documentation workflows.

Nursing implications

Trend ordered renal-function results and communicate clinically important changes through the care team according to local escalation and documentation workflows.

Limitations & cautions

Abstract-only summary. This was a retrospective, single-center study of 161 hospitalizations; urine-output criteria and reliable preadmission creatinine values were unavailable, and the reference creatinine method may affect case classification.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Renal failure (PubMed). Underdocumentation of laboratory-defined acute kidney injury in internal medicine wards: a retrospective cohort study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

European heart journal (PubMed)Sep 6, 2026Research Article

In the pragmatic TARGET-D randomized trial, vitamin D dosing titrated to a serum target did not significantly reduce the composite of death, recurrent myocardial infarction, heart-failure hospitalization, or stroke after myocardial infarction.

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Research ArticleResearchMedication SafetyPatient EducationAI summary · original source linked below

Among 630 participants followed for an average of 4.2 years, major cardiovascular events occurred in 15.7% with targeted vitamin D management and 18.4% with usual care (hazard ratio 0.85, 95% CI 0.58 to 1.24; P=0.40).

Key takeaways

At baseline, 87% of participants had a 25-hydroxyvitamin D level of 40 ng/mL or lower.
The primary composite outcome and the individual outcomes of death, heart-failure hospitalization, and stroke were not significantly different.
A lower recurrent-MI rate was a secondary finding and should not override the nonsignificant primary result.

Why this matters on shift

The trial cautions against presenting targeted vitamin D supplementation as a proven strategy for reducing major cardiovascular events after myocardial infarction.

Bedside takeaway

Present vitamin D as prescribed supplementation, not as a replacement for established post-MI secondary prevention.

Nursing implications

Reinforce the prescribed secondary-prevention plan and avoid implying that vitamin D replaces therapies with established post-MI benefit.

Limitations & cautions

Abstract-only summary. The trial included 630 participants, 78.1% were men, the primary confidence interval included benefit and no benefit, and individual secondary outcomes were not the primary endpoint.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

European heart journal (PubMed). Targeted vitamin D supplementation and major adverse cardiovascular events after myocardial infarction: the TARGET-D trial.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

Journal of the American Medical Directors Association (PubMed)Sep 5, 2026Research Article

A prospective Dutch nursing-home cohort found clinically important differences in illness burden across respiratory viruses, with influenza and human metapneumovirus standing out.

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Research ArticleResearchInfection ControlAI summary · original source linked below

Among 3,195 residents at 15 nursing homes, 526 suspected acute respiratory-infection episodes were recorded and a virus was identified in 291. Influenza A was associated with delayed recovery, oxygen use, and threefold secondary-bacterial-pneumonia risk; hMPV was linked to fourfold more time in bed.

Key takeaways

SARS-CoV-2, influenza A, rhinovirus or enterovirus, and RSV were the most frequently identified viruses.
hMPV and RSV tended to have higher odds of moderate or severe disease.
Virus-specific patterns were associations from a cohort, not randomized comparisons.

Why this matters on shift

Frailty can amplify respiratory-infection consequences, and the causative virus may help anticipate recovery, oxygen, mobility, and secondary-infection needs.

Bedside takeaway

Trend oxygen needs, mobility, recovery, and secondary-pneumonia signs during nursing-home respiratory infections.

Nursing implications

During outbreaks or suspected infection, trend oxygen needs, mobility and time in bed, recovery, and signs of bacterial pneumonia according to facility protocols.

Limitations & cautions

Abstract-only summary. Data came from 15 Dutch nursing homes, the overall suspected-infection risk estimate was imprecise, and virus-outcome comparisons may be affected by confounding and small subgroup counts.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Journal of the American Medical Directors Association (PubMed). Clinical Impact of Acute Respiratory Virus Infections in Nursing Home Residents.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

One in four laboratory-defined AKI cases went undocumented on medicine wards

Targeted vitamin D did not significantly reduce major cardiovascular events after MI

Influenza and hMPV carried substantial illness burden in nursing home residents