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Our second evidence synthesis was a systematic review of primary studies on the benefits and harms of e-cigarettes for smoking cessation,23 which updated an existing Cochrane review from 2016.86 Although Cochrane has since transformed its review into a living systematic review,24 it had not yet done so when we developed our evidence review protocol.87 The Evidence Review and Synthesis Centre at the University of Ottawa conducted the systematic reviews according to our protocol.87 Peer-reviewed search strategies (using the Peer Review of Electronic Search Strategies checklist88) were conducted in MEDLINE, Embase, PsycINFO, and the Cochrane Library in September 2020

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After 1 Year of Smoking Structural Changes Begin Chest CT and HRCT scans of early smokers often show : Airway thickening Mucus gland enlargement Early emphysema-like changes Functional Impairment A study by the European Respiratory Society shows that even 12 months of smoking causes: 510% reduction in lung function Reduced capacity for pollutant clearance Increased incidence of cough, colds, and allergies After 5 Years of Smoking Lung damage, by this stage, has become more pronounced and is visible on imaging