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it penetrates deep into the enamel and even the dentin, the layer beneath the enamel, making it more challenging to remove
[20] A 2015 review found "Avoiding withdrawal symptoms is one of the causes of continued smoking or relapses during attempts at cessation, and the severity and duration of nicotine withdrawal symptoms predict relapse." [23] Symptoms of nicotine dependence include irritability, anger, impatience, and problems in concentrating
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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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