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Its use is only contraindicated in smokers with ischaemic heart disease of less than 4 weeks duration and in subjects with severe cardiac arrhythmias.41 A recent meta-analysis found that using standard dose nicotine patches for the 15 days prior to D-day was accompanied by an increase in their efficacy compared to when they were used with the usual regimen (OR: 2.17 [95% CI: 1.463.22).43 Nevertheless, this is a consistent recommendation with low quality evidence

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Nicotine addiction: E-cigarettes often contain high levels of nicotine, leading to dependence, withdrawal, and long-term cardiovascular risks

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