what is the importance literature review

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• Literature Review: The What, Why and How-to Guide
• Introduction

Literature Review: The What, Why and How-to Guide — Introduction

• Getting Started
• How to Pick a Topic
• Strategies to Find Sources
• Evaluating Sources & Lit. Reviews
• Tips for Writing Literature Reviews
• Writing Literature Review: Useful Sites
• Citation Resources
• Other Academic Writings

What are Literature Reviews?

So, what is a literature review? "A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries." Taylor, D.  The literature review: A few tips on conducting it . University of Toronto Health Sciences Writing Centre.

Goals of Literature Reviews

What are the goals of creating a Literature Review?  A literature could be written to accomplish different aims:

• To develop a theory or evaluate an existing theory
• To summarize the historical or existing state of a research topic
• Identify a problem in a field of research 

Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews .  Review of General Psychology , 1 (3), 311-320.

What kinds of sources require a Literature Review?

• A research paper assigned in a course
• A thesis or dissertation
• A grant proposal
• An article intended for publication in a journal

All these instances require you to collect what has been written about your research topic so that you can demonstrate how your own research sheds new light on the topic.

Types of Literature Reviews

What kinds of literature reviews are written?

Narrative review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.

• Example : Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework:  10.1177/08948453211037398  

Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L. K. (2013). Research in Communication Sciences and Disorders . Plural Publishing.

• Example : The effect of leave policies on increasing fertility: a systematic review:  10.1057/s41599-022-01270-w

Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M. C., & Ilardi, S. S. (2003). Handbook of Research Methods in Clinical Psychology . Blackwell Publishing.

• Example : Employment Instability and Fertility in Europe: A Meta-Analysis:  10.1215/00703370-9164737

Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). Qualitative meta-synthesis: A question of dialoguing with texts .  Journal of Advanced Nursing , 53 (3), 311-318.

• Example : Women’s perspectives on career successes and barriers: A qualitative meta-synthesis:  10.1177/05390184221113735

Literature Reviews in the Health Sciences

• UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
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What is the Purpose of a Literature Review?

4-minute read

• 23rd October 2023

If you’re writing a research paper or dissertation , then you’ll most likely need to include a comprehensive literature review . In this post, we’ll review the purpose of literature reviews, why they are so significant, and the specific elements to include in one. Literature reviews can:

1. Provide a foundation for current research.

2. Define key concepts and theories.

3. Demonstrate critical evaluation.

4. Show how research and methodologies have evolved.

5. Identify gaps in existing research.

6. Support your argument.

Keep reading to enter the exciting world of literature reviews!

What is a Literature Review?

A literature review is a critical summary and evaluation of the existing research (e.g., academic journal articles and books) on a specific topic. It is typically included as a separate section or chapter of a research paper or dissertation, serving as a contextual framework for a study. Literature reviews can vary in length depending on the subject and nature of the study, with most being about equal length to other sections or chapters included in the paper. Essentially, the literature review highlights previous studies in the context of your research and summarizes your insights in a structured, organized format. Next, let’s look at the overall purpose of a literature review.

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Literature reviews are considered an integral part of research across most academic subjects and fields. The primary purpose of a literature review in your study is to:

Provide a Foundation for Current Research

Since the literature review provides a comprehensive evaluation of the existing research, it serves as a solid foundation for your current study. It’s a way to contextualize your work and show how your research fits into the broader landscape of your specific area of study.  

Define Key Concepts and Theories

The literature review highlights the central theories and concepts that have arisen from previous research on your chosen topic. It gives your readers a more thorough understanding of the background of your study and why your research is particularly significant .

Demonstrate Critical Evaluation 

A comprehensive literature review shows your ability to critically analyze and evaluate a broad range of source material. And since you’re considering and acknowledging the contribution of key scholars alongside your own, it establishes your own credibility and knowledge.

Show How Research and Methodologies Have Evolved

Another purpose of literature reviews is to provide a historical perspective and demonstrate how research and methodologies have changed over time, especially as data collection methods and technology have advanced. And studying past methodologies allows you, as the researcher, to understand what did and did not work and apply that knowledge to your own research.  

Identify Gaps in Existing Research

Besides discussing current research and methodologies, the literature review should also address areas that are lacking in the existing literature. This helps further demonstrate the relevance of your own research by explaining why your study is necessary to fill the gaps.

Support Your Argument

A good literature review should provide evidence that supports your research questions and hypothesis. For example, your study may show that your research supports existing theories or builds on them in some way. Referencing previous related studies shows your work is grounded in established research and will ultimately be a contribution to the field.  

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Ensure your literature review is polished and ready for submission by having it professionally proofread and edited by our expert team. Our literature review editing services will help your research stand out and make an impact. Not convinced yet? Send in your free sample today and see for yourself! 

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• University of Texas Libraries

Literature Reviews

• What is a literature review?
• Steps in the Literature Review Process
• Define your research question
• Determine inclusion and exclusion criteria
• Choose databases and search
• Review Results
• Synthesize Results
• Analyze Results
• Librarian Support

What is a Literature Review?

A literature or narrative review is a comprehensive review and analysis of the published literature on a specific topic or research question. The literature that is reviewed contains: books, articles, academic articles, conference proceedings, association papers, and dissertations. It contains the most pertinent studies and points to important past and current research and practices. It provides background and context, and shows how your research will contribute to the field. 

A literature review should: 

• Provide a comprehensive and updated review of the literature;
• Explain why this review has taken place;
• Articulate a position or hypothesis;
• Acknowledge and account for conflicting and corroborating points of view

From  S age Research Methods

Purpose of a Literature Review

A literature review can be written as an introduction to a study to:

• Demonstrate how a study fills a gap in research
• Compare a study with other research that's been done

Or it can be a separate work (a research article on its own) which:

• Organizes or describes a topic
• Describes variables within a particular issue/problem

Limitations of a Literature Review

Some of the limitations of a literature review are:

• It's a snapshot in time. Unlike other reviews, this one has beginning, a middle and an end. There may be future developments that could make your work less relevant.
• It may be too focused. Some niche studies may miss the bigger picture.
• It can be difficult to be comprehensive. There is no way to make sure all the literature on a topic was considered.
• It is easy to be biased if you stick to top tier journals. There may be other places where people are publishing exemplary research. Look to open access publications and conferences to reflect a more inclusive collection. Also, make sure to include opposing views (and not just supporting evidence).

Source: Grant, Maria J., and Andrew Booth. “A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies.” Health Information & Libraries Journal, vol. 26, no. 2, June 2009, pp. 91–108. Wiley Online Library, doi:10.1111/j.1471-1842.2009.00848.x.

Meryl Brodsky : Communication and Information Studies

Hannah Chapman Tripp : Biology, Neuroscience

Carolyn Cunningham : Human Development & Family Sciences, Psychology, Sociology

Larayne Dallas : Engineering

Janelle Hedstrom : Special Education, Curriculum & Instruction, Ed Leadership & Policy ​

Susan Macicak : Linguistics

Imelda Vetter : Dell Medical School

For help in other subject areas, please see the guide to library specialists by subject .

Periodically, UT Libraries runs a workshop covering the basics and library support for literature reviews. While we try to offer these once per academic year, we find providing the recording to be helpful to community members who have missed the session. Following is the most recent recording of the workshop, Conducting a Literature Review. To view the recording, a UT login is required.

• October 26, 2022 recording
• Last Updated: Oct 26, 2022 2:49 PM
• URL: https://guides.lib.utexas.edu/literaturereviews

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Conducting a literature review: why do a literature review, why do a literature review.

• How To Find "The Literature"
• Found it -- Now What?

Besides the obvious reason for students -- because it is assigned! -- a literature review helps you explore the research that has come before you, to see how your research question has (or has not) already been addressed.

You identify:

• core research in the field
• experts in the subject area
• methodology you may want to use (or avoid)
• gaps in knowledge -- or where your research would fit in

It Also Helps You:

• Publish and share your findings
• Justify requests for grants and other funding
• Identify best practices to inform practice
• Set wider context for a program evaluation
• Compile information to support community organizing

Great brief overview, from NCSU

Want To Know More?

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• Last Updated: Apr 25, 2024 1:10 PM
• URL: https://guides.lib.berkeley.edu/litreview

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Literature Review: The What, Why and How-to Guide: Literature Reviews?

• Literature Reviews?
• Strategies to Finding Sources
• Keeping up with Research!
• Evaluating Sources & Literature Reviews
• Organizing for Writing
• Writing Literature Review
• Other Academic Writings

What is a Literature Review?

So, what is a literature review .

"A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available or a set of summaries." - Quote from Taylor, D. (n.d)."The Literature Review: A Few Tips on Conducting it".

• Citation: "The Literature Review: A Few Tips on Conducting it"

What kinds of literature reviews are written?

Each field has a particular way to do reviews for academic research literature. In the social sciences and humanities the most common are:

• Narrative Reviews: The purpose of this type of review is to describe the current state of the research on a specific research topic and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weaknesses, and gaps are identified. The review ends with a conclusion section that summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.
• Book review essays/ Historiographical review essays : A type of literature review typical in History and related fields, e.g., Latin American studies. For example, the Latin American Research Review explains that the purpose of this type of review is to “(1) to familiarize readers with the subject, approach, arguments, and conclusions found in a group of books whose common focus is a historical period; a country or region within Latin America; or a practice, development, or issue of interest to specialists and others; (2) to locate these books within current scholarship, critical methodologies, and approaches; and (3) to probe the relation of these new books to previous work on the subject, especially canonical texts. Unlike individual book reviews, the cluster reviews found in LARR seek to address the state of the field or discipline and not solely the works at issue.” - LARR

What are the Goals of Creating a Literature Review?

• To develop a theory or evaluate an existing theory
• To summarize the historical or existing state of a research topic
• Identify a problem in a field of research 
• Baumeister, R.F. & Leary, M.R. (1997). "Writing narrative literature reviews," Review of General Psychology , 1(3), 311-320.

When do you need to write a Literature Review?

• When writing a prospectus or a thesis/dissertation
• When writing a research paper
• When writing a grant proposal

In all these cases you need to dedicate a chapter in these works to showcase what has been written about your research topic and to point out how your own research will shed new light into a body of scholarship.

Where I can find examples of Literature Reviews?

Note:  In the humanities, even if they don't use the term "literature review", they may have a dedicated  chapter that reviewed the "critical bibliography" or they incorporated that review in the introduction or first chapter of the dissertation, book, or article.

• UCSB electronic theses and dissertations In partnership with the Graduate Division, the UC Santa Barbara Library is making available theses and dissertations produced by UCSB students. Currently included in ADRL are theses and dissertations that were originally filed electronically, starting in 2011. In future phases of ADRL, all theses and dissertations created by UCSB students may be digitized and made available.

Where to Find Standalone Literature Reviews

Literature reviews are also written as standalone articles as a way to survey a particular research topic in-depth. This type of literature review looks at a topic from a historical perspective to see how the understanding of the topic has changed over time. 

• Find e-Journals for Standalone Literature Reviews The best way to get familiar with and to learn how to write literature reviews is by reading them. You can use our Journal Search option to find journals that specialize in publishing literature reviews from major disciplines like anthropology, sociology, etc. Usually these titles are called, "Annual Review of [discipline name] OR [Discipline name] Review. This option works best if you know the title of the publication you are looking for. Below are some examples of these journals! more... less... Journal Search can be found by hovering over the link for Research on the library website.

Social Sciences

• Annual Review of Anthropology
• Annual Review of Political Science
• Annual Review of Sociology
• Ethnic Studies Review

Hard science and health sciences:

• Annual Review of Biomedical Data Science
• Annual Review of Materials Science
• Systematic Review From journal site: "The journal Systematic Reviews encompasses all aspects of the design, conduct, and reporting of systematic reviews" in the health sciences.
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• Last Updated: Mar 5, 2024 11:44 AM
• URL: https://guides.library.ucsb.edu/litreview

What Is A Literature Review?

A plain-language explainer (with examples).

By:  Derek Jansen (MBA) & Kerryn Warren (PhD) | June 2020 (Updated May 2023)

If you’re faced with writing a dissertation or thesis, chances are you’ve encountered the term “literature review” . If you’re on this page, you’re probably not 100% what the literature review is all about. The good news is that you’ve come to the right place.

Literature Review 101

• What (exactly) is a literature review
• What’s the purpose of the literature review chapter
• How to find high-quality resources
• How to structure your literature review chapter
• Example of an actual literature review

What is a literature review?

The word “literature review” can refer to two related things that are part of the broader literature review process. The first is the task of  reviewing the literature  – i.e. sourcing and reading through the existing research relating to your research topic. The second is the  actual chapter  that you write up in your dissertation, thesis or research project. Let’s look at each of them:

Reviewing the literature

The first step of any literature review is to hunt down and  read through the existing research  that’s relevant to your research topic. To do this, you’ll use a combination of tools (we’ll discuss some of these later) to find journal articles, books, ebooks, research reports, dissertations, theses and any other credible sources of information that relate to your topic. You’ll then  summarise and catalogue these  for easy reference when you write up your literature review chapter. 

The literature review chapter

The second step of the literature review is to write the actual literature review chapter (this is usually the second chapter in a typical dissertation or thesis structure ). At the simplest level, the literature review chapter is an  overview of the key literature  that’s relevant to your research topic. This chapter should provide a smooth-flowing discussion of what research has already been done, what is known, what is unknown and what is contested in relation to your research topic. So, you can think of it as an  integrated review of the state of knowledge  around your research topic. 

What’s the purpose of a literature review?

The literature review chapter has a few important functions within your dissertation, thesis or research project. Let’s take a look at these:

Purpose #1 – Demonstrate your topic knowledge

The first function of the literature review chapter is, quite simply, to show the reader (or marker) that you  know what you’re talking about . In other words, a good literature review chapter demonstrates that you’ve read the relevant existing research and understand what’s going on – who’s said what, what’s agreed upon, disagreed upon and so on. This needs to be  more than just a summary  of who said what – it needs to integrate the existing research to  show how it all fits together  and what’s missing (which leads us to purpose #2, next). 

Purpose #2 – Reveal the research gap that you’ll fill

The second function of the literature review chapter is to  show what’s currently missing  from the existing research, to lay the foundation for your own research topic. In other words, your literature review chapter needs to show that there are currently “missing pieces” in terms of the bigger puzzle, and that  your study will fill one of those research gaps . By doing this, you are showing that your research topic is original and will help contribute to the body of knowledge. In other words, the literature review helps justify your research topic.  

Purpose #3 – Lay the foundation for your conceptual framework

The third function of the literature review is to form the  basis for a conceptual framework . Not every research topic will necessarily have a conceptual framework, but if your topic does require one, it needs to be rooted in your literature review. 

For example, let’s say your research aims to identify the drivers of a certain outcome – the factors which contribute to burnout in office workers. In this case, you’d likely develop a conceptual framework which details the potential factors (e.g. long hours, excessive stress, etc), as well as the outcome (burnout). Those factors would need to emerge from the literature review chapter – they can’t just come from your gut! 

So, in this case, the literature review chapter would uncover each of the potential factors (based on previous studies about burnout), which would then be modelled into a framework. 

Purpose #4 – To inform your methodology

The fourth function of the literature review is to  inform the choice of methodology  for your own research. As we’ve  discussed on the Grad Coach blog , your choice of methodology will be heavily influenced by your research aims, objectives and questions . Given that you’ll be reviewing studies covering a topic close to yours, it makes sense that you could learn a lot from their (well-considered) methodologies.

So, when you’re reviewing the literature, you’ll need to  pay close attention to the research design , methodology and methods used in similar studies, and use these to inform your methodology. Quite often, you’ll be able to  “borrow” from previous studies . This is especially true for quantitative studies , as you can use previously tried and tested measures and scales. 

How do I find articles for my literature review?

Finding quality journal articles is essential to crafting a rock-solid literature review. As you probably already know, not all research is created equally, and so you need to make sure that your literature review is  built on credible research . 

We could write an entire post on how to find quality literature (actually, we have ), but a good starting point is Google Scholar . Google Scholar is essentially the academic equivalent of Google, using Google’s powerful search capabilities to find relevant journal articles and reports. It certainly doesn’t cover every possible resource, but it’s a very useful way to get started on your literature review journey, as it will very quickly give you a good indication of what the  most popular pieces of research  are in your field.

One downside of Google Scholar is that it’s merely a search engine – that is, it lists the articles, but oftentimes  it doesn’t host the articles . So you’ll often hit a paywall when clicking through to journal websites. 

Thankfully, your university should provide you with access to their library, so you can find the article titles using Google Scholar and then search for them by name in your university’s online library. Your university may also provide you with access to  ResearchGate , which is another great source for existing research. 

Remember, the correct search keywords will be super important to get the right information from the start. So, pay close attention to the keywords used in the journal articles you read and use those keywords to search for more articles. If you can’t find a spoon in the kitchen, you haven’t looked in the right drawer. 

Need a helping hand?

How should I structure my literature review?

Unfortunately, there’s no generic universal answer for this one. The structure of your literature review will depend largely on your topic area and your research aims and objectives.

You could potentially structure your literature review chapter according to theme, group, variables , chronologically or per concepts in your field of research. We explain the main approaches to structuring your literature review here . You can also download a copy of our free literature review template to help you establish an initial structure.

In general, it’s also a good idea to start wide (i.e. the big-picture-level) and then narrow down, ending your literature review close to your research questions . However, there’s no universal one “right way” to structure your literature review. The most important thing is not to discuss your sources one after the other like a list – as we touched on earlier, your literature review needs to synthesise the research , not summarise it .

Ultimately, you need to craft your literature review so that it conveys the most important information effectively – it needs to tell a logical story in a digestible way. It’s no use starting off with highly technical terms and then only explaining what these terms mean later. Always assume your reader is not a subject matter expert and hold their hand through a journe y of the literature while keeping the functions of the literature review chapter (which we discussed earlier) front of mind.

Example of a literature review

In the video below, we walk you through a high-quality literature review from a dissertation that earned full distinction. This will give you a clearer view of what a strong literature review looks like in practice and hopefully provide some inspiration for your own. 

Wrapping Up

In this post, we’ve (hopefully) answered the question, “ what is a literature review? “. We’ve also considered the purpose and functions of the literature review, as well as how to find literature and how to structure the literature review chapter. If you’re keen to learn more, check out the literature review section of the Grad Coach blog , as well as our detailed video post covering how to write a literature review . 

Psst… there’s more!

This post is an extract from our bestselling short course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

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• What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research.

There are five key steps to writing a literature review:

• Search for relevant literature
• Evaluate sources
• Identify themes, debates and gaps
• Outline the structure
• Write your literature review

A good literature review doesn’t just summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

Why write a literature review, examples of literature reviews, step 1: search for relevant literature, step 2: evaluate and select sources, step 3: identify themes, debates and gaps, step 4: outline your literature review’s structure, step 5: write your literature review, frequently asked questions about literature reviews, introduction.

• Quick Run-through
• Step 1 & 2

When you write a dissertation or thesis, you will have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:

• Demonstrate your familiarity with the topic and scholarly context
• Develop a theoretical framework and methodology for your research
• Position yourself in relation to other researchers and theorists
• Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

Prevent plagiarism, run a free check.

Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.

• Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
• Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
• Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
• Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)

You can also check out our templates with literature review examples and sample outlines at the links below.

Download Word doc Download Google doc

Before you begin searching for literature, you need a clearly defined topic .

If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research objectives and questions .

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

Start by creating a list of keywords related to your research topic. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list if you discover new keywords in the process of your literature search.

• Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
• Body image, self-perception, self-esteem, mental health
• Generation Z, teenagers, adolescents, youth

Search for relevant sources

Use your keywords to begin searching for sources. Some databases to search for journals and articles include:

• Your university’s library catalogue
• Google Scholar
• Project Muse (humanities and social sciences)
• Medline (life sciences and biomedicine)
• EconLit (economics)
• Inspec (physics, engineering and computer science)

You can use boolean operators to help narrow down your search:

Read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

For each publication, ask yourself:

• What question or problem is the author addressing?
• What are the key concepts and how are they defined?
• What are the key theories, models and methods? Does the research use established frameworks or take an innovative approach?
• What are the results and conclusions of the study?
• How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
• How does the publication contribute to your understanding of the topic? What are its key insights and arguments?
• What are the strengths and weaknesses of the research?

Make sure the sources you use are credible, and make sure you read any landmark studies and major theories in your field of research.

You can find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

Take notes and cite your sources

As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.

It’s important to keep track of your sources with references to avoid plagiarism . It can be helpful to make an annotated bibliography, where you compile full reference information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.

You can use our free APA Reference Generator for quick, correct, consistent citations.

To begin organising your literature review’s argument and structure, you need to understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:

• Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
• Themes: what questions or concepts recur across the literature?
• Debates, conflicts and contradictions: where do sources disagree?
• Pivotal publications: are there any influential theories or studies that changed the direction of the field?
• Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?

This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.

• Most research has focused on young women.
• There is an increasing interest in the visual aspects of social media.
• But there is still a lack of robust research on highly-visual platforms like Instagram and Snapchat – this is a gap that you could address in your own research.

There are various approaches to organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarising sources in order.

Try to analyse patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.

If you have found some recurring central themes, you can organise your literature review into subsections that address different aspects of the topic.

For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.

Methodological

If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:

• Look at what results have emerged in qualitative versus quantitative research
• Discuss how the topic has been approached by empirical versus theoretical scholarship
• Divide the literature into sociological, historical, and cultural sources

Theoretical

A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.

You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.

Like any other academic text, your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.

The introduction should clearly establish the focus and purpose of the literature review.

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.

As you write, make sure to follow these tips:

• Summarise and synthesise: give an overview of the main points of each source and combine them into a coherent whole.
• Analyse and interpret: don’t just paraphrase other researchers – add your own interpretations, discussing the significance of findings in relation to the literature as a whole.
• Critically evaluate: mention the strengths and weaknesses of your sources.
• Write in well-structured paragraphs: use transitions and topic sentences to draw connections, comparisons and contrasts.

In the conclusion, you should summarise the key findings you have taken from the literature and emphasise their significance.

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .

It is often written as part of a dissertation , thesis, research paper , or proposal .

There are several reasons to conduct a literature review at the beginning of a research project:

• To familiarise yourself with the current state of knowledge on your topic
• To ensure that you’re not just repeating what others have already done
• To identify gaps in knowledge and unresolved problems that your research can address
• To develop your theoretical framework and methodology
• To provide an overview of the key findings and debates on the topic

Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.

The literature review usually comes near the beginning of your  dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the ‘Cite this Scribbr article’ button to automatically add the citation to our free Reference Generator.

McCombes, S. (2022, June 07). What is a Literature Review? | Guide, Template, & Examples. Scribbr. Retrieved 21 May 2024, from https://www.scribbr.co.uk/thesis-dissertation/literature-review/

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• 04 December 2020
• Correction 09 December 2020

How to write a superb literature review

Andy Tay is a freelance writer based in Singapore.

You can also search for this author in PubMed   Google Scholar

Literature reviews are important resources for scientists. They provide historical context for a field while offering opinions on its future trajectory. Creating them can provide inspiration for one’s own research, as well as some practice in writing. But few scientists are trained in how to write a review — or in what constitutes an excellent one. Even picking the appropriate software to use can be an involved decision (see ‘Tools and techniques’). So Nature asked editors and working scientists with well-cited reviews for their tips.

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doi: https://doi.org/10.1038/d41586-020-03422-x

Interviews have been edited for length and clarity.

Updates & Corrections

Correction 09 December 2020 : An earlier version of the tables in this article included some incorrect details about the programs Zotero, Endnote and Manubot. These have now been corrected.

Hsing, I.-M., Xu, Y. & Zhao, W. Electroanalysis 19 , 755–768 (2007).

Article   Google Scholar  

Ledesma, H. A. et al. Nature Nanotechnol. 14 , 645–657 (2019).

Article   PubMed   Google Scholar  

Brahlek, M., Koirala, N., Bansal, N. & Oh, S. Solid State Commun. 215–216 , 54–62 (2015).

Choi, Y. & Lee, S. Y. Nature Rev. Chem . https://doi.org/10.1038/s41570-020-00221-w (2020).

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Literature reviews, what is a literature review, learning more about how to do a literature review.

• Planning the Review
• The Research Question
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A literature review is a review and synthesis of existing research on a topic or research question. A literature review is meant to analyze the scholarly literature, make connections across writings and identify strengths, weaknesses, trends, and missing conversations. A literature review should address different aspects of a topic as it relates to your research question. A literature review goes beyond a description or summary of the literature you have read. 

• Sage Research Methods Core Collection This link opens in a new window SAGE Research Methods supports research at all levels by providing material to guide users through every step of the research process. SAGE Research Methods is the ultimate methods library with more than 1000 books, reference works, journal articles, and instructional videos by world-leading academics from across the social sciences, including the largest collection of qualitative methods books available online from any scholarly publisher. – Publisher

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Literature Review in Research Writing

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Table of Contents

Research on research? If you find this idea rather peculiar, know that nowadays, with the huge amount of information produced daily all around the world, it is becoming more and more difficult to keep up to date with all of it. In addition to the sheer amount of research, there is also its origin. We are witnessing the economic and intellectual emergence of countries like China, Brazil, Turkey, and United Arab Emirates, for example, that are producing scholarly literature in their own languages. So, apart from the effort of gathering information, there must also be translators prepared to unify all of it in a single language to be the object of the literature survey. At Elsevier, our team of translators is ready to support researchers by delivering high-quality scientific translations , in several languages, to serve their research – no matter the topic.

What is a literature review?

A literature review is a study – or, more accurately, a survey – involving scholarly material, with the aim to discuss published information about a specific topic or research question. Therefore, to write a literature review, it is compulsory that you are a real expert in the object of study. The results and findings will be published and made available to the public, namely scientists working in the same area of research.

How to Write a Literature Review

First of all, don’t forget that writing a literature review is a great responsibility. It’s a document that is expected to be highly reliable, especially concerning its sources and findings. You have to feel intellectually comfortable in the area of study and highly proficient in the target language; misconceptions and errors do not have a place in a document as important as a literature review. In fact, you might want to consider text editing services, like those offered at Elsevier, to make sure your literature is following the highest standards of text quality. You want to make sure your literature review is memorable by its novelty and quality rather than language errors.

Writing a literature review requires expertise but also organization. We cannot teach you about your topic of research, but we can provide a few steps to guide you through conducting a literature review:

• Choose your topic or research question: It should not be too comprehensive or too limited. You have to complete your task within a feasible time frame.
• Set the scope: Define boundaries concerning the number of sources, time frame to be covered, geographical area, etc.
• Decide which databases you will use for your searches: In order to search the best viable sources for your literature review, use highly regarded, comprehensive databases to get a big picture of the literature related to your topic.
• Search, search, and search: Now you’ll start to investigate the research on your topic. It’s critical that you keep track of all the sources. Start by looking at research abstracts in detail to see if their respective studies relate to or are useful for your own work. Next, search for bibliographies and references that can help you broaden your list of resources. Choose the most relevant literature and remember to keep notes of their bibliographic references to be used later on.
• Review all the literature, appraising carefully it’s content: After reading the study’s abstract, pay attention to the rest of the content of the articles you deem the “most relevant.” Identify methodologies, the most important questions they address, if they are well-designed and executed, and if they are cited enough, etc.

If it’s the first time you’ve published a literature review, note that it is important to follow a special structure. Just like in a thesis, for example, it is expected that you have an introduction – giving the general idea of the central topic and organizational pattern – a body – which contains the actual discussion of the sources – and finally the conclusion or recommendations – where you bring forward whatever you have drawn from the reviewed literature. The conclusion may even suggest there are no agreeable findings and that the discussion should be continued.

Why are literature reviews important?

Literature reviews constantly feed new research, that constantly feeds literature reviews…and we could go on and on. The fact is, one acts like a force over the other and this is what makes science, as a global discipline, constantly develop and evolve. As a scientist, writing a literature review can be very beneficial to your career, and set you apart from the expert elite in your field of interest. But it also can be an overwhelming task, so don’t hesitate in contacting Elsevier for text editing services, either for profound edition or just a last revision. We guarantee the very highest standards. You can also save time by letting us suggest and make the necessary amendments to your manuscript, so that it fits the structural pattern of a literature review. Who knows how many worldwide researchers you will impact with your next perfectly written literature review.

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Literature Reviews

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• 2. Plan your search
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Definition: A literature review is a systematic examination and synthesis of existing scholarly research on a specific topic or subject.

Purpose: It serves to provide a comprehensive overview of the current state of knowledge within a particular field.

Analysis: Involves critically evaluating and summarizing key findings, methodologies, and debates found in academic literature.

Identifying Gaps: Aims to pinpoint areas where there is a lack of research or unresolved questions, highlighting opportunities for further investigation.

Contextualization: Enables researchers to understand how their work fits into the broader academic conversation and contributes to the existing body of knowledge.

tl;dr  A literature review critically examines and synthesizes existing scholarly research and publications on a specific topic to provide a comprehensive understanding of the current state of knowledge in the field.

What is a literature review NOT?

❌ An annotated bibliography

❌ Original research

❌ A summary

❌ Something to be conducted at the end of your research

❌ An opinion piece

❌ A chronological compilation of studies

The reason for conducting a literature review is to:

Literature Reviews: An Overview for Graduate Students

While this 9-minute video from NCSU is geared toward graduate students, it is useful for anyone conducting a literature review.

Writing the literature review: A practical guide

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Conducting a Literature Review

Benefits of conducting a literature review.

• Steps in Conducting a Literature Review
• Summary of the Process
• Additional Resources
• Literature Review Tutorial by American University Library
• The Literature Review: A Few Tips On Conducting It by University of Toronto
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While there might be many reasons for conducting a literature review, following are four key outcomes of doing the review.

Assessment of the current state of research on a topic . This is probably the most obvious value of the literature review. Once a researcher has determined an area to work with for a research project, a search of relevant information sources will help determine what is already known about the topic and how extensively the topic has already been researched.

Identification of the experts on a particular topic . One of the additional benefits derived from doing the literature review is that it will quickly reveal which researchers have written the most on a particular topic and are, therefore, probably the experts on the topic. Someone who has written twenty articles on a topic or on related topics is more than likely more knowledgeable than someone who has written a single article. This same writer will likely turn up as a reference in most of the other articles written on the same topic. From the number of articles written by the author and the number of times the writer has been cited by other authors, a researcher will be able to assume that the particular author is an expert in the area and, thus, a key resource for consultation in the current research to be undertaken.

Identification of key questions about a topic that need further research . In many cases a researcher may discover new angles that need further exploration by reviewing what has already been written on a topic. For example, research may suggest that listening to music while studying might lead to better retention of ideas, but the research might not have assessed whether a particular style of music is more beneficial than another. A researcher who is interested in pursuing this topic would then do well to follow up existing studies with a new study, based on previous research, that tries to identify which styles of music are most beneficial to retention.

Determination of methodologies used in past studies of the same or similar topics.  It is often useful to review the types of studies that previous researchers have launched as a means of determining what approaches might be of most benefit in further developing a topic. By the same token, a review of previously conducted studies might lend itself to researchers determining a new angle for approaching research.

Upon completion of the literature review, a researcher should have a solid foundation of knowledge in the area and a good feel for the direction any new research should take. Should any additional questions arise during the course of the research, the researcher will know which experts to consult in order to quickly clear up those questions.

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A literature review surveys prior research published in books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have used in researching a particular topic and to demonstrate to your readers how your research fits within existing scholarship about the topic.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

• Give a new interpretation of old material or combine new with old interpretations,
• Trace the intellectual progression of the field, including major debates,
• Depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant research, or
• Usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

Given this, the purpose of a literature review is to:

• Place each work in the context of its contribution to understanding the research problem being studied.
• Describe the relationship of each work to the others under consideration.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.
• Resolve conflicts amongst seemingly contradictory previous studies.
• Identify areas of prior scholarship to prevent duplication of effort.
• Point the way in fulfilling a need for additional research.
• Locate your own research within the context of existing literature [very important].

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

It is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the field.

In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews. Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are a number of approaches you could adopt depending upon the type of analysis underpinning your study.

Argumentative Review This form examines literature selectively in order to support or refute an argument, deeply embedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to make summary claims of the sort found in systematic reviews [see below].

Integrative Review Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses or research problems. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication. This is the most common form of review in the social sciences.

Historical Review Few things rest in isolation from historical precedent. Historical literature reviews focus on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review A review does not always focus on what someone said [findings], but how they came about saying what they say [method of analysis]. Reviewing methods of analysis provides a framework of understanding at different levels [i.e. those of theory, substantive fields, research approaches, and data collection and analysis techniques], how researchers draw upon a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection, and data analysis. This approach helps highlight ethical issues which you should be aware of and consider as you go through your own study.

Systematic Review This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

Theoretical Review The purpose of this form is to examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review helps to establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

NOTE : Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

• An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider :

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
• Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most convincing or least convincing?
• Validity -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] A thematic literature review is the most common approach to summarizing prior research in the social and behavioral sciences. Thematic reviews are organized around a topic or issue, rather than the progression of time, although the progression of time may still be incorporated into a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it would still be organized chronologically reflecting technological developments in media. The difference in this example between a "chronological" and a "thematic" approach is what is emphasized the most: themes related to the role of the Internet in presidential politics. Note that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point being made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

• Current Situation : Information necessary to understand the current topic or focus of the literature review.
• Sources Used : Describes the methods and resources [e.g., databases] you used to identify the literature you reviewed.
• History : The chronological progression of the field, the research literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Selection Methods : Criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed [i.e., scholarly] sources.
• Standards : Description of the way in which you present your information.
• Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information, but that are not key to understanding the research problem, can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

• Sources in your literature review do not clearly relate to the research problem;
• You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem;
• Relies exclusively on secondary analytical sources rather than including relevant primary research studies or data;
• Uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
• Does not describe the search procedures that were used in identifying the literature to review;
• Reports isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods; and,
• Only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

• How are they organizing their ideas?
• What methods have they used to study the problem?
• What theories have been used to explain, predict, or understand their research problem?
• What sources have they cited to support their conclusions?
• How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

• Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a conceptual dead end. At this point consider: Does your study extend current research?  Does it forge a new path? Or, does is merely add more of the same thing being said?
• Look at sources the authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been generated to address the research problem.
• Search Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review [see next sub-tab]. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline. Here again, if the same authors are being cited again and again, this may indicate no new literature has been written on the topic.

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

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Literature Review: Purpose of a Literature Review

• Literature Review
• Purpose of a Literature Review
• Work in Progress
• Compiling & Writing
• Books, Articles, & Web Pages
• Types of Literature Reviews
• Departmental Differences
• Citation Styles & Plagiarism
• Know the Difference! Systematic Review vs. Literature Review

The purpose of a literature review is to:

• Provide a foundation of knowledge on a topic
• Identify areas of prior scholarship to prevent duplication and give credit to other researchers
• Identify inconstancies: gaps in research, conflicts in previous studies, open questions left from other research
• Identify the need for additional research (justifying your research)
• Identify the relationship of works in the context of their contribution to the topic and other works
• Place your own research within the context of existing literature, making a case for why further study is needed.

Videos & Tutorials

VIDEO: What is the role of a literature review in research? What's it mean to "review" the literature? Get the big picture of what to expect as part of the process. This video is published under a Creative Commons 3.0 BY-NC-SA US license. License, credits, and contact information can be found here: https://www.lib.ncsu.edu/tutorials/litreview/

Elements in a Literature Review

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Literature Review

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The purpose of a literature review is to collect relevant, timely research on your chosen topic, and synthesize it into a cohesive summary of existing knowledge in the field. This then prepares you for making your own argument on that topic, or for conducting your own original research.

Depending on your field of study, literature reviews can take different forms. Some disciplines require that you synthesize your sources topically, organizing your paragraphs according to how your different sources discuss similar topics. Other disciplines require that you discuss each source in individual paragraphs, covering various aspects in that single article, chapter, or book.

Within your review of a given source, you can cover many different aspects, including (if a research study) the purpose, scope, methods, results, any discussion points, limitations, and implications for future research. Make sure you know which model your professor expects you to follow when writing your own literature reviews.

Tip : Literature reviews may or may not be a graded component of your class or major assignment, but even if it is not, it is a good idea to draft one so that you know the current conversations taking place on your chosen topic. It can better prepare you to write your own, unique argument.

Benefits of Literature Reviews

• Literature reviews allow you to gain familiarity with the current knowledge in your chosen field, as well as the boundaries and limitations of that field.
• Literature reviews also help you to gain an understanding of the theory(ies) driving the field, allowing you to place your research question into context.
• Literature reviews provide an opportunity for you to see and even evaluate successful and unsuccessful assessment and research methods in your field.
• Literature reviews prevent you from duplicating the same information as others writing in your field, allowing you to find your own, unique approach to your topic.
• Literature reviews give you familiarity with the knowledge in your field, giving you the chance to analyze the significance of your additional research.

Choosing Your Sources

When selecting your sources to compile your literature review, make sure you follow these guidelines to ensure you are working with the strongest, most appropriate sources possible.

Topically Relevant

Find sources within the scope of your topic

Appropriately Aged

Find sources that are not too old for your assignment

Find sources whose authors have authority on your topic

Appropriately “Published”

Find sources that meet your instructor’s guidelines (academic, professional, print, etc.)

Tip:  Treat your professors and librarians as experts you can turn to for advice on how to locate sources. They are a valuable asset to you, so take advantage of them!

Organizing Your Literature Review

Synthesizing topically.

Some assignments require discussing your sources together, in paragraphs organized according to shared topics between them.

For example, in a literature review covering current conversations on Alison Bechdel’s  Fun Home , authors may discuss various topics including:

• her graphic style
• her allusions to various literary texts
• her story’s implications regarding LGBT experiences in 20 th  century America.

In this case, you would cluster your sources on these three topics. One paragraph would cover how the sources you collected dealt with Bechdel’s graphic style. Another, her allusions. A third, her implications.

Each of these paragraphs would discuss how the sources you found treated these topics in connection to one another. Basically, you compare and contrast how your sources discuss similar issues and points.

To determine these shared topics, examine aspects including:

• Definition of terms
• Common ground
• Issues that divide
• Rhetorical context

Summarizing Individually

Depending on the assignment, your professor may prefer that you discuss each source in your literature review individually (in their own, separate paragraphs or sections). Your professor may give you specific guidelines as far as what to cover in these paragraphs/sections.

If, for instance, your sources are all primary research studies, here are some aspects to consider covering:

• Participants
• Limitations
• Implications
• Significance

Each section of your literature review, in this case, will identify all of these elements for each individual article.

You may or may not need to separate your information into multiple paragraphs for each source. If you do, using proper headings in the appropriate citation style (APA, MLA, etc.) will help keep you organized.

If you are writing a literature review as part of a larger assignment, you generally do not need an introduction and/or conclusion, because it is embedded within the context of your larger paper.

If, however, your literature review is a standalone assignment, it is a good idea to include some sort of introduction and conclusion to provide your reader with context regarding your topic, purpose, and any relevant implications or further questions. Make sure you know what your professor is expecting for your literature review’s content.

Typically, a literature review concludes with a full bibliography of your included sources. Make sure you use the style guide required by your professor for this assignment.

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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 

How to write a good literature review 

• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• How to write a literature review faster with Paperpal? 
• Frequently asked questions 

What is a literature review?

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

What is the purpose of literature review?

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

1. Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 

2. Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field. 

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3. Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 

4. Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 

5. Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 

6. Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

a. Habitat Loss and Species Extinction:

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

b. Range Shifts and Phenological Changes:

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

c. Ocean Acidification and Coral Reefs:

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

d. Adaptive Strategies and Conservation Efforts:

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

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Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

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Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

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How to write a literature review faster with Paperpal?

Paperpal, an AI writing assistant, integrates powerful academic search capabilities within its writing platform. With the Research feature, you get 100% factual insights, with citations backed by 250M+ verified research articles, directly within your writing interface with the option to save relevant references in your Citation Library. By eliminating the need to switch tabs to find answers to all your research questions, Paperpal saves time and helps you stay focused on your writing.   

Here’s how to use the Research feature:  

• Ask a question: Get started with a new document on paperpal.com. Click on the “Research” feature and type your question in plain English. Paperpal will scour over 250 million research articles, including conference papers and preprints, to provide you with accurate insights and citations. 
• Review and Save: Paperpal summarizes the information, while citing sources and listing relevant reads. You can quickly scan the results to identify relevant references and save these directly to your built-in citations library for later access. 
• Cite with Confidence: Paperpal makes it easy to incorporate relevant citations and references into your writing, ensuring your arguments are well-supported by credible sources. This translates to a polished, well-researched literature review. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a good literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. By combining effortless research with an easy citation process, Paperpal Research streamlines the literature review process and empowers you to write faster and with more confidence. Try Paperpal Research now and see for yourself.  

Frequently asked questions

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

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Why is it important to do a literature review in research?

The importance of scientific communication in the healthcare industry

The Importance and Role of Biostatistics in Clinical Research

 “A substantive, thorough, sophisticated literature review is a precondition for doing substantive, thorough, sophisticated research”. Boote and Baile 2005

Authors of manuscripts treat writing a literature review as a routine work or a mere formality. But a seasoned one knows the purpose and importance of a well-written literature review.  Since it is one of the basic needs for researches at any level, they have to be done vigilantly. Only then the reader will know that the basics of research have not been neglected.

The aim of any literature review is to summarize and synthesize the arguments and ideas of existing knowledge in a particular field without adding any new contributions.   Being built on existing knowledge they help the researcher to even turn the wheels of the topic of research.  It is possible only with profound knowledge of what is wrong in the existing findings in detail to overpower them.  For other researches, the literature review gives the direction to be headed for its success. 

The common perception of literature review and reality:

As per the common belief, literature reviews are only a summary of the sources related to the research. And many authors of scientific manuscripts believe that they are only surveys of what are the researches are done on the chosen topic.  But on the contrary, it uses published information from pertinent and relevant sources like

• Scholarly books
• Scientific papers
• Latest studies in the field
• Established school of thoughts
• Relevant articles from renowned scientific journals

and many more for a field of study or theory or a particular problem to do the following:

• Summarize into a brief account of all information
• Synthesize the information by restructuring and reorganizing
• Critical evaluation of a concept or a school of thought or ideas
• Familiarize the authors to the extent of knowledge in the particular field
• Encapsulate
• Compare & contrast

By doing the above on the relevant information, it provides the reader of the scientific manuscript with the following for a better understanding of it:

• It establishes the authors’  in-depth understanding and knowledge of their field subject
• It gives the background of the research
• Portrays the scientific manuscript plan of examining the research result
• Illuminates on how the knowledge has changed within the field
• Highlights what has already been done in a particular field
• Information of the generally accepted facts, emerging and current state of the topic of research
• Identifies the research gap that is still unexplored or under-researched fields
• Demonstrates how the research fits within a larger field of study
• Provides an overview of the sources explored during the research of a particular topic

Importance of literature review in research:

The importance of literature review in scientific manuscripts can be condensed into an analytical feature to enable the multifold reach of its significance.  It adds value to the legitimacy of the research in many ways:

• Provides the interpretation of existing literature in light of updated developments in the field to help in establishing the consistency in knowledge and relevancy of existing materials
• It helps in calculating the impact of the latest information in the field by mapping their progress of knowledge.
• It brings out the dialects of contradictions between various thoughts within the field to establish facts
• The research gaps scrutinized initially are further explored to establish the latest facts of theories to add value to the field
• Indicates the current research place in the schema of a particular field
• Provides information for relevancy and coherency to check the research
• Apart from elucidating the continuance of knowledge, it also points out areas that require further investigation and thus aid as a starting point of any future research
• Justifies the research and sets up the research question
• Sets up a theoretical framework comprising the concepts and theories of the research upon which its success can be judged
• Helps to adopt a more appropriate methodology for the research by examining the strengths and weaknesses of existing research in the same field
• Increases the significance of the results by comparing it with the existing literature
• Provides a point of reference by writing the findings in the scientific manuscript
• Helps to get the due credit from the audience for having done the fact-finding and fact-checking mission in the scientific manuscripts
• The more the reference of relevant sources of it could increase more of its trustworthiness with the readers
• Helps to prevent plagiarism by tailoring and uniquely tweaking the scientific manuscript not to repeat other’s original idea
• By preventing plagiarism , it saves the scientific manuscript from rejection and thus also saves a lot of time and money
• Helps to evaluate, condense and synthesize gist in the author’s own words to sharpen the research focus
• Helps to compare and contrast to  show the originality and uniqueness of the research than that of the existing other researches
• Rationalizes the need for conducting the particular research in a specified field
• Helps to collect data accurately for allowing any new methodology of research than the existing ones
• Enables the readers of the manuscript to answer the following questions of its readers for its better chances for publication
• What do the researchers know?
• What do they not know?
• Is the scientific manuscript reliable and trustworthy?
• What are the knowledge gaps of the researcher?

22. It helps the readers to identify the following for further reading of the scientific manuscript:

• What has been already established, discredited and accepted in the particular field of research
• Areas of controversy and conflicts among different schools of thought
• Unsolved problems and issues in the connected field of research
• The emerging trends and approaches
• How the research extends, builds upon and leaves behind from the previous research

A profound literature review with many relevant sources of reference will enhance the chances of the scientific manuscript publication in renowned and reputed scientific journals .

References:

http://www.math.montana.edu/jobo/phdprep/phd6.pdf

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What is a literature review?

A literature review is an integrated analysis -- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.  That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

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1. Choose a topic. Define your research question.

Your literature review should be guided by your central research question.  The literature represents background and research developments related to a specific research question, interpreted and analyzed by you in a synthesized way.

• Make sure your research question is not too broad or too narrow.  Is it manageable?
• Begin writing down terms that are related to your question. These will be useful for searches later.
• If you have the opportunity, discuss your topic with your professor and your class mates.

2. Decide on the scope of your review

How many studies do you need to look at? How comprehensive should it be? How many years should it cover? 

• This may depend on your assignment.  How many sources does the assignment require?

3. Select the databases you will use to conduct your searches.

Make a list of the databases you will search. 

Where to find databases:

• use the tabs on this guide
• Find other databases in the Nursing Information Resources web page
• More on the Medical Library web page
• ... and more on the Yale University Library web page

4. Conduct your searches to find the evidence. Keep track of your searches.

• Use the key words in your question, as well as synonyms for those words, as terms in your search. Use the database tutorials for help.
• Save the searches in the databases. This saves time when you want to redo, or modify, the searches. It is also helpful to use as a guide is the searches are not finding any useful results.
• Review the abstracts of research studies carefully. This will save you time.
• Use the bibliographies and references of research studies you find to locate others.
• Check with your professor, or a subject expert in the field, if you are missing any key works in the field.
• Ask your librarian for help at any time.
• Use a citation manager, such as EndNote as the repository for your citations. See the EndNote tutorials for help.

Review the literature

Some questions to help you analyze the research:

• What was the research question of the study you are reviewing? What were the authors trying to discover?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.
• Does the research seem to be complete? Could it have been conducted more soundly? What further questions does it raise?
• If there are conflicting studies, why do you think that is?
• How are the authors viewed in the field? Has this study been cited? If so, how has it been analyzed?

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
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Rapid literature review: definition and methodology

Beata smela.

a Assignity, Cracow, Poland

Mondher Toumi

b Public Health Department, Aix-Marseille University, Marseille, France

Karolina Świerk

Clement francois, małgorzata biernikiewicz.

c Studio Slowa, Wroclaw, Poland

Emilie Clay

d Clever-Access, Paris, France

Laurent Boyer

Introduction: A rapid literature review (RLR) is an alternative to systematic literature review (SLR) that can speed up the analysis of newly published data. The objective was to identify and summarize available information regarding different approaches to defining RLR and the methodology applied to the conduct of such reviews.

Methods: The Medline and EMBASE databases, as well as the grey literature, were searched using the set of keywords and their combination related to the targeted and rapid review, as well as design, approach, and methodology. Of the 3,898 records retrieved, 12 articles were included.

Results: Specific definition of RLRs has only been developed in 2021. In terms of methodology, the RLR should be completed within shorter timeframes using simplified procedures in comparison to SLRs, while maintaining a similar level of transparency and minimizing bias. Inherent components of the RLR process should be a clear research question, search protocol, simplified process of study selection, data extraction, and quality assurance.

Conclusions: There is a lack of consensus on the formal definition of the RLR and the best approaches to perform it. The evidence-based supporting methods are evolving, and more work is needed to define the most robust approaches.

Introduction

A systematic literature review (SLR) summarizes the results of all available studies on a specific topic and provides a high level of evidence. Authors of the SLR have to follow an advanced plan that covers defining a priori information regarding the research question, sources they are going to search, inclusion criteria applied to choose studies answering the research question, and information regarding how they are going to summarize findings [ 1 ].

The rigor and transparency of SLRs make them the most reliable form of literature review [ 2 ], providing a comprehensive, objective summary of the evidence for a given topic [ 3 , 4 ]. On the other hand, the SLR process is usually very time-consuming and requires a lot of human resources. Taking into account a high increase of newly published data and a growing need to analyze information in the fastest possible way, rapid literature reviews (RLRs) often replace standard SLRs.

There are several guidelines on the methodology of RLRs [ 5–11 ]; however, only recently, one publication from 2021 attempted to construct a unified definition [ 11 ]. Generally, by RLRs, researchers understand evidence synthesis during which some of the components of the systematic approach are being used to facilitate answering a focused research question; however, scope restrictions and a narrower search strategy help to make the project manageable in a shorter time and to get the key conclusions faster [ 4 ].

The objective of this research was to collect and summarize available information on different approaches to the definition and methodology of RLRs. An RLR has been run to capture publications providing data that fit the project objective.

To find publications reporting information on the methodology of RLRs, searches were run in the Medline and EMBASE databases in November 2022. The following keywords were searched for in titles and abstracts: ‘targeted adj2 review’ OR ‘focused adj2 review’ OR ‘rapid adj2 review’, and ‘methodology’ OR ‘design’ OR ‘scheme’ OR ‘approach’. The grey literature was identified using Google Scholar with keywords including ‘targeted review methodology’ OR ‘focused review methodology’ OR ‘rapid review methodology’. Only publications in English were included, and the date of publication was restricted to year 2016 onward in order to identify the most up-to-date literature. The reference lists of each included article were searched manually to obtain the potentially eligible articles. Titles and abstracts of the retrieved records were first screened to exclude articles that were evidently irrelevant. The full texts of potentially relevant papers were further reviewed to examine their eligibility.

A pre-defined Excel grid was developed to extract the following information related to the methodology of RLR from guidelines:

• Definition,
• Research question and searches,
• Studies selection,
• Data extraction and quality assessment,
• Additional information.

There was no restriction on the study types to be analyzed; any study reporting on the methodology of RLRs could be included: reviews, practice guidelines, commentaries, and expert opinions on RLR relevant to healthcare policymakers or practitioners. The data extraction and evidence summary were conducted by one analyst and further examined by a senior analyst to ensure that relevant information was not omitted. Disagreements were resolved by discussion and consensus.

Studies selection

A total of 3,898 records (3,864 articles from a database search and 34 grey literature from Google Scholar) were retrieved. After removing duplicates, titles and abstracts of 3,813 articles were uploaded and screened. The full texts of 43 articles were analyzed resulting in 12 articles selected for this review, including 7 guidelines [ 5–11 ] on the methodology of RLRs, together with 2 papers summarizing the results of the Delphi consensus on the topic [ 12 , 13 ], and 3 publications analyzing and assessing different approaches to RLRs [ 4 , 14 , 15 ].

Overall, seven guidelines were identified: from the World Health Organization (WHO) [ 5 ], National Collaborating Centre for Methods and Tools (NCCMT) [ 7 ], the UK government [ 8 ], the Oxford Centre for Evidence Based Medicine [ 9 ], the Cochrane group [ 6 , 11 ], and one multi-national review [ 10 ]. Among the papers that did not describe the guidelines, Gordon et al. [ 4 ] proposed 12 tips for conducting a rapid review in the right settings and discussed why these reviews may be more beneficial in some circumstances. The objective of work conducted by Tricco et al. [ 13 ] and Pandor et al. [ 12 ] was to collect and compare perceptions of rapid reviews from stakeholders, including researchers, policymakers, industry, journal editors, and healthcare providers, and to reach a consensus outlining the domains to consider when deciding on approaches for RLRs. Haby et al. [ 14 ] run a rapid review of systematic reviews and primary studies to find out the best way to conduct an RLR in health policy and practice. In Tricco et al. (2022) [ 15 ], JBI position statement for RLRs is presented.

From all the seven identified guidelines information regarding definitions the authors used for RLRs, approach to the PICOS criteria and search strategy development, studies selection, data extractions, quality assessment, and reporting were extracted.

Cochrane Rapid Reviews Methods Group developed methods guidance based on scoping review of the underlying evidence, primary methods studies conducted, as well as surveys sent to Cochrane representative and discussion among those with expertise [ 11 ]. They analyzed over 300 RLRs or RLR method papers and based on the methodology of those studies, constructed a broad definition RLR, one that meets a minimum set of requirements identified in the thematic analysis: ‘ A rapid review is a form of knowledge synthesis that accelerates the process of conducting a traditional systematic review through streamlining or omitting a variety of methods to produce evidence in a resource-efficient manner .’ This interpretation aligns with more than 50% of RLRs identified in this study. The authors additionally provided several other definitions, depending on specific situations or requirements (e.g., when RLR is produced on stakeholder’s request). It was additionally underlined that RLRs should be driven by the need of timely evidence for decision-making purposes [ 11 ].

Rapid reviews vary in their objective, format, and methods used for evidence synthesis. This is a quite new area, and still no agreement on optimal methods can be found [ 5 ]. All of the definitions are highlighting that RLRs are completed within shorter timeframes than SLRs, and also lack of time is one of the main reasons they are conducted. It has been suggested that most rapid reviews are conducted within 12 weeks; however, some of the resources suggest time between a few weeks to no more than 6 months [ 5 , 6 ]. Some of the definitions are highlighting that RLRs follow the SLR process, but certain phases of the process are simplified or omitted to retrieve information in a time-saving way [ 6 , 7 ]. Different mechanisms are used to enhance the timeliness of reviews. They can be used independently or concurrently: increasing the intensity of work by intensifying the efforts of multiple analysts by parallelization of tasks, using review shortcuts whereby one or more systematic review steps may be reduced, automatizing review steps by using new technologies [ 5 ]. The UK government report [ 8 ] referred to two different RLRs: in the form of quick scoping reviews (QSR) or rapid evidence assessments (REA). While being less resource and time-consuming compared to standard SLRs, QSRs and REAs are designed to be similarly transparent and to minimize bias. QSRs can be applied to rather open-ended questions, e.g., ‘what do we know about something’ but both, QSRs and REAs, provide an understanding of the volume and characteristics of evidence on a specific topic, allowing answering questions by maximizing the use of existing data, and providing a clear picture of the adequacy of existing evidence [ 8 ].

Research questions and searches

The guidelines suggest creating a clear research question and search protocol at the beginning of the project. Additionally, to not duplicate RLRs, the Cochrane Rapid Reviews Methods Group encourages all people working on RLRs to consider registering their search protocol with PROSPERO, the international prospective register of reviews; however, so far they are not formally registered in most cases [ 5 , 6 ]. They also recommend involving key stakeholders (review users) to set and refine the review question, criteria, and outcomes, as well as consulting them through the entire process [ 11 ].

Regarding research questions, it is better to structure them in a neutral way rather than focus on a specific direction for the outcome. By doing so, the researcher is in a better position to identify all the relevant evidence [ 7 ]. Authors can add a second, supportive research question when needed [ 8 ]. It is encouraged to limit the number of interventions, comparators and outcomes, to focus on the ones that are most important for decision-making [ 11 ]. Useful could be also reviewing additional materials, e.g., SLRs on the topic, as well as conducting a quick literature search to better understand the topic before starting with RLRs [ 7 ]. In SLRs researchers usually do not need to care a lot about time spent on creating PICOS, they need to make sure that the scope is broad enough, and they cannot use many restrictions. When working on RLRs, a reviewer may spend more or less time defining each of the components of the study question, and the main step is making sure that PICOS addresses the needs of those who requested the rapid review, and at the same time, it is feasible within the required time frame [ 7 ]. Search protocol should contain an outline of how the following review steps are to be carried out, including selected search keywords and a full strategy, a list of data sources, precise inclusion and exclusion criteria, a strategy for data extraction and critical appraisal, and a plan of how the information will be synthesized [ 8 ].

In terms of searches running, in most cases, an exhaustive process will not be feasible. Researchers should make sure that the search is effective and efficient to produce results in a timely manner. Cochrane Rapid Reviews Methods Group recommends involving an information specialist and conducting peer review of at least one search strategy [ 11 ]. According to the rapid review guidebook by McMaster University [ 7 ], it is important that RLRs, especially those that support policy and program decisions, are being fed by the results of a body of literature, rather than single studies, when possible. It would result in more generalizable findings applied at the level of a population and serve more realistic findings for program decisions [ 7 ]. It is important to document the search strategy, together with a record of the date and any date limits of the search, so that it can easily be run again, modified, or updated. Furthermore, the information on the individual databases included in platform services should always be reported, as this depends on organizations’ subscriptions and must be included for transparency and repeatability [ 7 , 8 ]. Good solution for RLRs is narrowing the scope or searching a limited number of databases and other sources [ 7 ]. Often, the authors use the PubMed/MEDLINE, Cochrane Library, and Embase databases. In most reviews, two or more databases are searched, and common limits are language (usually restricted to English), date, study design, and geographical area. Some RLRs include searching of grey literature; however, contact with authors is rather uncommon [ 5 , 8 ]. According to the flexible framework for restricted systematic review published by the University of Oxford, the search should be run in at least one major scientific database such as PubMed, and one other source, e.g., Google Scholar [ 9 ]. Grey literature and unpublished evidence may be particularly needed and important for intervention questions. It is related to the fact that studies that do not report the effects of interventions are less likely to be published [ 8 ]. If there is any type of evidence that will not be considered by the RLRs, e.g., reviews or theoretical and conceptual studies, it should also be stated in the protocol together with justification [ 8 ]. Additionally, authors of a practical guide published by WHO suggest using a staged search to identify existing SLRs at the beginning, and then focusing on studies with other designs [ 5 ]. If a low number of citations have been retrieved, it is acceptable to expand searches, remove some of the limits, and add additional databases and sources [ 7 ].

Searching for RLRs is an iterative process, and revising the approach is usually needed [ 7 ]. Changes should be confirmed with stakeholders and should be tracked and reflected in the final report [ 5 ].

The next step in the rapid review is the selection of studies consisting of two phases: screening of titles and abstracts, and analysis of full texts. Prior to screening initiation, it is recommended to conduct a pilot exercise using the same 30–50 abstracts and 5–10 full-texts for the entire screening team in order to calibrate and test the review form [ 11 ]. In contrast to SLRs, it can be done by one reviewer with or without verification by a second one. If verification is performed, usually the second reviewer checks only a subset of records and compares them. Cochrane Group, in contrast, recommends a stricter approach: at least 20% of references should be double-screened at titles and abstracts stage, and while the rest of the references may be screened by one reviewer, the excluded items need to be re-examined by second reviewer; similar approach is used in full-text screening [ 11 ]. This helps to ensure that bias was reduced and that the PICOS criteria are applied in a relevant way [ 5 , 8 , 9 , 11 ]. During the analysis of titles and abstracts, there is no need to report reasons for exclusion; however, they should be tracked for all excluded full texts [ 7 ].

Data extraction and quality assessment

According to the WHO guide, the most common method for data extraction in RLRs is extraction done by a single reviewer with or without partial verification. The authors point out that a reasonable approach is to use a second reviewer to check a random sample of at least 10% of the extractions for accuracy. Dual performance is more necessary for the extraction of quantitative results than for descriptive study information. In contrast, Cochrane group recommends that second reviewer should check the correctness and completeness of all data [ 11 ]. When possible, extractions should be limited to key characteristics and outcomes of the study. The same approach to data extraction is also suggested for a quality assessment process within rapid reviews [ 5 , 9 , 11 ]. Authors of the guidebook from McMaster University highlight that data extraction should be done ideally by two reviewers independently and consensus on the discrepancies should always be reached [ 7 ]. The final decision on the approach to this important step of review should depend on the available time and should also reflect the complexity of the research question [ 9 ].

For screening, analysis of full texts, extractions, and quality assessments, researchers can use information technologies to support them by making these review steps more efficient [ 5 ].

Before data reporting, a reviewer should prepare a document with key message headings, executive summary, background related to the topic and status of the current knowledge, project question, synthesis of findings, conclusions, and recommendations. According to the McMaster University guidebook, a report should be structured in a 1:2:20 format, that is, one page for key messages, two pages for an executive summary, and a full report of up to 20 pages [ 7 ]. All the limitations of the RLRs should be analyzed, and conclusions should be drawn with caution [ 5 ]. The quality of the accumulated evidence and the strength of recommendations can be assessed using, e.g., the GRADE system [ 5 ]. When working on references quoting, researchers should remember to use a primary source, not secondary references [ 7 ]. It would be worth considering the support of some software tools to automate reporting steps. Additionally, any standardization of the process and the usage of templates can support report development and enhance the transparency of the review [ 5 ].

Ideally, all the review steps should be completed during RLRs; however, often some steps may need skipping or will not be completed as thoroughly as should because of time constraints. It is always crucial to decide which steps may be skipped, and which are the key ones, depending on the project [ 7 ]. Guidelines suggest that it may be helpful to invite researchers with experience in the operations of SLRs to participate in the rapid review development [ 5 , 9 ]. As some of the steps will be completed by one reviewer only, it is important to provide them with relevant training at the beginning of the process, as well as during the review, to minimize the risk of mistakes [ 5 ].

Additional information

Depending on the policy goal and available resources and deadlines, methodology of the RLRs may be modified. Wilson et al. [ 10 ] provided extensive guidelines for performing RLR within days (e.g., to inform urgent internal policy discussions and/or management decisions), weeks (e.g., to inform public debates), or months (e.g., to inform policy development cycles that have a longer timeline, but that cannot wait for a traditional full systematic review). These approaches vary in terms of data synthesis, types of considered evidence and project management considerations.

In shortest timeframes, focused questions and subquestions should be formulated, typically to conduct a policy analysis; the report should consist of tables along with a brief narrative summary. Evidence from SLRs is often considered, as well as key informant interviews may be conducted to identify additional literature and insights about the topic, while primary studies and other types of evidence are not typically feasible due to time restrictions. The review would be best conducted with 1–2 reviewers sharing the work, enabling rapid iterations of the review. As for RLRs with longer timeline (weeks), these may use a mix of policy, systems and political analysis. Structure of the review would be similar to shorter RLRs – tabular with short narrative summary, as the timeline does not allow for comprehensive synthesis of data. Besides SLRs, primary studies and other evidence may be feasible in this timeframe, if obtained using the targeted searches in the most relevant databases. The review team should be larger, and standardized procedures for reviewing of the results and data extraction should be applied. In contrast to previous timeframe, merit review process may be feasible. For both timeframes, brief consultations with small transdisciplinary team should be conducted at the beginning and in the final stage of the review to discuss important matters.

For RLRs spanning several months, more comprehensive methodology may be adapted in terms of data synthesis and types of evidence. However, authors advise that review may be best conducted with a small review team in order to allow for more in-depth interpretation and iteration.

Studies analyzing methodology

There have been two interesting publications summarizing the results of Delphi consensus on the RLR methodology identified and included in this review [ 12 , 13 ].

Tricco et al. [ 13 ] first conducted an international survey and scoping review to collect information on the possible approaches to the running of rapid reviews, based on which, they employed a modified Delphi method that included inputs from 113 stakeholders to explore the most optimized approach. Among the six most frequent rapid review approaches (not all detailed here) being evaluated, the approach that combines inclusion of published literature only, a search of more than one database and limitations by date and language, study selection by one analyst, data extraction, and quality assessment by one analyst and one verifier, was perceived as the most feasible approach (72%, 81/113 responses) with the potentially lowest risk of bias (12%, 12/103). The approach ranked as the first one when considering timelines assumes updating of the search from a previously published review, no additional limits on search, studies selection and data extraction done by one reviewer, and no quality assessment. Finally, based on the publication, the most comprehensive RLRs can be made by moving on with the following rules: searching more than one database and grey literature and using date restriction, and assigning one reviewer working on screening, data extraction, and risk of bias assessment ( Table 1 ). Pandor et al. [ 12 ] introduced a decision tool for SelecTing Approaches for Rapid Reviews (STARR) that were produced through the Delphi consensus of international experts through an iterative and rigorous process. Participants were asked to assess the importance of predefined items in four domains related to the rapid review process: interaction with commissioners, understanding the evidence base, data extraction and synthesis methods, and reporting of rapid review methods. All items assigned to four domains achieved > 70% of consensus, and in that way, the first consensus-driven tool has been created that supports authors of RLRs in planning and deciding on approaches.

Six most frequent approaches to RLRs (adapted from Tricco et al. [ 13 ]).

Haby et al. [ 14 ] run searches of 11 databases and two websites and developed a comprehensive overview of the methodology of RLRs. With five SLRs and one RCT being finally included, they identified the following approaches used in RLRs to make them faster than full SLRs: limiting the number and scope of questions, searching fewer databases, limited searching of grey literature, restrictions on language and date (e.g., English only, most recent publications), updating the existing SLRs, eliminating or limiting hand searches of reference lists, noniterative search strategies, eliminating consultation with experts, limiting dual study selection, data extraction and quality assessment, minimal data synthesis with short concise conclusions or recommendations. All the SLRs included in this review were consistent in stating that no agreed definition of rapid reviews is available, and there is still no final agreement on the best methodological rules to be followed.

Gordon et al. [ 4 ] explained the advantages of performing a focused review and provided 12 tips for its conduction. They define focused reviews as ‘a form of knowledge synthesis in which the components of the systematic process are applied to facilitate the analysis of a focused research question’. The first tip presented by the authors is related to deciding if a focused review is a right solution for the considered project. RLRs will suit emerging topics, approaches, or assessments where early synthesis can support doctors, policymakers, etc., but also can direct future research. The second, third, and fourth tips highlight the importance of running preliminary searches and considering narrowing the results by using reasonable constraints taking into account the local context, problems, efficiency perspectives, and available time. Further tips include creating a team of experienced reviewers working on the RLRs, thinking about the target journal from the beginning of work on the rapid review, registering the search protocol on the PROSPERO registry, and the need for contacting authors of papers when data available in publications are missing or incongruent. The last three tips are related to the choice of evidence synthesis method, using the visual presentation of data, and considering and describing all the limitations of the focused review.

Finally, a new publication by Tricco et al. from 2022, describing JBI position statement [ 15 ] underlined that for the time being, there is no specific tool for critical appraisal of the RLR’s methodological quality. Instead, reviewers may use available tools to assess the risk of bias or quality of SLRs, like ROBIS, the JBI critical appraisal tools, or the assessment of multiple systematic reviews (AMSTAR).

Inconsistency in the definitions and methodologies of RLR

Although RLR was broadly perceived as an approach to quicken the conduct of conventional SLR, there is a lack of consensus on the formal definition of the RLR, so as to the best approaches to perform it. Only in 2021, a study proposing unified definition was published; however, it is important to note that the most accurate definition was only matching slightly over 50% of papers analysed by the authors, which underlines the lack of homogeneity in the field [ 11 ]. The evidence-based supporting methods are evolving, and more evidence is needed to define the most robust approaches [ 5 ].

Diverse terms are used to describe the RLR, including ‘rapid review’, focused systematic review’, ‘quick scoping reviews’, and ‘rapid evidence assessments’. Although the general principles of conducting RLR are to accelerate the whole process, complexity was seen in the methodologies used for RLRs, as reflected in this study. Also, inconsistencies related to the scope of the questions, search strategies, inclusion criteria, study screening, full-text review, quality assessment, and evidence presentation were implied. All these factors may hamper decision-making about optimal methodologies for conducting rapid reviews, and as a result, the efficiency of RLR might be decreased. Additionally, researchers may tend to report the methodology of their reviews without a sufficient level of detail, making it difficult to appraise the quality and robustness of their work.

Advantages and weaknesses of RLR

Although RLR used simplified approaches for evidence synthesis compared with SLR, the methodologies for RLR should be replicable, rigorous, and transparent to the greatest extent [ 16 ]. When time and resources are limited, RLR could be a practical and efficient tool to provide the summary of evidence that is critical for making rapid clinical or policy-related decisions [ 5 ]. Focusing on specific questions that are of controversy or special interest could be powerful in reaffirming whether the existing recommendation statements are still appropriate [ 17 ].

The weakness of RLR should also be borne in mind, and the trade-off of using RLR should be carefully considered regarding the thoroughness of the search, breadth of a research question, and depth of analysis [ 18 ]. If allowed, SLR is preferred over RLR considering that some relevant studies might be omitted with narrowed search strategies and simplified screening process [ 14 ]. Additionally, omitting the quality assessment of included studies could result in an increased risk of bias, making the comprehensiveness of RLR compromised [ 13 ]. Furthermore, in situations that require high accuracy, for example, where a small relative difference in an intervention has great impacts, for the purpose of drafting clinical guidelines, or making licensing decisions, a comprehensive SLR may remain the priority [ 19 ]. Therefore, clear communications with policymakers are recommended to reach an agreement on whether an RLR is justified and whether the methodologies of RLR are acceptable to address the unanswered questions [ 18 ].

Disclosure statement

No potential conflict of interest was reported by the author(s).

From economic wealth to well-being: exploring the importance of happiness economy for sustainable development through systematic literature review

• Open access
• Published: 23 May 2024

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• Shruti Agrawal   ORCID: orcid.org/0000-0002-1620-9429 1 , 5 ,
• Nidhi Sharma 1 , 5 ,
• Karambir Singh Dhayal   ORCID: orcid.org/0000-0002-0000-4330 2 &
• Luca Esposito   ORCID: orcid.org/0000-0001-5983-6898 3 , 4  

The pursuit of happiness has been an essential goal of individuals and countries throughout history. In the past few years, researchers and academicians have developed a huge interest in the notion of a ‘happiness economy’ that aims to prioritize subjective well-being and life satisfaction over traditional economic indicators such as Gross Domestic Product (GDP). Over the past few years, many countries have adopted a happiness and well-being-oriented framework to re-design the welfare policies and assess environmental, social, economic, and sustainable progress. Such a policy framework focuses on human and planetary well-being instead of material growth and income. The present study offers a comprehensive summary of the existing studies on the subject, exploring how a happiness economy framework can help achieve sustainable development. For this purpose, a systematic literature review (SLR) summarised 257 research publications from 1995 to 2023. The review yielded five major thematic clusters, namely- (i) Going beyond GDP: Transition towards happiness economy, (ii) Rethinking growth for sustainability and ecological regeneration, (iii) Beyond money and happiness policy, (iv) Health, human capital and wellbeing and (v) Policy push for happiness economy. Furthermore, the study proposes future research directions to help researchers and policymakers build a happiness economy framework.

Avoid common mistakes on your manuscript.

1 Introduction

Happiness is considered the ultimate goal of human beings (Ikeda, 2010 ; Lama, 2012 ). All economic, social, environmental and political human activities are aligned towards achieving this goal. This fundamental pursuit of human life introduces a new scope of research, namely the ‘happiness economy’ (Agrawal and Sharma 2023 ). The happiness economy is an emerging economic domain wherein many countries are working to envision and implement a happiness-oriented framework by expanding how they measure economic success, which includes wellbeing and sustainability (Cook and Davíðsdóttir 2021 ; Forgeard et al., 2011 ). The investigation of happiness, life-satisfaction and subjective well-being has witnessed increasing research interest across the disciplines- from psychology, philosophy, psychiatry, and cognitive neuroscience to sociology, economics and management (Diener 1984 ; Hallberg and Kullenberg, 2019 ).

In the post-Covid era, the world seeks an enormous transformation shift in the public system (Costanza 2020 ). However, public authorities need more time to realize such needs. To experience the ‘policy transformation’ within the coming few years, we require a paradigm shift that helps warm peoples’ hearts and minds. The new economic paradigm can penetrate the policy processes in advanced economies and every part of the world affected by the epidemic with the support of intellectuals, researchers, entrepreneurs and professionals.

OECD ( 2016 ) proposed a well-being economy framework to measure living conditions and people’s well-being. In 2020, developed countries like Finland, New Zealand, Iceland, Scotland and Wales have become members of the Wellbeing Economy Government (WEGo) (Abrar 2021 ). Since then, the network of government and international authorities across the globe has gained a quick momentum concerning an increasing tendency about a growing tendency to concentrate governmental decisions around human well-being rather than wealth and economic growth (Coscieme et al. 2019 ; Costanza et al. 2020 ).

In light of these circumstances, the purpose of this article is to describe the concept of a “happiness economy” or one that seeks to give everyone fair possibilities for growth, a sense of social inclusion, and stability that can support human resilience (Coyne and Boettke 2006 ). It provides a promising route towards improved social well-being and environmental health and is oriented towards serving individuals and communities (Skul’skaya & Shirokova, 2010 ). Moreover, the happiness economy paradigm is a transition from material production and consumption of commodities and services as the only means to economic development towards embracing a considerable variety of economic, social, environmental and subjective well-being dynamics that are considered fundamental contributors to human happiness (Atkinson et al., 2012 ; King et al., 2014 ; Agrawal and Sharma 2023 ). In following so, it reflects the ‘beyond growth’ approach that empathizes with the revised concept of growth, which is not centred around an increase in income or material production; instead it is grounded in the philosophy of achieving greater happiness for more people (Fioramonti et al. 2019a ).

Whereas the other critiques of economic growth emphasize contraction, frugality and deprivation, the happiness economy relies on a cumulative approach of humanity, hope and well-being, with a perceptive to build a ‘forward-looking’ narrative of ways for humans to live a happy and motivated life by inspiring the cumulative actions and encouraging policy-reforms in the measuring growth of an economy (Stucke 2013 ). Agrawal et al. ( 2023a , b ) explore the domain of happiness economics through a review of the various trends coupled with the future directions and highlight why it needs to be supported for a well-managed economic system and a happy society.

In this paper, we define a “happiness economy as an economy that aims to achieve the well-being of individuals in a nation, promoting human happiness, environmental up-gradation, and sustainability. Alternatively, as an economy where the wellbeing of people counts more than the goals of production and income”. Moreover, we have examined the existing body of research on the happiness economy and analyzed the emerging research themes related to rethinking the conventional approach to economic growth. We conclude by discussing how the happiness economy concept has been accepted so far and realizing its importance by triggering policy reforms at the societal level, by outlining potential future directions that might be included into the current national post-growth policies.

Various researchers and experts in the field of happiness economy support the idea that there is a lack of thorough studies related to the concept, definitions, and themes of the happiness economy model in the nations. This gap has motivated us to conduct a SLR in order to identify the evolution in the domain of happiness economy and to identify the emerging themes in this context. Therefore, this present study seeks to offer a holistic outline of the emerging research area of the happiness economy and helps to understand how the happiness economy can accelerate sustainable development. With the following research questions, this study seeks to give an all-encompassing review of this subject.

What is the annual publication trend in this domain and the most contributing authors, journals, countries etc?

Which themes and upcoming research areas are present in this field?

What directions will the happiness economics study field go in the future?

The SCOPUS database was used to achieve the above research objectives. We have selected 257 articles for examination by hand-selecting the pertinent keywords and going over each one. In the methods section, a thorough explanation of the procedures for gathering, reviewing, and selecting documents is provided.

The remainder of this paper is structured as follows; A thorough survey of the literature on the happiness economy is provided in Sect.  2 . The research approach employed in the study is presented in Sect.  3 . A thorough data analysis of the research findings is given in Sect.  4 . After discussing the results in Sect.  5 , Sect.  6 suggests areas for further research in this field. The study is summarised with a conclusion in Sect.  7 . Section  8 outlines the study’s limitation.

2 Literature review

The supporters of conventional economic growth proclaim that the material production of goods and services and consumption is vital to enhancing one’s living standards. The statement is true to some degree, mainly in countries of enormous deprivation. Some studies have found significantly less correlation between growth and happiness after fulfilling minimum threshold needs (Easterlin 1995 ; Kahneman and Krueger, 2006 ; Inglehart et al., 2008 ). These studies recommend that rather than concentrating solely on economic growth, governmental policy should give priority to non-economic aspects of human existence above a particular income level. According to some researchers, it is challenging to distinguish between the use and emissions of natural resources and economic growth (absolute decoupling) because of the interdependence between socioeconomic conditions and their biophysical basis (Wiedenhofer et al. 2020 ; Wang and Su, 2019 ; Wu et al., 2018 ). However, a shred of increasing evidence shows that it could be possible for humans to maintain a quality of life and a decent standard of living inside the ecological frontier of the environment, given that a contemporary perspective on the production and use of materials are adopted in conjunction with more fair wealth distribution (Millward-Hopkins et al. 2020 ; Bengtsson et al., 2018 ; Ni et al., 2022 ).

The scholarly discourse and institutional framework on the relationship between happiness and economic progress are synthesised in the happiness economy (Frey and Gallus 2012 ; Sohn, 2010 ; Clark et al., 2016 ; Easterlin, 2015 ; Su et al., 2022 ). From a happiness economy perspective, extreme materialism is unsustainable as it significantly impacts natural resources and hinders social coherence and individuals psychological and physical well-being (Fioramonti et al. 2022a ). Additionally, inequalities within countries have grown, while psychological suffering has increased, especially during accelerated growth (Vicente 2020 ; Galbraith, 2009 ). The modern world is witnessing anxiety, depression, wars, reduction of empathy, climate change, pandemics, loss of social bonds and other psychological disorders (Brahmi et al., 2022 ; Santini et al., 2015 ).

It has been scientifically proven that cordial human relations, care-based activity, voluntary activities and the living environment immensely impact a person’s health and societal well-being (Bowler et al. 2010 ; Keniger et al., 2013 ). Ecological economists demonstrated that free ecosystem services have enhanced human well-being (Fang et al. 2022 ). Social epidemiologists have long argued that an increase in inequalities has a negative influence on society while providing equality tends to improve significant objective ways of well-being, from healthier communities to happier communities, declining hate and crime and enhancing social cohesion, productivity, unity and mutual trust (Aiyar and Ebeke 2020 ; Ferriss, 2010 ).

From moving beyond materialistic growth, the happiness economy promotes, appreciates, and protects the environmental, societal, and human capital contributions that lead to cummalative well-being. In a happiness economy framework, a multidimensional approach is needed to evaluate the level of development based on the environmental parameters, health outcomes, as well as public trust, hope, value-creating education and social bonds (Agrawal and Sharma 2023 ; Bayani et al. 2023 ; Lavrov, 2010 ). Such factors have consistently been excluded from any traditional concept or assessment of economic growth. As a result, countries have promoted more industrial activities that deteriorate the authentic ways of human well-being and, hence, the foundations of economic progress.

An excess of production can create a detrimental effect on climate and people’s health, thereby creating a negative externality for society (Fioramonti et al. 2022b ). Moderation of output may be more efficient and desirable than hyper/over-production, as the former can reduce negative environmental externalities (e.g. waste, climate change) and create positive externalities (e.g. employment of the local resources and community) (Kim et al. 2019 ; Kinman and Jones, 2008 ). Moreover, people can also be productive in other contexts outside of the workplace, such as as volunteers, business owners, artists, friends, or members of the community (Fioramonti et al. 2022a ).

Various scholars and scientific research have established that the essential contributions to happiness in one’s life are made by natural surroundings, green and blue spaces, eco-friendly environment, healthy social relations, spirituality, good health, responsible consumption and value-creating education (Helliwell et al. 2021 ; Francart et al., 2018 ; Armstrong et al., 2016 ; Gilead, 2016 ; Giannetti et al., 2015 ). Unfortunately, existing conventional growth theories have ignored all these significant contributions. For example, GDP considers natural ecosystems as economically helpful only up until they are mined and their products are traded (Carrero et al. 2020 ). The non-market benefits they generate, such as natural fertilization, soil regeneration, climate regulation, clean air and maintenance of biodiversity, are entirely ignored (Boyd 2007 ; Hirschauer et al., 2014). The quality time people spend with their families and communities for leisure, educating future generations and making a healthy communal harmony is regarded meaningless, even in the event that they are important to enhance people’s well-being and, hence, to assist any dimension of economic engagement (Griep et al. 2015 ; Agrawal et al., 2020 ). Similarly, if an economy is focusing on people’s healthy lifestyle (for example, by providing comfortable working hours, improving work-life balance, emphasizing mental health, focusing on healthy food, reducing pollution, and promoting sustainable consumption), it is not considered in sync with the growth paradigm (Roy 2021 ; Scrieciu et al., 2013; Shrivastava and Zsolnai 2022 ; Lauzon et al., 2023 ).

Among the latest reviews, Bayani et al. ( 2023 ) highlight that the economics of happiness helps reduce the country’s financial crime by providing a livelihood that reduces financial delinquency. Chen ( 2023 ) highlights that smart city performance enhances urban happiness by adopting green spaces, reusing and recycling products, and controlling pollution. The study by (Agrawal and Sharma 2023 ) proposed a conceptual framework for a happiness economy to achieve sustainability by going beyond GDP. Similarly, Fioramonti et al. ( 2019b ) explored going beyond GDP for a transition towards a happy and well-being economy. The article by Laurent et al. ( 2022 ) has intensively reviewed the well-being indicators in Rome and proposed a conceptual framework for it.

Table  1 provides a thorough summary of the prior review studies about the happiness economy and its contribution to public policy and sustainable development.

3 Research methodology

In the current study, we have adopted an integrative review approach of SLR and bibliometric analysis of the academic literature to get a detailed knowledge of the study, which could also help propose future research avenues. The existing scientific production’s qualitative and quantitative context must be incorporated for a conclusive decision. The study by Meredith ( 1993 ) defines that SLR enables an “integrating several different works on the same topic, summarising the common elements, contrasting the differences, and extending the work in some fashion”. In the present study, the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) is applied to perform the SLR to follow systematic and transparent steps for the research methodology, as shown in Fig.  1 . The PRISMA technique includes the identification, screening, eligibility, and exclusion criteria parts of the review process.

Additionally, examples of the data abstraction and analysis processes are provided (Mengist et al. 2020 ; Moher et al., 2015 ). The four main phases of the PRISMA process are eligibility, identification, screening, and data abstraction and analysis. Because the PRISMA technique employs sequential steps to accomplish the study’s purpose, it benefits SLR research. Moreover, the bibliometric analysis helps summarise the existing literature’s bibliographic data and determine the emerging condition of the intellectual structure and developing tendencies in the specified research domain (Dervis 2019 ).

3.1 Identification

The step to conduct the PRISMA is the identification of the relevant keywords to initiate the search for material. Next, search strings for the digital library’s search services are created using the selected keywords. The basic search query is for digital library article titles, keywords, and abstracts. Next, a Boolean AND or OR operator is used to generate the search string (Boolean combinations of the operators may also be used).

There are different search databases to conduct the review studies, such as Scopus, Sage, Web of Science, IEEE, and Google Scholar. Among all the available search databases, we have used the Scopus database to identify the articles; since 84% of the material on Web of Science (WoS) overlaps with Scopus, very few authors have addressed the benefits of adopting Scopus over WoS (Mongeon and Paul-Hus 2016 ). Scopus is widely used by academicians and researchers for quantitative analysis (Donthu et al. 2021 ). It is the biggest database of scientific research and contains citations and abstracts from peer-reviewed publications consisting of journal research articles, books and conference articles (Farooque et al., 2019 ; Dhayal et al., 2022 ; Brahmi et al., 2022 ). The following search term was used: (TITLE-ABS-KEY (“happiness economy” OR “economics of happiness” OR “happiness in economy” OR “economy of happiness” OR “economy of wellbeing” OR “wellbeing economy” OR “wellbeing in economy” OR “beyond growth”). This process yields 380 artciles in the initial phase.

3.2 Screening

The second phase is completed by all identified articles from the Scopus database obtained from the search string in the identification phase. The publications are either included or excluded throughout the screening process based on the standards established by the authors and with the aid of particular databases. Exclusion and inclusion criteria are shown during the screening phase to identify pertinent articles for the systematic review procedure. The timeline of this study’s selected articles is from 1995 to 2023. The first article related to the research domain was published in 1995. The second criterion for the inclusion includes the types of documents. In the present research, the authors have regarded only peer-reviewed journals and review articles. Other types of articles, such as books, book chapters, conference articles, notes, and editorials, are excluded to maintain the quality of the review. The third inclusion and exclusion criterion is based on language. All the non-English language documents are excluded to avoid translation confusion; hence, only the English language articles are considered for the final review. After the screening process, 297 articles are obtained.

3.3 Eligibility

Articles are manually selected or excluded depending on specific criteria specified by the authors during the eligibility process. During the elimination process, the authors excluded the articles that did not fit into the scope of review after manual screening of the articles. Two hundred fifty-seven articles were selected after the eligibility procedure. These selected articles are carefully reviewed for the study by reviewing the titles, abstracts, and standards from earlier screening processes.

3.4 Data abstraction and analysis

Analysis and abstraction of data are part of the fourth step. Finally, 257 papers were taken into account for final review. After that, the studies are culled to identify pertinent themes and subthemes for the current investigation by thoroughly reviewing each article’s text. An integrative review is a form of study that combines mixed, qualitative, and quantitative research procedures. It is carried out as shown in Fig.  1 . R-studio Bibliometrix and VOSviewer version 1.6.18 were used to evaluate the final study dataset corpus of 257 articles. Since the Bibliometrix software package is a free-source tool programmed in the R language. It is proficient of conducting comprehensive scientific mapping. It also contains several graphical and statistical features with flexible and frequent updates (Agrawal et al. 2023a , b ).

Extraction of articles and selection process

This section provides an answer to the first research question, RQ1, by indicating the main information of corpus data, research publication trends, influential prolific authors, journals, countries and most used keywords, etc. (Refer to Tables  2 , 3 and 4 ) and (Refer to Figs.  2 , 3 , 4 , 5 and 6 ).

4.1 Bibliometric analysis

Table  2 shows the relevant information gathered from the publication-related details. It presents the cognitive knowledge of the research area, for instance, details about authors, annual average publication, average citations and collaboration index. By observing the rate of document publishing, the study illustrates how much has already been done and how much remains to be investigated.

The annual publication trend is shown in Fig.  2 . It is reflected that the first article related to happiness in an economy was released in the year 1995 when (Bowling 1995 ) published the article “What things are important in people’s lives? A survey of the public’s judgements to inform scales of health related quality of life” where the article discussed “quality of life” and “happiness” as an essential component of a healthy life. Oswald ( 1997 ) brought the concept of happiness and economics together and raised questions such as “Does money buy happiness?” or “Do you think your children’s lives will be better than your own?”. Eventually, the gross national product of the past year and the coming year’s exchange rate was no longer the concern; instead, happiness as the sublime moment became more accurate (Schyns 1998 ; Easterlin, 2001; Frey and Stutzer, 2005 ). Post-2013, we can see exponential growth in the publication trend, and the reason behind the growth is the report published by the “ Stiglitz-Sen-Fitoussi” Commission, which has identified limitations of GDP and questioned the metric of wealth, economic and societal progress. The affirmed questions have gained the attention of researchers and organizations, and thus, they have explored the alternatives to GDP. As a result, the “Organization for Economic Co-operation and Development” (OECD) have proposed a wellbeing framework. Some research work has significantly impacted that time, contributing to the immense growth in this research area (Sangha et al. 2015 ; Spruk and Kešeljević, 2015 ; Nunes et al., 2016 ).

Publication trend

Table  3 shows the top prolific journals concerning the topmost publications in the domain of happiness economy for the corpus of 257 articles, namely “International Journal of Environmental Research and Public Health”, “Ecological Economics”, “Ecological Indicators”, “Sustainability” and “Journal of Cleaner Production” with 5, 4, 4,4 and 4 articles respectively (Refer to Table  4 ). Moreover, the most influential journals with maximum citations are “Nature Human Behavior”, “Quality of Life Research”, “Journal of Applied Behavior Analysis”, “Journal of Cleaner Production” and “Ecological Economics”, with 219, 205, 186, 154 and 142 citations, respectively. “Journal of Cleaner Production” and “Ecological Economics” are highly prolific and the most influential journals in the happiness economy research domain.

Table  4 shows the most influential authors. Baños, R.M. and Botella, C. are the two most contributing authors with maximum publications. For the maximum number of citations, Zheng G. and Coscieme L. are the topmost authors for their research work. The nations were sorted according to the quantity of publications, and Fig.  3 showed where the top ten countries with the highest number of publications are listed originated. It can be seen from the figure that the United Stated has contributed the maximum publications, 66, followed by the United Kingdom with 41 articles, followed by Germany with 32 articles. It is worth noting that emerging nation such as India and China have also made significant contributions.

Top ten contributing countries

Figure  4 shows semantic network analysis in which the relationships between words in individual texts are performed. In the present study, we have identified word frequency distributions and the co-occurrences of the authors’ keywords in this study. We employed co-word analysis to find repeated keywords or terms in the title, abstract, or body of a text. In Fig.  5 , the circle’s colour represents a particular cluster, and the circle’s radius indicates how frequently the words occur. The size of a keyword’s node indicates how frequently that keyword appears. The arcs connecting the nodes represent their co-occurrence in the same publication. The greater the distance between two nodes, the more often the two terms co-occur. It can be seen that “happiness” is linked with “growth” and “life satisfaction”. The nodes of “green economy”, “ecological economics”, and “climate change” are in a separate cluster that shows they are emerging areas, and future studies can explore the relationship between happiness economy with these keywords.

Co-ocurrance of author’s keyword (Author’s compilation)

4.2 Thematic map analysis through R studio

The thematic analysis map, as shown in Fig.  5 , displays, beneath the author’s keywords, the visualisation of four distinct topic typologies produced via a biblioshiny interface. The thematic map shows nine themes/clusters under four quadrants segregated in “Callon’s centrality” and “density value”. The degree of interconnectedness between networks is determined by Callon’s centrality, while Callon’s density determines the internal strength of networks. (Chen et al. 2019 ). The rectangular boxes in Fig.  5 represent the subthemes under each topic or cluster that are either directly or indirectly connected to the major themes, based on the available research. In the upper-right quadrant, four themes have appeared, namely “circular economy”, “well-being economy”, “depression”, and “sustainable development”, they fall under the category of motor themes since they are extremely pertinent to the research field, highly repetitious, and well-developed. When compared to other issues with internal linkages but few exterior relations, “urban population” in the upper-left quadrant is seen as a niche concern since it is not as significant. This cluster may have affected the urban population’s happiness (Knickel et al. 2021 ). “Social innovation” is categorised as an emerging or declining subject with low centrality and density, meaning it is peripheral and undeveloped. It is positioned in the lower-left quadrant. Last but not least, the transversal and fundamental themes “happiness economy”, “subjective well-being”, and “climate change” in the lower-right quadrant are seen to be crucial to the happiness economy study field but are still in the early stages of development. As a result, future research must place greater emphasis on the quantitative and qualitative growth of the study area in light of the key themes that have been identified.

Thematic map analysis

4.3 Science mapping through cluster analysis

In the study, science mapping was conducted to examine the interrelationship between the research domains that could be intellectual (Aria and Cuccurullo 2017 ; Donthu et al. 2021 ). It includes various techniques, such as co-authorship analysis, co-occurrence analysis, bibliographic coupling, etc. We have used R-Studio for the study’s temporal analysis by cluster analysis. To answer RQ2, the authors have performed a qualitative examination of the emerging cluster themes through the science mapping of the existing research corpus of 257 articles by performing bibliographic coupling of documents. Bibliographic coupling analysis helps identify clusters reflecting the most recent research themes in the happiness economy field to illuminate the field’s current areas of interest.

The visual presentation of science mapping relied on VoSviewer version 1.6.18 (refer to Fig.  6 ). Five significant clusters emerged in this research domain (refer to Table  5 ). Going beyond GDP: Transition towards happiness economy, rethinking growth for sustainability and ecological regeneration, beyond money and happiness policy, health, human capital and wellbeing and Policy-Push for happiness economy. A thorough examination identified cluster analyzes has also assists us in identifying potential future research proposals. (Franceschet 2009 )

4.4 Cluster 1: Going beyond GDP: transition towards happiness economy

It depicts from the green colour circles and nodes, where seven research articles were identified with a common theme of beyond GDP that can be seen in Fig.  6 . Cook and Davíðsdóttir ( 2021 ) investigated the linkages between the alternative measure of the beyond growth approach such as a well-being economy prespective and the SDGs. They proposed a conceptual model of a well-being economy consisting of four capital assets interrelated with SDGs that promote well-being goals and domains. To extend the concept of going beyond GDP, various economic well-being indicators are being aligned with the different economic, environmental, and social dimensions to target the set goals of SDG. It is found that the “Genuine Progress Indicator” (GPI) is consider as the most extensive method that covers the fourteen targets among the seventeen’s SDG’s. Cook et al. ( 2022 ) consider SDGs to represent the classical, neoclassical and growth-based economy model and as an emerging paradigm for a well-being economy. The significance of GDP is more recognized within the goals of sustainable development.

GPI is considered an alternative indicator of economic well-being. On this basis, excess consumption of high-quality energy will expand macro-economic activity, which GDP measures. For such, a conceptual exploration of the study is conducted on how pursuing “Sustainable Energy Development” (SED) that can increase the GPI results. As the study’s outcome, according to the GPI, SED will have a significant advantage in implementing energy and environment policy and will also contribute to the advancement of social and economic well-being. Coscieme et al. ( 2020a ) explored the connection between the unconditional growth of GDP and SDG. The author considered that policy coherence for sustainable development should lessen the damaging effects of cyclic manufacturing on the ecosystem. Thus, the services considered free of charge in the GDP model should be valued as a component of society. Generally, such services include ecosystem services and a myriad of “economic” functions like rainfall and carbon sequestration. To work for SDG 8, defined by the “United Nations Sustainable Development Goals” (UNSDGs), a higher GDP growth rate would eventually make it more difficult to achieve environmental targets and lessen inequality. Various guidelines were proposed to select alternative variables for SDG-8 to enhance coherence among all the SDG and other policies for sustainability.

Fioramonti et al. ( 2019a ) state their focus is to go beyond GDP toward a well-being economy rather than material output with the help of convergence reforms in policies and economic shifts. To achieve the SDG through protecting the environment, promoting equality, equitable development and sharing economy. The authors have developed the Sustainable Well-Being Index (SWBI) to consolidate the “Beyond GDP” streams as a metric of well-being matched with the objectives to achieve SDG. The indicators of well-being for an economy have enough possibility to connect current transformations in the economic policies and the economy that, generally, GDP is unable to capture.

Fioramonti et al. ( 2022a ) investigate the critical features of the Wellbeing Economy (WE), including its various parameters like work, technology, and productivity. Posting a WE framework that works for mainstream post-growth policy at the national and international levels was the study’s primary goal. The authors have focused on building a society that promotes well-being that should be empowering, adaptable, and integrative. A well-being economic model should develop new tools and indicators to monitor all ecological and human well-being contributors. A multidimensional approach including critical components for a well-being economy was proposed that creates value to re-focus on economic, societal, personal, and natural aspects. Rubio-Mozos et al. ( 2019 ) conducted in-depth interviews with Fourth Sector business leaders, entrepreneurs, and academicians to investigate the function of small and medium-sized businesses and the pressing need to update the economic model using a new measure in line with UN2030. They have proposed a network from “limits to growth” to a “sustainable well-being economy”.

4.5 Cluster 2: Rethinking growth for sustainability and ecological regeneration

Figure  6 depicts it from blue circles and nodes, wherein four papers were identified. Knickel et al. ( 2021 ) proposed an analytical approach by collecting the data from 11 European areas to examine the existing conditions, difficulties, and anticipated routes forward. The goal of the study is to define the many ideas of a sustainable well-being economy and territorial development plans that adhere to the fundamental characteristics of a well-being economy. A transition from a conventional economic viewpoint to a broader view of sustainable well-being is centred on regional development plans and shifting rural-urban interactions.

Pillay ( 2020 ) investigates the new theories of de-growth, ecosocialism, well-being and happiness economy to break the barriers of traditional economic debates by investigating ways to commercialise and subjugate the state to a society in line with non-human nature. The significant indicator of Gross National Happiness (GNH) is an alternative working indicator of development; thus, the Chinese wall between Buddha and Marx has been built. They questioned the perspective of Buddha and Marx, whether they were harmonized or became a counter-hegemonic movement. In order to determine if the happiness principle is grounded in spiritual values and aligns with the counter-hegemonic ecosocialist movement, the author examined the ecosocialist perspective. Shrivastava and Zsolnai ( 2022 ) have investigated the theoretical and practical ramifications of creative organisations for well-being rooted in the drive for a well-being economy. Wellbeing and happiness-focused economic frameworks are emerging primarily in developed countries. This new policy framework also abolishes GDP-based economic growth and prioritizes individual well-being and ecological regeneration. To understand its application and interpretation, Van Niekerk ( 2019 ) develops a conceptual framework and theoretical analysis of inclusive economics. It contributes to developing a new paradigm for economic growth, both theoretically and practically.

4.6 Cluster 3: ‘Beyond money’ and happiness policy

It depicts pink circles and nodes, wherein five articles were identified, as shown in Fig.  6 . According to Diener and Seligman ( 2004a ) economic indicators are critical in the early phases of economic growth when meeting basic requirements is the primary focus. However, as society becomes wealthier, an individual’s well-being becomes less dependent on money and more on social interactions and job satisfaction. Individuals reporting high well-being outperform those reporting low well-being in terms of income and performance. A national well-being index is required to evaluate well-being variables and shape policies systematically. Diener and Seligman ( 2018 ) propounded the ‘Beyond Money’ concept in 2004. In response to the shortcomings of GDP and economic measures, other quality-of-life indicators, such as health and education, have been created. The national account of well-being has been proposed as a common path to provide societies with an overall quality of life metric. While measuring the subjective well-being of people, the authors reasoned a societal indicator of the quality of life. In this article, the authors have proposed an economy of well-being model by combining subjective and objective measures to convince policymakers and academicians to enact policies that enhance human welfare. The well-being economy includes quality of life indicators and life satisfaction, subjective well-being and happiness.

Frey and Stutzer ( 2000 ) perceived the microeconomic well-being variables in countries. In the study, survey data was used from 6000 individuals in Switzerland and showed that the individuals are happier in developed democracies and institutions (government federalization). They analyzed the reported subjective well-being data to determine the function of federal and democratic institutions on an individual’s satisfaction with life. The study found a negative relationship between income and unemployment. Three criteria have been employed in the study to determine happiness: demographic and psychological traits, macro- and microeconomic factors, and constitutional circumstances. Thus, a new pair of determinants reflects happiness’s effect on individuals’ income, unemployment, inflation and income growth.

Happiness policy, according to Frey and Gallus ( 2013b ), is an intrinsic aspect of the democratic process in which various opinions are collected and examined. “Happiness policy” is far more critical than continuing a goal such as increasing national income and instead considered an official policy goal. The article focuses on how politicians behave differently when they believe that achieving happiness is the primary objective of policy. Frey et al. ( 2014 ) explored the three critical areas of happiness, which are positive and negative shocks on happiness, choice of comparison and its extent to derive the theoretical propositions that can be investigated in future research. It discussed the areas where a more novel and comprehensive theoretical framework is needed: comparison, adaptation, and happiness policy. Wolfgramm et al. ( 2020 ) derived a value-driven transformation framework in Māori economics of wellbeing. It contributes to a multilevel and comprehensive review of Māori economics and well-being. The framework is adopted to advance the policies and implement economies of well-being.

4.7 Cluster 4: Health, human capital and wellbeing

It is depicted as a red colour circle and nodes in Fig.  6 , and only three papers on empirical investigations were found. Laurent et al. ( 2022 ) investigated the Health-Environment Nexus report published by the “Wellbeing Economy Alliance”. In place of increased production and consumption, they suggested a comprehensive framework for human health and the environment that includes six essential paths. The six key pathways are well-being energy, sustainable food, health care, education, social cooperation and health-environment nexus. The proposed variables yield the co-benefits for the climate, health and sustainable economy. Steer clear of the false perception of trade-offs, such as balancing the economy against the environment or the need to save lives. McKinnon and Kennedy ( 2021 ) focuses on community economics of well-being that benefits entrepreneurs and employees. They investigated the interactions of four social enterprises that work for their employees inside and within the broader community. Cylus et al. ( 2020 ) proposed the opportunities and challenges in adopting the model of happiness or well-being in an economy as an alternative measure of GDP. Orekhov et al. ( 2020 ) proposed the derivation of happiness from the World Happiness Index (WHI) data to estimate the regression model for developed countries.

4.8 Cluster 5: Policy-push for happiness economy

It is depicted as an orange circle and nodes in Fig.  6 , and only five papers on empirical and review investigations were found. Oehler-Șincai et al. ( 2023 ) proposed the conceptual and practical perspective of household-income-labour dynamics for policy formulation. It discusses the measurement of well-being as a representation of various policies focusing on health, productivity, and longevity. It focuses on the role of policy in building the subjective and objective dimensions of well-being, defines the correlation between well-being, employment policies, and governance, is inclined to the well-being performance of various countries, and underscores present risks that jeopardize well-being. Musa et al. ( 2018 ) have developed a “community happiness index” by incorporating the four aspects of sustainability—economic, social, environmental, and urban governance—as well as the other sustainability domains, such as human well-being and eco-environmental well-being. From then onwards, community happiness and sustainable urban development emerged. Chernyahivska et al. ( 2020 ) developed strategies to raise the standard of living for people in countries undergoing economic transition by using the quality of life index. The methods uncovered are enhancing employment opportunities and uplifting the international labour market in urban and rural areas, prioritizing human capital, eliminating gender inequality, focusing on improving the individual’s health, and enhancing social protection. Zheng et al. ( 2019 ) investigated the livelihood and well-being index of the population that makes liveable conditions and city construction in society based on people’s happiness index. The structure of a liveable city should be emphasised on sustainable development. The growth strategy in urban areas is an essential aspect of building a liveable city. Frey and Gallus ( 2013a ) criticised the National Happiness Index as a policy goal in a country because it cannot be measured and thus fails to measure the true happiness of people. To measure real happiness, the government should establish living conditions that enable individuals to become happy. The rule of law and human rights must support the process.

The structure of a liveable city should be emphasized in sustainable development. The growth strategy in urban areas is an essential aspect of building a liveable city. Frey and Gallus ( 2013a ) criticized the National Happiness Index as a policy goal in a country because it cannot be measured and thus fails to identify the true individuals happiness. To measure real happiness, the government should establish living conditions that enable individuals to be happy. The process needs to be supported by human rights and the rule of law.

Visualization of cluster analysis

5 Discussion of findings

Concerns like the improved quality-of-life and a decent standard of living within the ecological frontier of the environment have various effects on individuals overall well-being and life satisfaction. The ‘beyond growth’ approach empathized with the revised concept of growth, which is based on the idea of maximising happiness for a larger number of people rather than being driven by a desire for financial wealth or production. In that aspect, the notion of happiness economy is designed that prioritizes serving both people and the environment over the other. This present article has focused on the beyond growth approach and towards a new economic paradigm by doing bibliometric and visual analysis on the dataset that was obtained from Scopus, helping to determine which nations, publications, and authors were most significant in this field of study.

In this field of study, developed nations have made significant contributions as compared to the developing nations. In total, 59 countries have made the substantial contribution to the beyond growth approach literature an some of them have proposed their respective national well-being economy framwework. Among 59 countries the United States and the United Kingdom have been crucial to the publishing. With the exception of five of the top 10 nations, Europe contributes the most to scientific research. The existing research shows the inclination of developed and developing countries to build a new economic paradigm that goes beyond growth by prioritizing the happiness level at individual as well as at collective level.

The most prolific journals in this research domain are the “International Journal of Environmental Research” and “Public Health” with the total publication of 5 and 4. The top two cited journals were the “ Nature Human Behavior” with 219 citations and the “Quality of Life Research” with 205 citations. Due to various economic and non-economic factors, these journals struggled to strike a balance between scientific accuracy and timeliness, and it became vital to spread accurate and logical knowledge. For, example, discussing the relationship between inequality and well-being, exploring the challenges and opportunites of happiness economy in different countries, assessing the role of health in all policies to support the transition to the well-being economy. Visualization of semantic network analysis of co-ocurrance of authors keywords from the VOSviewer showed the future research scope to explore the association between happiness economy along with green economy, climate change, spirituality and sustainability. However, in the thematic mapping, the motor themes denotes the themes that are well-developed and repetative in research, such as, well-being economy, depression, sustainable development and circular economy. The basic themes depicts the developing and transveral themes such as happiness economy, subjective well-being and climate condition. As a result, future research must place greater emphasis on the theoretical and practical expansion of the research field in view of the determined major subjects.

The present study have performed the cluster analysis to identify the emerging research themes in this domain through VOSviewer that helps to analyze the network of published documents. Based on published papers, the author can analyse the interconnected network structure with the use of cluster analysis. We have identified the top five clusters from the study. Each cluster denote the specific and defined theme of the research in this domain. In cluster 1, the majorly of the authors are working in the area of going beyond GDP and transition towards happiness economy, which consists of empirical and review studies. Cluster 2 represents that authors are exploring the relationship between rethinking growth for sustainability and ecological regeneration to evaluate the transition from a conventional economic thought to a broader view of sustainable well-being which is centred on regional development plans and shifting rural-urban interactions. In cluster 3, the authors are exploring the beyond money and happiness policy themes and identified the shortcomings of GDP and economic measures, other quality-of-life indicators, such as health and education. They have proposed the well-being index to evaluate the well-being variables and shape socio-economic policies systematically. The authors have proposed an economy of well-being model by combining subjective and objective measures to convince policymakers and academicians to enact policies that enhance human welfare. The well-being economy includes quality of life indicators and life satisfaction, subjective well-being and happiness. In cluster 4, the authors are working of related theme of Health, human capital and wellbeing, whereby they have put up a comprehensive framework for health and the environment that includes several important avenues for prioritising human and ecological well-being over increased production and consumption. In cluster 5, the authors have suggested the policy-push for happiness economy in which they have identified the conceptual and practical perspective of household-income-labour dynamics for policy formulation. Majorly of the authors in this clutster have focused on the role of policy in building the subjective and objective dimensions of well-being, defines the correlation between well-being, employment policies, and governance, is inclined to the well-being performance of various countries, and underscores present risks that jeopardize well-being. Hence, the present study will give academics, researchers, and policymakers a thorough understanding of the productivity, features, key factors, and research outcomes in this field of study.

6 Scope for future research avenues

The emergence of a happiness economy will transform society’s traditional welfare measure. Such changes will generate more reliable and practical means to measure the well-being or welfare of an economy. After a rigorous analysis of the existing literature, we have proposed the scope for future research in Table  6 .

7 Conclusion

In 2015, the United Nations proposed the pathbreaking and ambitious seventeen “Sustainable Development Goals” (SDGs) for countries to steer their policies toward achieving them by 2030. In reality, economic growth remains central to the agenda for SDGs, demonstrating the absence of a ground-breaking and inspirational vision that might genuinely place people and their happiness at the core of a new paradigm for development. As this research has reflect, there are various evidence that the happiness economy strategy is well-suited to permeate policies geared towards sustainable development. In this context, ‘happiness’ may be a strong concept that ensures the post-2030 growth will resonate with the socioeconomic and environmental traits of everyone around the world while motivating public policies for happiness.

The current research has emphasized the many dynamics of the happiness economy by using a bibliometric analytic study of 257 articles. We have concluded that the happiness economy is an emerging area that includes different dimensions of happiness, such as ecological regeneration, circular economy, sustainability, sustainable well-being, economic well-being, subjective well-being, and well-being economy. In addition to taking into consideration the advantages and disadvantages of human participation in the market, a happiness-based economic system would offer new metrics to assess all contributions to human and planetary well-being. In terms of theoretical ramifications, we suggest that future scholars concentrate on fusing the welfare and happiness theory with economic policy. As countries are predisposed to generate disharmony and imbalance, maximizing societal well-being now entails expanding sustainable development. Since the happiness economy is still a relatively novel field, it offers numerous potential research opportunities.

8 Limitations

Similar to every other research, this one has significant restrictions as well. We are primarily concerned that all our data were extracted from the Scopus database. Furthermore, future research can utilize other software like BibExcel and Gephi to expound novel variables and linkages. Given the research limitations, this article still provides insightful and relevant direction to policymakers, scholars, and those intrigued by the idea of happiness and well-being in mainstream economics.

The study offers scope for future research in connecting the happiness economy framework with different SDGs. Future studies can also carry empirical research towards creating a universally acceptable ‘happiness economy index’ with human and planetary well-being at its core.

Data availability

Data not used in this article.

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Luca Esposito

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Agrawal, S., Sharma, N., Dhayal, K.S. et al. From economic wealth to well-being: exploring the importance of happiness economy for sustainable development through systematic literature review. Qual Quant (2024). https://doi.org/10.1007/s11135-024-01892-z

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Mindful Eating

What Is It?

Mindful eating stems from the broader philosophy of mindfulness, a widespread, centuries-old practice used in many religions. Mindfulness is an intentional focus on one’s thoughts, emotions, and physical sensations in the present moment. Mindfulness targets becoming more aware of, rather than reacting to, one’s situation and choices. Eating mindfully means that you are using all of your physical and emotional senses to experience and enjoy the food choices you make. This helps to increase gratitude for food, which can improve the overall eating experience. Mindful eating encourages one to make choices that will be satisfying and nourishing to the body. However, it discourages “judging” one’s eating behaviors as there are different types of eating experiences. As we become more aware of our eating habits, we may take steps towards behavior changes that will benefit ourselves and our environment.

How It Works

Mindful eating focuses on your eating experiences, body-related sensations, and thoughts and feelings about food, with heightened awareness and without judgment. Attention is paid to the foods being chosen, internal and external physical cues, and your responses to those cues. [1] The goal is to promote a more enjoyable meal experience and understanding of the eating environment. Fung and colleagues described a mindful eating model that is guided by four aspects: what to eat , why we eat what we eat , how much to eat , and how to eat . [1]

Mindful eating:

• considers the wider spectrum of the meal: where the food came from, how it was prepared, and who prepared it
• notices internal and external cues that affect how much we eat
• notices how the food looks, tastes, smells, and feels in our bodies as we eat
• acknowledges how the body feels after eating the meal
• expresses gratitude for the meal
• may use deep breathing or meditation before or after the meal
• reflects on how our food choices affect our local and global environment

Seven practices of mindful eating

• Honor the food . Acknowledge where the food was grown and who prepared the meal. Eat without distractions to help deepen the eating experience.
• Engage all senses . Notice the sounds, colors, smells, tastes, and textures of the food and how you feel when eating. Pause periodically to engage these senses.
• Serve in modest portions . This can help avoid overeating and food waste. Use a dinner plate no larger than 9 inches across and fill it only once.
• Savor small bites, and chew thoroughly . These practices can help slow down the meal and fully experience the food’s flavors.
• Eat slowly to avoid overeating . If you eat slowly, you are more likely to recognize when you are feeling satisfied, or when you are about 80% full, and can stop eating.
• Don’t skip meals . Going too long without eating increases the risk of strong hunger, which may lead to the quickest and easiest food choice, not always a healthful one. Setting meals at around the same time each day, as well as planning for enough time to enjoy a meal or snack reduces these risks.
• Eat a plant-based diet, for your health and for the planet . Consider the long-term effects of eating certain foods. Processed meat and saturated fat are associated with an increased risk of colon cancer and heart disease . Production of animal-based foods like meat and dairy takes a heavier toll on our environment than plant-based foods.

Watch: Practicing mindful eating

The Research So Far

The opposite of mindful eating, sometimes referred to as mindless or distracted eating, is associated with anxiety, overeating, and weight gain. [3] Examples of mindless eating are eating while driving, while working, or viewing a television or other screen (phone, tablet). [4] Although socializing with friends and family during a meal can enhance an eating experience, talking on the phone or taking a work call while eating can detract from it. In these scenarios, one is not fully focused on and enjoying the meal experience. Interest in mindful eating has grown as a strategy to eat with less distractions and to improve eating behaviors.

Intervention studies have shown that mindfulness approaches can be an effective tool in the treatment of unfavorable behaviors such as emotional eating and binge eating that can lead to weight gain and obesity, although weight loss as an outcome measure is not always seen. [5-7] This may be due to differences in study design in which information on diet quality or weight loss may or may not be provided. Mindfulness addresses the shame and guilt associated with these behaviors by promoting a non-judgmental attitude. Mindfulness training develops the skills needed to be aware of and accept thoughts and emotions without judgment; it also distinguishes between emotional versus physical hunger cues. These skills can improve one’s ability to cope with the psychological distress that sometimes leads to binge eating. [6]

Mindful eating is sometimes associated with a higher diet quality, such as choosing fruit instead of sweets as a snack, or opting for smaller serving sizes of calorie-dense foods. [1]

• A literature review of 68 intervention and observational studies on mindfulness and mindful eating found that these strategies improved eating behaviors such as slowing down the pace of a meal and recognizing feelings of fullness and greater control over eating. [8] Slower eating was associated with eating less food, as participants felt fuller sooner. Mindfulness and mindful eating interventions appeared most successful in reducing binge eating and emotional eating. However, the review did not show that these interventions consistently reduced body weight. Limitation of the studies included small sample sizes, limited durations of about 6 months or less, lack of focus on diet quality, and lack of follow-up so that longer-term success was not determined.
• A randomized controlled trial following 194 adults with obesity (78% were women) for 5.5 months looked at the effects of a mindfulness intervention on mindful eating, sweets consumption, and fasting glucose levels. The participants were randomly assigned to one of two groups: a diet and exercise program with mindfulness concepts (stress reduction, chair yoga, meditation, affirmations) or the same program but without mindfulness concepts. After 12 months, the mindfulness group showed a decreased intake of sweets and maintenance of fasting blood glucose, as opposed to the control group showing increased fasting blood glucose. [9] The research authors also evaluated weight loss with these participants, but did not find a significant difference in weight changes between the mindfulness group and control group. [10]
• A small controlled trial of 50 adults with type 2 diabetes were randomized to either a 3-month mindful eating intervention that was focused on reducing overeating and improving eating regulation or to a diabetes self-management education (DSME) intervention that was focused on improving food choices. Both groups showed significant improvements in measures of depression, nutrition self-efficacy, and controlling overeating behaviors. Both groups lost weight during the intervention but there was no difference in amount of weight loss between groups. [11]

It is important to note that currently there is no standard for what defines mindful eating behavior, and there is no one widely recognized standardized protocol for mindful eating. Research uses a variety of mindfulness scales and questionnaires. Study designs often vary as well, with some protocols including a weight reduction component or basic education on diet quality, while others do not. Additional research is needed to determine what behaviors constitute a mindful eating practice so that a more standardized approach can be used in future studies. [1] Standardized tools can help to determine the longer-term impact of mindful eating on health behaviors and disease risk and prevention, and determine which groups of people may most benefit from mindfulness strategies. [1]

Mindfulness is a strategy used to address unfavorable eating behaviors in adults, and there is emerging interest in applying this method in adolescents and children due to the high prevalence of unhealthy food behaviors and obesity in younger ages. More than one-third of adolescents in the U.S. have overweight or obesity. Youth who have overweight/obesity are likely to experience weight-related stigma and bullying by their peers, which in turn can negatively affect eating behaviors and lead to eating disorders. [12] Studies have found that eating disorders are developing at younger ages, with an increased number of children younger than 12 years of age presenting for treatment. [12]

• A review of 15 studies of mindfulness-based interventions in adolescents found that mindfulness techniques were associated with reduced concerns about body shape, less dietary restraint, decreased weight, and less binge eating. [12] However, interestingly, the overall acceptability of the mindfulness-related interventions was rated low by the participants, compared with general health education. It is likely that the way mindful strategies are presented to younger ages needs better understanding as it may be different than in adults. An example could be using new online technologies that are specific to their developmental age and learning ability. The review also found that mindfulness in the form of meditation and mindful breathing can have significant effects on disordered eating through better stress management and reduced overeating caused by depression and anxiety.
• Studies are still scarce in children, but novel programs are emerging. A pilot mindful eating intervention was tested in a low-income school in California involving third-through-fifth grade children including Hispanic and non-Hispanic children. [13] The goal was to foster healthy eating behaviors in the children and their parents. The program included topics such as “Master Mindless Munching,” “Getting to Know Hunger and Fullness,” and “Sensational Senses,” and provided take-home activities to do with their parents. Surveys at the end of the program showed that the children and parents liked the activities, and there was an increase in parents serving nutritious meals and practicing mindfulness during meals (e.g., recognizing when hungry vs. full).

Potential Pitfalls

• Mindful eating is not intended to replace traditional treatments for severe clinical conditions such as eating disorders . Neurochemical imbalances are a risk factor for developing eating disorders such as bulimia and anorexia nervosa, and although mindfulness may be an effective component of a treatment plan, it should not be used as a sole treatment.
• May not be effective as a weight loss strategy on its own, but rather a complement to a weight loss program. Mindful eating embraces making food choices that promote well-being and increasing enjoyment of the eating experience. Traditional weight loss regimens focus on following a structured meal plan that may not necessarily be satisfying or enjoyable. Combining mindfulness with a meal plan under the guidance of a registered dietitian may reduce the risk of emotional overeating or binge eating. [14] Research has not consistently shown that mindfulness strategies lead to weight loss, but this may be due to the study design not including education on healthy eating choices as part of the mindfulness intervention.

Bottom Line

Mindful eating is an approach to eating that can complement any eating pattern. Research has shown that mindful eating can lead to greater psychological wellbeing, increased pleasure when eating, and body satisfaction. Combining behavioral strategies such as mindfulness training with nutrition knowledge can lead to healthful food choices that reduce the risk of chronic diseases, promote more enjoyable meal experiences, and support a healthy body image. More research is needed to examine whether mindful eating is an effective strategy for weight management.

Mindful eating in context of COVID-19

In the meantime, individuals may consider incorporating any number of mindful eating strategies in their daily lives alongside other important measures to help stay healthy during COVID-19 . For example:

• If you’re working from home and find that “office” time blends into all hours of the day, schedule times in your calendar to only eat : a lunch break away from your computer, a reserved time for dinner with your family, etc.
• If you find yourself standing in your pantry or staring in your refrigerator, pause and ask yourself: “am I truly hungry, or am I just bored or stressed?” If hungry, eat. If boredom or stress is the source, reroute your attention to an activity you enjoy, call a friend, or simply spend some time breathing.
• If you have a craving for comfort foods, pause and take a few in-breaths and out-breaths to be fully present with your craving. Take a portion of the food from the container (a handful of chips, a scoop of ice cream) and put it on a plate. Eat mindfully, savoring each bite.

A note about eating disorders : The COVID-19 pandemic may raise unique challenges for individuals with experience of eating disorders. [17] In the U.S., the National Eating Disorders Association has reported a significant increase in calls and messages for help as compared to a year ago. As noted, mindful eating is not intended to replace traditional treatments for severe clinical conditions such as eating disorders. If you or someone you know is struggling with an eating disorder, you can call the National Eating Disorders Association Helpline at 1-800-931-2237, or text “NEDA” to 741-741.

A note about food insecurity : Many individuals may be facing food shortages because of unemployment or other issues related to the pandemic. If you (or someone you know) are struggling to access enough food to keep yourself or your family healthy, there are several options to help. Learn more about navigating supplemental food resources .

• Healthy Weight
• The Best Diet: Quality Counts
• Diet Reviews
• Fung TT, Long MW, Hung P, Cheung LW. An expanded model for mindful eating for health promotion and sustainability: issues and challenges for dietetics practice. Journal of the Academy of Nutrition and Dietetics . 2016 Jul 1;116(7):1081-6.
• Hanh TN, Cheung L. Savor: Mindful Eating, Mindful Life . HarperCollins Publishers. 2010.  
• Stanszus LS, Frank P, Geiger SM. Healthy eating and sustainable nutrition through mindfulness? Mixed method results of a controlled intervention study. Appetite . 2019 Oct 1;141:104325.
• Ogden J, Coop N, Cousins C, Crump R, Field L, Hughes S, Woodger N. Distraction, the desire to eat and food intake. Towards an expanded model of mindless eating. Appetite . 2013 Mar 1;62:119-26.
• Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eating behaviors . 2014 Apr 1;15(2):197-204.
• O’Reilly GA, Cook L, Spruijt‐Metz D, Black DS. Mindfulness‐based interventions for obesity‐related eating behaviours: a literature review. Obesity reviews . 2014 Jun;15(6):453-61.
• Ruffault A, Czernichow S, Hagger MS, Ferrand M, Erichot N, Carette C, Boujut E, Flahault C. The effects of mindfulness training on weight-loss and health-related behaviours in adults with overweight and obesity: A systematic review and meta-analysis. Obesity research & clinical practice . 2017 Sep 1;11(5):90-111.
• Warren JM, Smith N, Ashwell M. A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms. Nutrition research reviews . 2017 Dec;30(2):272-83. *Disclosure: Study  was  funded by Mondelez International.  
• Mason AE, Epel ES, Kristeller J, Moran PJ, Dallman M, Lustig RH, Acree M, Bacchetti P, Laraia BA, Hecht FM, Daubenmier J. Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial. Journal of behavioral medicine . 2016 Apr 1;39(2):201-13.
• Daubenmier J, Moran PJ, Kristeller J, Acree M, Bacchetti P, Kemeny ME, Dallman M, Lustig RH, Grunfeld C, Nixon DF, Milush JM. Effects of a mindfulness‐based weight loss intervention in adults with obesity: A randomized clinical trial. Obesity . 2016 Apr;24(4):794-804.
• Miller CK, Kristeller JL, Headings A, Nagaraja H. Comparison of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a randomized controlled trial. Health Education & Behavior . 2014 Apr;41(2):145-54.
• Omiwole M, Richardson C, Huniewicz P, Dettmer E, Paslakis G. Review of mindfulness-related interventions to modify eating behaviors in adolescents. Nutrients . 2019 Dec;11(12):2917.
• Wylie A, Pierson S, Goto K, Giampaoli J. Evaluation of a mindful eating intervention curriculum among elementary school children and their parents. Journal of nutrition education and behavior . 2018 Feb 1;50(2):206-8.
• Tapper K, Shaw C, Ilsley J, Hill AJ, Bond FW, Moore L. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite . 2009 Apr 1;52(2):396-404.
• Bhutani S, Cooper JA. COVID‐19 related home confinement in adults: weight gain risks and opportunities. Obesity . 2020 May 19.
• Clemmensen C, Petersen MB, Sørensen TI. Will the COVID-19 pandemic worsen the obesity epidemic?. Nature Reviews Endocrinology . 2020 Sep;16(9):469-70.
• Branley-Bell D, Talbot CV. Exploring the impact of the COVID-19 pandemic and UK lockdown on individuals with experience of eating disorders.  Journal of Eating Disorders .  2-2020 Aug;8(44).

Last reviewed September 2020

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• Open access
• Published: 22 May 2024

A systematic review and meta-analysis of the association between e-cigarette use among non-tobacco users and initiating smoking of combustible cigarettes

• Mimi M. Kim 1 ,
• Isabella Steffensen 1 ,
• Red Thaddeus D. Miguel 1 ,
• Tanja Babic 1 &
• Julien Carlone 1  

Harm Reduction Journal volume  21 , Article number:  99 ( 2024 ) Cite this article

Metrics details

Introduction

The rapid increase in e-cigarette use over the past decade has triggered an important public health question on the potential association between e-cigarette use and combustible cigarette smoking. Following AMSTAR 2 and PRISMA guidelines, this evidence synthesis sought to identify and characterize any associations between e-cigarette use among individuals not smoking cigarettes and initiation of cigarette smoking.

The protocol was registered on September 24, 2018 (PROSPERO 2018 CRD42018108540). Three databases were queried from January 01, 2007 to April 26, 2023. Search results were screened using the PICOS review method.

Among 55 included studies (40 “good” and 15 “fair”; evidence grade: “high”) that adjusted for gender, age, and race/ethnicity between groups, generally, there was a significant association between non-regular e-cigarette use and initiation of cigarette smoking, further supported by the meta-analytic results (AOR 3.71; 95% CI 2.86–4.81). However, smoking initiation was most often measured as ever/current cigarette smoking. Two studies (quality: 2 “good”) evaluated progression to regular cigarette smoking among individuals with regular use of e-cigarettes, and generally found no significant associations. One study (“good”) evaluated smoking initiation among individuals with regular use of e-cigarettes, finding an increasing probability of ever smoking cigarettes with increased e-cigarette use. Twelve studies (10 “good” and two “fair”) examining progression to regular smoking among individuals with non-regular use of e-cigarettes reported inconsistent findings.

Conclusions

Numerous methodological flaws in the body of literature limit the generalizability of these results to all individuals who are not smoking cigarettes with few studies measuring established/regular use/smoking of e-cigarettes and cigarettes. Further, studies did not control adequately for specific confounding variables representing common liabilities between e-cigarette use and cigarette smoking, nor did they account for sufficient follow-up durations. Collectively, these flaws limit the generalizability of findings to the question of an association between e-cigarette use and cigarette smoking initiation.

Implications

In order to support robust determinations regarding e-cigarette use and the initiation of—or progression to—cigarette smoking, future research should apply measures of e-cigarette and cigarette use in a manner consistent with examining true initiation (i.e., established and/or regular use, as opposed to ever or current use), increase follow-up durations to adequately evaluate progression to regular smoking, and sufficiently account for known or suspected confounding variables that would represent common liabilities between e-cigarette use and cigarette smoking.

Empirical evidence suggests e-cigarette aerosol does not contain most of the approximately 7000 chemicals present in cigarette smoke [ 1 , 2 ]. However, with the decline in cigarette smoking prevalence, there has been a parallel increasing prevalence in electronic cigarette (e-cigarette) use [ 3 , 4 , 5 , 6 ].

The potential association between e-cigarette use and cigarette smoking is an important public health issue [ 7 , 8 , 9 ]. Understanding the individual and population level impact of e-cigarettes requires an objective synthesis of the empirical evidence that informs on the potential association between e-cigarette use and subsequent cigarette smoking and the inherent risks to health presented by e-cigarettes themselves [ 2 ]. Among the public health concerns of the use of e-cigarettes is the question of youth who may transition from e-cigarettes to cigarette smoking [ 2 ]. Hence, an assessment of causality is central to understanding the public health effect of e-cigarettes.

The Common Liability model is an important consideration when assessing causality between e-cigarette and cigarette smoking, particularly among tobacco non-users [ 10 , 11 ]. Specifically, the common liability model posits that risks associated with using different substances can be explained by identifying common predisposing factors that also influence use behaviors [ 10 , 11 ]. According to this model, where risk-taking propensities and psychosocial processes can be factors that link patterns of multiple addictions, common liability can provide a parsimonious explanation of substance use and addiction co-occurrence [ 11 ]. Thus, narrowly focusing on the association between e-cigarette use and subsequent cigarette smoking without consideration of potential common liability factors limits an inference of causality [ 12 ].

The current systematic review and meta-analysis evaluated potential associations between e-cigarette use among tobacco non-users and cigarette smoking initiation, applying a level of methodological rigor not previously reported in other reviews. Based on a general understanding of the available published literature on e-cigarette use and cigarette smoking, a priori outcome measures included: age at initiation of smoking combustible cigarettes; percent who initiated smoking combustible cigarettes; and initiation and progression to regular smoking of combustible cigarettes. Study design was not limited in the inclusion criteria. While previous systematic reviews have examined the relationship between e-cigarette use and the onset of cigarette smoking in youth and young adults [ 3 , 13 , 14 , 15 , 16 , 17 ], as well as in the general population [ 18 , 19 ], this review specifically focused on initiation of and progression to regular cigarette smoking—an outcome measure unique to this systematic review. Furthermore, given the rapid rate of emerging evidence on e-cigarette use, this review provides an important timely evidence synthesis to previous reviews.

The methods and results reported here correspond to a larger systematic review addressing the key research question, “Are there any potential associations between e-cigarette use among non-tobacco users and intention to smoke combustible cigarettes or initiating smoking of combustible cigarettes?” The focus of the findings reported here is the identification and characterization of any potential associations between e-cigarette use among non-tobacco users and the initiation of cigarette smoking.

The review protocol was registered with PROSPERO (The International Prospective Register of Systematic Reviews) on September 24, 2018 (PROSPERO 2018 CRD42018108540; http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018108540 ).

This review strictly followed standards of systematic review methodology (“high” overall rating by A MeaSurement Tool to Assess systematic Reviews [AMSTAR] 2) [ 20 ] and reporting (Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA]) [ 21 ].

Terminology

Specific terminology in this review are fully reported in Supplemental Section 1 : Terminology.

Literature search methods

MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica Database), and PsycINFO were the database sources for the literature search. Applying search terms developed using medical subject headings (MeSH) and text words related to the associations between e-cigarette use and cigarette smoking intention and initiation, a full literature search was executed by an information specialist. Search dates were restricted to 2007 onwards due to the mass market introduction of e-cigarettes in the US [ 1 , 2 ] (Supplemental Section 2 : Literature Search Strategy).

The screening process was executed according to the PICOS (Population or participants and conditions of interest, Interventions or exposures, Comparisons or control groups, Outcomes of interest, and Study designs) review method (Supplemental Section 3 : Inclusion/Exclusion Criteria) [ 22 ]. The population of interest—tobacco non-users—without restriction by age. The interventions and controls were individuals using e-cigarettes and non-users, respectively. Outcome measures identified a priori included: age of initiation for cigarette smoking, initiation of cigarette smoking, and initiation and progression to regular cigarette smoking (not included in previously published systematic reviews [ 3 , 13 ]). Given the limited available evidence from randomized controlled trials (RCTs), this review was not limited by study design. The search strategy included: published peer-reviewed literature; theses and dissertations; government and industry documents; clinical trial registries (clinicaltrials.gov); gray literature in Google Scholar; consideration of reference lists across included studies; and content expert consultation. Studies were restricted to English-only publications.

Although the established/regular e-cigarette use provides the strongest evidence measure of sustained use behaviors, this review did not restrict use criteria. Additionally, studies were not restricted to those controlling for specific confounding variables that would represent common liabilities between e-cigarette use and cigarette smoking. The current review focused on studies that adjusted for at least the confounders of age, gender, and race/ethnicity.

Evidence synthesis

Two reviewers independently screened articles based on the inclusion/exclusion criteria at the title/abstract level and then, full-text for studies not excluded based on the title/abstract alone. Data extraction was first conducted by one reviewer and then checked by a second reviewer. Across all levels of review and data extraction, discrepancies were resolved through discussion between the two reviewers and included a third team member when adjudication was necessary. All data were extracted and recorded in the DistillerSR platform (Evidence Partners, Ottawa, Canada) [ 23 ].

Estimates of the difference between individuals using e-cigarettes and individuals who are not using e-cigarettes are presented with the best measures of precision (i.e., 95% confidence intervals [CIs]) and/or statistical significance (i.e., p value) reported in the included studies. Reporting references to “significant” and/or “significantly” are only used to indicate statistical significance (i.e., p  < 0.05 and/or CI excludes 1.0). The DerSimonian–Laird method was used to conduct random-effects meta-analyses where included studies were weighted by the inverse of the sum of within-study variance plus between-study variance [ 24 ]. The Cochran’s Q statistic assessed heterogeneity across pooled studies which was then quantified using the inconsistency index (I 2 ).

Study authors were contacted to obtain missing data. All meta-analytic data were analyzed through Review Manager version 5.3 [ 25 ], in Windows 10 Pro version 22H2.

Sensitivity analyses

Data permitting, sensitivity analyses were planned to include stratification of results (or removal of data inputs) from: studies that did not adjust for meso- and macro-level variables in addition to age, race/ethnicity, and gender; studies that did not define e-cigarette use or regular cigarette smoking; and studies with a questionable definition of e-cigarette use and/or regular cigarette smoking. Additionally, data permitting, stratification by age group, and a sensitivity analysis of age, was planned. A sub-group analysis for the meta-analysis based on the country where the study was implemented, and a sensitivity analysis excluding studies graded as “Fair,” was likewise planned.

Assessment of confounding

This review applied the Socio-Ecological Model as defined by McLeroy et al. [ 26 ] to guide consideration of the interrelationships between individuals and their social (micro-), physical (meso-), and policy (macro-) environments (further detail reported in Supplemental Section 4 : Conceptual Framework).

Evaluation of confounding factors was followed according to Cochrane guidelines for systematic reviews [ 27 ]; specifically, during protocol writing, a list of potential confounding factors was identified a priori based on evidence and expert opinion from members of the research team and external advisors; and during the systematic review process, the variables that individual study authors considered were recorded for additional post hoc consideration.

Outcomes and related psychometrics

Recognizing that not all the outcome measures are equally valid and reliable, this review examined the Contextual Question (CQ): “Have measures used to examine initiation and progression to regular cigarette smoking been psychometrically assessed as reliable and valid?” Specific criteria were applied to assess reliability and validity across the outcome measures [ 28 ] (full reporting in Supplemental Section 5 : Contextual Questions).

Study quality assessment

Two reviewers independently appraised study quality using the Downs and Black checklist. Individual studies were graded as either “excellent,” “good,” “fair,” or “poor” [ 29 ] (Full reporting in Supplemental Section 6 : Study Quality Assessment). A funnel plot was planned to test for the risk of publication bias if 10 or more studies provided estimates pooled in the meta-analysis.

Strength of evidence evaluation

Strength of evidence (SOE) was assessed for studies that controlled for age, gender, and race/ethnicity and those that did not control for key confounders. The overall SOE was graded as “high,” “moderate,” “low,” or “insufficient” using the Agency for Healthcare Research and Quality (AHRQ) Evidence Based Practice (EPC) grading system [ 30 ] (full reporting in Supplemental Section 7 : Strength of Evidence).

Consideration of industry funding bias

The potential impact of funding bias on results and conclusions has been a topic addressed in the evidence base [ 31 , 32 , 33 ]. As indicated in the conflict-of-interest disclosure for this review, and given the recent increase of peer-reviewed systematic reviews and meta-analyses, this topic with potential industry and public health impact may have a heightened importance as a methodological issue. To specifically address any potential concerns of funding bias in this reported evidence synthesis, this review was executed with the highest standards of the systematic review methodology including: a priori protocol registration (PROSPERO 2018 CRD42018108540; http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018108540 ); strict adherence to the PICOS throughout the execution of this review; a transparent and replicable search strategy executed by an information specialist with corresponding literature research results (Supplemental Section 8 : Literature Search Output, Studies Reviewed at the Full-Text Level); full reporting of excluded studies including reason for exclusion (Supplemental Section 9 : List of Excluded Studies); full reporting details on quantitative methods; and the expected details, per AMSTAR-2 and PRISMA guidelines, to disseminate a fully transparent and replicable evidence synthesis. Overall, the methodological rigor of this review with fully transparent and replicable reporting can also serve as a measure to minimize publication bias with systematic reviews.

The initial database search (January 1, 2007 to August 31, 2018) yielded 2526 articles, with four additional articles identified through other sources [ 3 , 34 , 35 , 36 ], resulting in 2530 articles. The first updated literature search (January 1, 2018 to August 30, 2019) yielded 1525 articles with 307 duplicate articles due to applied overlapping timeframes between the two searches. This overlapping timeframe conducted searches from the first of the year; therefore, overlapping search timeframes were unavoidable. Additionally, two articles were identified through other sources [ 37 , 38 ], resulting in 1220 unique articled retrieved. A second updated literature search for the timeframe of January 1, 2019 to October 7, 2020 yielded 2211 articles, of which 595 were duplicate articles with the previous database search, resulting in 1616 unique articles retrieved. A third updated search for the January 1, 2020 to November 24, 2021 timeframe yielded 3245 articles, of which 935 were duplicate articles with the previous database search, resulting in 2310 unique articles retrieved. Finally, a fourth updated search for the January 1, 2021 to April 26, 2023 period yielded 3925 articles, of which 1420 were duplicate articles with the previous database search, resulting in 2505 unique articles retrieved.

A cumulative total of 10,175 articles were retrieved from the specified databases, with an additional six additional articles identified from other sources (total: 10,181). Of the 10,181 potentially relevant articles, 9186 were excluded at the title/abstract level, resulting in 995 articles eligible for review at full-text level (Supplemental Section 8 : Literature Search Output, Studies Reviewed at the Full-Text Level). Subsequently, a further 873 articles were excluded (Supplemental Section 9 : List of Excluded Studies), resulting in 122 studies eligible for inclusion in the larger systematic review (Supplemental Section 10 : List of Included Studies). Inter-rater reliability at Level 2 screening was considered substantial or near perfect agreement [ 39 ] across all literature searches with a weighted overall kappa ranging from 0.72 to 0.95 (refer to Fig.  1 for each level of screening).

PRISMA flowchart

Of the 122 studies identified in the systematic review, 99 studies reported on cigarette smoking initiation or progression and were eligible for the qualitative and quantitative evidence. Of these 99 studies, 55 reported results that were adjusted for gender, age, and race/ethnicity between groups. For each included study, data were extracted on: study characteristics (Supplemental Section 11 : Study and Sample Characteristics, Adjusted Studies), demographic and baseline characteristics (Supplemental Section 12 : Demographic and Baseline Characteristics, Adjusted Studies), and study outcomes (Supplemental Section 13 : Evidence Tables, Adjusted Studies). Studies reporting unadjusted results are presented in Supplemental Section 14 (Study and Sample Characteristics, Unadjusted Studies), Supplemental Section 15 (Study and Sample Characteristics, Unadjusted Studies), and Supplemental Section 16 (Evidence Tables, Unadjusted Studies), but are not included in the qualitative or quantitative synthesis of evidence.

The highest number of studies (10 studies) were published in both 2020 [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ] and 2018 [ 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ]; followed by 7 studies in each of 2021 [ 60 , 61 , 62 , 63 , 64 , 65 , 66 ], 2019 [ 37 , 67 , 68 , 69 , 70 , 71 , 72 ], and 2017 [ 34 , 36 , 73 , 74 , 75 , 76 , 77 ]; six studies in 2022 [ 78 , 79 , 80 , 81 , 82 , 83 ]; three studies in each of 2023 [ 84 , 85 , 86 ] and 2015 [ 87 , 88 , 89 ]; and two studies in 2016 [ 90 , 91 ]. Studies were predominantly longitudinal in design and were from registered surveys. Of the 55 included studies, 41 were conducted in the US [ 36 , 40 , 41 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 51 , 52 , 53 , 54 , 56 , 58 , 59 , 62 , 63 , 64 , 65 , 67 , 68 , 69 , 70 , 71 , 72 , 75 , 76 , 77 , 78 , 79 , 81 , 82 , 83 , 86 , 87 , 88 , 89 , 90 , 91 ], five in the UK [ 34 , 37 , 61 , 66 , 85 ], two in Canada [ 60 , 73 ], one study in each of Mexico [ 74 ], Netherlands [ 57 ], Netherlands and Belgium [ 84 ], Romania [ 55 ], South Korea [ 42 ], Switzerland [ 50 ], and Thailand [ 80 ]. In terms of the study population, four studies defined their study population as “adults” [ 40 , 48 , 69 , 72 ], one study stratified their results by youth and adult populations [ 43 ]; three studies defined their participants as 12 years or older [ 59 , 81 , 86 ]. For the remaining 47 studies that defined participants, respondents were categorized as “youth,” “adolescents,” or “young adults” (participants defined as “students” were between grade 6 and college level) [ 34 , 36 , 37 , 41 , 42 , 44 , 45 , 46 , 47 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 70 , 71 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 82 , 83 , 84 , 85 , 87 , 88 , 89 , 90 , 91 ].

In addition to age, sex, and race/ethnicity, most studies included further adjustments with varying combinations of other micro, meso, and macro covariates. However, none of the studies sufficiently adjusted for potential confounding variables that would represent common liabilities between e-cigarette use and cigarette smoking [ 92 ]—meaning that a bias for those predisposing elements would exist among individuals using e-cigarettes that would likely be unadjusted for in the included studies.

Initiation of cigarette smoking was evaluated by the largest number of included studies (49 adjusted studies) [ 34 , 36 , 37 , 41 , 42 , 43 , 44 , 46 , 47 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 66 , 67 , 68 , 70 , 71 , 72 , 73 , 74 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 ], followed by initiation and progression to regular cigarette smoking (12 adjusted studies) [ 37 , 40 , 45 , 48 , 54 , 61 , 65 , 66 , 69 , 72 , 73 , 86 ]. One adjusted study examined the potential relationship between e-cigarette use and age of initiation for cigarette smoking [ 75 ].

The reliability and validity of each outcome measure were evaluated according to the CQ with a comprehensive but not systematic review of the literature. The objective in doing so was to provide fuller context for the interpretation of findings from the evidence synthesis. All measures were single-item measures related to the initiation and/or progression of cigarette smoking. All three measures of initiation were supported by empirical data regarding their reliability and/or validity, and therefore qualified as “acceptable”—including initiation of cigarette smoking, age of initiation for cigarette smoking, and initiation and progression to regular cigarette smoking (full reporting in Supplemental Section 5 : Contextual Questions).

Quality appraisal for each included study was conducted by two reviewers according to the Downs and Black checklist [ 29 ]. Forty (73%) were rated “good” quality [ 34 , 37 , 40 , 41 , 44 , 45 , 46 , 47 , 48 , 49 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 66 , 67 , 68 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 84 , 86 , 87 , 88 , 90 , 91 ], 15 (27%) were rated “fair,” [ 36 , 42 , 43 , 50 , 63 , 69 , 70 , 71 , 79 , 80 , 81 , 82 , 83 , 85 , 89 ] and no studies were rated “excellent” or “poor” (Supplemental Section 6 : Study Quality Assessment). Publication bias was assessed using funnel plots, and no publication bias was detected.

The overall SOE among the adjusted data regarding the association between e-cigarette use and age of initiation of cigarette smoking was graded “moderate”; the body of evidence specific to e-cigarette use and initiation of cigarette smoking was graded “high”; and the body of evidence specific to initiation and progression to regular cigarette smoking was graded “moderate.” The SOE domain score table and the SOE and CQ ratings summary table for both the adjusted and unadjusted data are presented in Supplemental Section 7 : Strength of Evidence.

Definitions of e-cigarette use by outcome measure

Among the 55 included studies, one evaluated age of cigarette smoking initiation [ 75 ], 42 evaluated initiation of cigarette smoking [ 34 , 36 , 41 , 42 , 43 , 44 , 46 , 47 , 49 , 50 , 51 , 52 , 53 , 55 , 56 , 57 , 58 , 59 , 60 , 62 , 63 , 64 , 67 , 68 , 70 , 71 , 74 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 87 , 88 , 89 , 90 , 91 ], five evaluated progression to regular smoking [ 40 , 45 , 48 , 65 , 69 ], and seven studies evaluated both initiation of cigarette smoking and progression to regular smoking [ 37 , 54 , 61 , 66 , 72 , 73 , 86 ].

Among the 49 studies that examined initiation of cigarette smoking, only one evaluated the association between regular e-cigarette use and initiation of cigarette smoking. Wills et al. [ 77 ] defined e-cigarette use on a frequency scale (1–2 times ever use, 3–4 times ever use, yearly/monthly, and weekly/daily), with the initiation of cigarette smoking defined as having “ever smoked a whole cigarette”. For the remaining studies that examined initiation of cigarette smoking among individuals with non-regular use of e-cigarettes, ever use was the most common measure of both e-cigarette use (39 studies) [ 34 , 37 , 42 , 43 , 44 , 46 , 47 , 49 , 52 , 54 , 55 , 56 , 57 , 59 , 61 , 63 , 64 , 67 , 68 , 70 , 71 , 72 , 74 , 76 , 77 , 78 , 79 , 80 , 81 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 93 ] and cigarette use (33 studies) [ 34 , 37 , 42 , 43 , 44 , 46 , 47 , 49 , 52 , 55 , 56 , 57 , 58 , 61 , 63 , 64 , 66 , 67 , 68 , 70 , 71 , 72 , 73 , 74 , 76 , 77 , 78 , 79 , 80 , 84 , 87 , 89 , 91 ], with current or past 30-day use being the second most common measure (16 studies for e-cigarette use [ 36 , 41 , 52 , 53 , 54 , 58 , 60 , 62 , 67 , 72 , 73 , 78 , 79 , 80 , 86 , 91 ] and 23 studies for cigarette use [ 36 , 41 , 43 , 47 , 52 , 53 , 54 , 58 , 59 , 60 , 62 , 63 , 64 , 68 , 74 , 76 , 78 , 79 , 80 , 81 , 85 , 90 , 93 ]). The most commonly evaluated relationship for these two tobacco use behaviors was between ever use of e-cigarettes and ever use of cigarettes (30 studies) [ 34 , 37 , 42 , 43 , 44 , 46 , 47 , 49 , 52 , 55 , 56 , 57 , 61 , 63 , 64 , 66 , 67 , 68 , 70 , 71 , 72 , 74 , 76 , 77 , 78 , 79 , 80 , 84 , 87 , 88 ]. Ever use of e-cigarettes and current use of cigarettes was the second most commonly evaluated relationship (17 studies) [ 43 , 47 , 52 , 54 , 59 , 63 , 64 , 68 , 74 , 76 , 78 , 79 , 80 , 81 , 85 , 90 , 93 ], followed by current use of e-cigarettes and current use of cigarettes (11 studies) [ 36 , 41 , 52 , 53 , 54 , 58 , 60 , 62 , 78 , 79 , 80 ].

Twelve studies examined the association between e-cigarette use and initiation of and progression to regular cigarette smoking [ 37 , 45 , 48 , 54 , 61 , 65 , 66 , 69 , 72 , 73 , 86 , 94 ]. All of these 12 studies evaluated the association between non-regular e-cigarette use and progression to regular cigarette smoking. Additionally, two of the 12 studies also evaluated the association between regular e-cigarette use and progression to regular cigarette smoking [ 40 , 48 ]. Azagba et al. [ 94 ] defined e-cigarette use as either every day (current daily use and having ever used fairly regularly), some day (current use and having ever used fairly regularly), or experimental (current use and never having used fairly regularly), with progression to regular cigarette smoking defined as transitioning from either current non-established to current-established cigarette smoking, current non-established to current daily-established cigarette smoking, or current-established to current daily-established cigarette smoking [ 40 ]. Among individuals with established (having ever used fairly regularly) e-cigarette use, Wei et al. [ 48 ] evaluated transitions from non-current, non-established cigarette smoking to either exclusive current-established cigarette smoking or current-established dual use of cigarettes and e-cigarettes.

For the 12 studies that used definitions of non-regular e-cigarette use, e-cigarette use was defined as follows: current or past-30-day use in two studies [ 45 , 73 ]; e-cigarette experimentation, defined as non-established use (less than 100 times during lifetime) in one study [ 69 ]; and ever use of e-cigarettes in four studies [ 37 , 61 , 65 , 66 ]. Three studies applied multiple definitions of non-regular e-cigarette use: Chaffee et al. [ 54 ] included ever, past 30-day, and former e-cigarette use; Sun et al. [ 86 ] included ever and past 30-day use, while McMillen et al. [ 72 ] included ever and past 30-day e-cigarette use. Two studies that evaluated regular e-cigarette use also evaluated non-regular use defined as experimental use [ 40 , 48 ].

In the one study that evaluated age of initiation of cigarette smoking, e-cigarette use was defined as current use [ 75 ].

Qualitative synthesis of best available evidence

Fifty-five studies adjusted for three main confounders (gender, age, and race/ethnicity) between groups, and were analyzed in the qualitative review and quantitative syntheses reported below. Results for each outcome measure in the qualitative analysis were stratified by regular versus non-regular e-cigarette use.

Adjusted data for age of initiation, initiation of cigarette smoking, and progression to regular smoking are provided in Supplemental Section 13 : Evidence Tables, Adjusted Studies. Unadjusted data for age of initiation of cigarette smoking, initiation of cigarette smoking, and initiation and progression to regular cigarette smoking are provided in Supplemental Section 16 : Evidence Tables, Unadjusted Studies; however, unadjusted data are not included in qualitative analysis.

Age of initiation of cigarette smoking (regular e-cigarette use)

No studies provided adjusted analyses of age of initiation of cigarette smoking among individuals with regular use of e-cigarettes.

Age of initiation of cigarette smoking (non-regular e-cigarette use: 1 study)

One adjusted study was identified that investigated the association between non-regular e-cigarette use and age of initiation of cigarette smoking [ 75 ] (Summary characteristics of this study are provided in Table  1 ). In a cross-sectional analysis, McCabe et al. [ 75 ] reported that the adjusted odds of smoking the first cigarette at an earlier age (Grade 8 or below) were significantly higher among individuals using e-cigarettes (current [past-30-day]) versus individuals who are not using e-cigarettes (adjusted odds ratio [AOR] 4.12, 95% CI 2.56–6.62). Further, the odds of an earlier age of onset of daily cigarette smoking (before 8th grade level) were not significantly different between individuals currently using e-cigarettes (past-30-day) and individuals who are not using e-cigarettes (AOR 1.67, 95% CI 0.385–7.25) [ 75 ].

Initiation of cigarette smoking (regular e-cigarette use: 1 study)

One adjusted study was identified that investigated the association between regular e-cigarette use and odds of initiation of cigarette smoking among individuals not smoking cigarettes at baseline[ 77 ] (Summary characteristics of this study are provided in Table  2 ).

In their study of 1070 individuals who never smoked cigarettes at baseline, Wills et al. [ 77 ] examined the association between e-cigarette use and initiation of cigarette smoking by stratifying the probability of smoking onset by frequency of e-cigarette use at baseline, including a measure of regular (weekly/daily) e-cigarette use. Compared with individuals who are not using e-cigarettes, all individuals who have used e-cigarettes had significantly higher adjusted odds of initiating cigarette smoking: individuals who ever used e-cigarettes (1–2 times): AOR 2.88 (95% CI 1.96–4.22); individuals who ever used e-cigarettes (3–4 times): AOR 2.29 (95% CI 1.35–3.87); weekly/daily users: AOR 4.09 (95% CI 2.43–6.88); and yearly/monthly users: AOR 4.17 (95% CI 2.03–8.57).

Initiation of cigarette smoking (non-regular e-cigarette use: 49 studies)

Forty-nine adjusted studies examined the association between non-regular e-cigarette use and initiation of cigarette smoking among individuals not smoking cigarettes at baseline [ 34 , 36 , 37 , 41 , 42 , 43 , 44 , 46 , 47 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 66 , 67 , 68 , 70 , 71 , 72 , 73 , 74 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 ]. Summary characteristics of these 49 studies are provided in Table  3 .

As discussed in the search results of the meta-analysis, 12 studies met the inclusion criteria of the meta-analysis [ 34 , 43 , 52 , 56 , 59 , 63 , 66 , 76 , 77 , 80 , 81 , 84 ]. These studies are included in Table  3 , but are not discussed in qualitative synthesis. For a variety of reasons, 37 studies did not meet the criteria to be included in the quantitative synthesis (Supplemental Section 17 : Meta-Analytic Results); however, these studies contained information important to the research question and are described below.

Twenty-four studies—15 prospective cohort studies [ 37 , 46 , 49 , 55 , 58 , 61 , 62 , 68 , 70 , 71 , 73 , 83 , 87 , 89 , 90 ], eight longitudinal panel studies [ 41 , 47 , 50 , 53 , 72 , 82 , 86 , 88 ], and one retrospective cohort study [ 67 ]—all reported statistically significant AORs, showing a higher likelihood of individuals who have used e-cigarettes (non-regular use: ever, ever in the past 12 months, and current) initiating smoking compared with individuals who are not using e-cigarettes. Their AORs ranged from 1.75 (95% CI 1.10–2.77) in a prospective cohort of Grade 9 individuals who never smoked cigarettes at baseline reporting any cigarette use at follow-up (either 6 or 12 months) [ 87 ] to 8.3 (95% CI 1.2–58.6) in a prospective cohort of 16–26 year old non-susceptible individuals who never smoked a cigarette reporting ever cigarette use (at least one puff) at 18-month follow-up [ 89 ].

Four studies calculated the adjusted relative risk (ARR) of individuals who have used e-cigarettes (ever and current [past-30-day]) smoking cigarettes compared with individuals who are not using e-cigarettes [ 36 , 64 , 74 , 78 ]. Lozano et al. [ 74 ] found a statistically significantly higher risk for trying smoking (ARR 1.40, 95% CI 1.22–1.60), however, no significant difference was reported for current smoking (≥ 1 cigarette in the past 30 days; ARR 1.43, 95% CI 0.94–2.16). Miech et al. [ 36 ] also found a statistically significantly higher risk for current smoking (ARR 4.78, 95% CI 1.91–11.96).

Keller-Hamilton et al. [ 64 ] reported that individuals who have used e-cigarettes at baseline were more than twice as likely to report ever (ARR 2.71, 95% CI 1.89–3.87) and current (i.e., past 30 day) smoking (ARR 2.20, 95% CI 1.33–3.64) at follow-up compared to individuals who are not using e-cigarettes. Similar results were reported in a propensity score-matched analysis (ever cigarette use ARR 2.22; 95% CI 0.90–5.47; past 30-day cigarette use ARR 1.25; 95% CI 0.41–3.82). Using data from Waves 1–5 of the PATH study, Harlow et al. [ 78 ] showed that, among baseline never-smokers, ever e-cigarette use at Wave 2 was associated with a higher likelihood of ever smoking at Waves 3, 4, and 5 (ARR 2.7, 95% CI 2.4–3.0). This association was present for all sub-categories of e-cigarette ever-use, namely former use (ARR 2.5, 95% CI 2.2–2.9), current (i.e., past 30-day) use (ARR 3.5, 95% CI 2.9–4.1), use of tobacco-flavored (ARR 2.5, 95% CI 1.8–3.5), and nontobacco-flavored (ARR 2.8, 95% CI 2.5–3.1) e-cigarettes. In a marginal structural model that accounted for time-dependent confounding, ever e-cigarette use was similarly associated with a higher likelihood of ever smoking at follow-up waves (ARR 2.4, 95% CI 2.1–2.7), regardless of the sub-category of ever use (former use ARR 2.2, 95% CI 2.0–2.5; current use ARR 3.1, 95% CI 2.6–3.7), or e-cigarette flavor (tobacco flavored ARR 2.4, 95% CI 1.7–3.3; nontobacco flavored ARR 2.4, 95% CI 2.2–2.7) [ 78 ]. The study also reported that the likelihood of being an individual who currently smoked (i.e., past 30-day) at Waves 3–5 was higher among individuals who have ever used e-cigarettes at baseline (ARR 2.9, 95% CI 2.5–3.3), quit e-cigarette use (ARR 2.6, 95% CI 2.2–3.1), currently used (ARR 3.8, 95% CI 3.1–4.6), used tobacco-flavored (ARR 2.6, 95% CI 1.7–3.9), and non-tobacco-flavored (ARR 3.0, 95% CI 2.6–3.4) e-cigarettes [ 78 ]. Similarly, in the marginal structural model, the likelihood of past 30-day cigarette use at Waves 3–5 was associated with ever (ARR 2.5, 95% CI 2.2–2.9), former (ARR 2.3, 95% CI 1.9–2.7), current (ARR 3.4, 95% CI 2.8–4.2), tobacco-flavored (ARR 2.3, 95% CI 1.5–3.5), and nontobacco-flavored (ARR 2.6, 95% CI 2.2–3.0) [ 78 ] e-cigarette use.

A study by Aleyan et al. [ 60 ] calculated regression coefficients to estimate the association between past 30-day e-cigarette use at Wave 1 and initiation of cigarette smoking at Wave 3. Past-30-day e-cigarette use at Wave 1 was significantly associated with past 30-day cigarette smoking (β = 1.06; SE = 0.28; 95% CI 0.52–1.60; p  < 0.001), and dual use at Wave 3 (β = 1.31; SE = 0.24; 95% CI 0.84–1.79; p  < 0.001). Further, the association between past 30-day e-cigarette use at Wave 1 and cigarette smoking at Wave 3 remained significant after adjustment for having one or more friends who smoked at Wave 1.

Kintz et al. [ 44 ] calculated a phi-coefficient for the relationship between ever use of e-cigs at baseline and subsequent cigarette initiation (self-reported first use) at follow-up, and found that baseline ever e-cigarette use was significantly associated with cigarette smoking initiation at follow-up (phi coefficient = 0.141, p  < 0.001).

Two studies applied a multistate Markov model to evaluate the probability of transitioning to cigarette smoking [ 42 , 85 ]. A study by Kang et al. [ 42 ] applied a multistate Markov model to show that individuals who have ever used e-cigarettes at baseline had a 9.52% (95% CI 6.57–13.85) probability of transitioning to dual e-cigarette and cigarette use, whereas individuals who are not using e-cigarettes at baseline had a 1.39% (95% CI 1.29–1.49) probability of transitioning to exclusive cigarette use. Parnham et al. [ 85 ] examined transition probabilities between e-cigarette use and smoking in UK adolescents and young adults. In an analysis that adjusted for age, wave of data collection, sex, ethnicity, and tertiles of household income, adjusted probability of transition from ever e-cigarette use to smoking ranged from 14% (95% CI 13–16) in Year 1 to 27% (95% CI 25–29) in Year 5, while the probability of transitioning from e-cigarette never use to smoking ranged from 2% (95% CI 2–2) to 10% (95% CI 9–10) [ 85 ].

The study by Loukas et al. [ 79 ] reported hazard ratios for the association between past 30-day and ever e-cigarette use and transition from never to current cigarette smoking. After adjusting for covariates, both past 30-day (HR 2.69, 95% CI 1.95–3.72) and ever (HR 2.16, 95% CI 1.79–2.62) e-cigarette use were associated with a higher likelihood of transition to smoking.

Conner et al. [ 61 ] evaluated cigarette smoking initiation (ever use) among individuals who have used e-cigarettes “early” and “late”, defined as reporting ever e-cigarette use at either Wave 3 (early) or Wave 4 (late), respectively. The authors found that the adjusted odds of individuals using e-cigarettes early, compared to individuals who never used e-cigarettes, initiating cigarette smoking was statistically significant both at Wave 4 (AOR 1.39, 95% CI 1.29–1.50) and at Wave 5 (AOR 3.55, 95% CI 2.82–4.49). Similarly, individuals using e-cigarettes late were significantly more likely to initiate cigarette smoking at Wave 5 compared to individuals who have never used e-cigarettes (AOR 2.87, 95% CI 2.33–3.53) [ 61 ].

Chaffee et al. [ 54 ] calculated the AORs for initiating smoking in three different groups of individuals who have used e-cigarettes (versus individuals who have not used e-cigarettes) and found the following: a non-significant AOR of 1.57 (95% CI 0.99–2.49) for individuals who have ever used e-cigarettes and have smoked at least 100 + cigarettes; a non-significant AOR of 1.69 (95% CI 0.93–3.05) for individuals who have used e-cigarettes in the past-30-days who have smoked at least 100 cigarettes; a non-significant AOR for individuals who have smoked at least 100 cigarettes but have quit e-cigarette use (AOR 1.55, 95% CI 0.94–2.56); a non-significant AOR for individuals who have ever used e-cigarettes and smoked a cigarette in the past 30 days (AOR 1.32, 95% CI 0.99–1.76); a significant AOR for individuals who have used e-cigarettes in the past 30 days and smoked a cigarette in the past 30 days (AOR 1.64, 95% CI 1.12–2.41); and, a non-significant AOR for individuals who quit e-cigarette use and smoked in the past 30 days (AOR 1.20, 95% CI 0.86–1.68) [ 54 ].

In additional to their overall analysis, Owotomo et al. [ 46 ] reported AORs for cigarette smoking initiation among subgroups of adolescents according to their baseline cigarette smoking intentions. Overall, the authors found ever e-cigarette use to be significantly associated with ever cigarette smoking (AOR 2.58, 95% CI 1.73–3.85). The association remained significant in a subgroup analysis of adolescents with no baseline intention to smoke (AOR 4.62, 95% CI 2.87–7.42); however, among the subgroup of adolescents with baseline cigarette smoking intentions, the association between ever e-cigarette use and cigarette smoking initiation was nonsignificant (AOR 1.57, 95% CI 0.94–2.63). The AOR for the interaction between smoking intention and ever e-cigarette use with regards to smoking initiation was statistically significant (AOR 0.34, 95% CI 0.18–0.64), suggesting the association between e cigarette use and ever cigarette smoking was dependent on previous smoking intention status.

Three of the 37 studies not included in the meta-analysis evaluated initiation of cigarette smoking and either susceptibility or propensity to smoke cigarettes among individuals using e-cigarettes versus individuals who are not using e-cigarettes [ 52 , 57 , 91 ]. Barrington-Trimis et al. [ 52 ] evaluated the association between susceptibility and initiation of cigarette smoking in either individuals who have ever used e-cigarettes or individuals who are not using e-cigarettes and found a statistically significant difference between the two groups. The authors found that among individuals who are not using e-cigarettes, susceptibility to cigarette use was associated with over three times the odds of subsequent initiation of cigarette smoking compared with non-susceptible individuals who are not using e-cigarettes (AOR 3.47, 95% CI 2.38–5.07); however, only a small, non-statistically significant association was observed between susceptible and non-susceptible individuals who have ever used e-cigarettes and initiation of cigarette smoking (AOR 1.57, 95% CI 0.80–3.05) [ 52 ]. Thus, susceptibility only statistically significantly affected the subsequent initiation of cigarette smoking in individuals who are not using e-cigarettes ( p interaction  = 0.04).

Findings from a 2016 study by Wills et al. indicated that the effect of e-cigarette for cigarette smoking onset decreased as propensity increased—the AOR for smoking onset for individuals currently using e-cigarettes (past-30-day) versus individuals who are not using e-cigarettes was 2.23 (95% CI 1.57–3.17) for those in the bottom 10th percentile for propensity to smoke, and 1.32 (95% CI 1.19–1.47) for those in the top 10th percentile for propensity to smoke [ 91 ].

In a 2018 study, Treur et al. provided AORs for low-propensity- and high-propensity-to-smoke groups for ever e-cigarette versus individuals who are not using e-cigarettes, both with and without nicotine [ 57 ]. The investigators found that, for e-cigarettes containing nicotine, the AOR for initiating conventional smoking was 7.80 (95% CI 1.90–32.04) in the low-propensity-to-smoke group, and 2.89 (95% CI 1.47–5.68) in the high-propensity-to-smoke group; for e-cigarettes containing no nicotine, the AOR for initiating conventional smoking was 6.07 (95% CI 2.18–16.90) in the low-propensity-to-smoke group, and 3.30 (95% CI 2.33–4.67) in the high-propensity-to-smoke group.

Treur et al. also compared the effects of e-cigarette use with nicotine and e-cigarette use without nicotine in individuals using e-cigarettes versus individuals who have never used e-cigarettes [ 57 ]. The study reported an AOR for initiation of 5.36 (95% CI 2.73–10.52) for individuals who ever used e-cigarettes without nicotine compared with individuals who are not using e-cigarettes, and an AOR of 11.90 (95% CI 3.36–42.11) for individuals who ever used e-cigarettes with nicotine compared with individuals not using e-cigarettes.

Three studies evaluated initiation in susceptible subgroups [ 34 , 68 , 90 ], two of which were included in the meta-analysis for initiation of cigarette smoking [ 34 , 90 ]. The association between ever e-cigarette use and susceptibility to smoking was evaluated in a 2016 prospective cohort study by Barrington-Trimis et al. [ 90 ]. The study found that ever e-cigarette use had less of an effect in individuals classified as being susceptible to smoking, as demonstrated by a lower odds of initiation of cigarette smoking in that group (AOR 2.12, 95% CI 0.79–5.74), compared with individuals using e-cigarettes initially classified as non-susceptible to smoking (AOR 9.69, 95% CI 4.02–23.4) ( p interaction  = 0.025) [ 90 ]. Interestingly, the effect of e-cigarette use in the susceptible group on initiation of cigarette smoking was not statistically significant.

Berry et al. [ 68 ] reported similar outcomes, both in terms of ever and current cigarette use. In terms of ever cigarette use, the authors demonstrated lower odds of initiation among individuals who had used e-cigarettes in the past versus individuals who are not using e-cigarettes (AOR 3.51, 95% CI 2.52–4.89) among individuals classified as intermediate/high risk for smoking, compared with those classified as low risk (AOR 8.57, 95% CI 3.87–18.97). Similarly, in terms of current cigarette use, odds of initiation were lower among individuals classified as intermediate/high risk (AOR 2.16, 95% CI 1.23–3.79) compared with those classified as low risk (AOR 10.36, 95% CI 3.11–34.54). In both cases, this indicates that e-cigarette use had less of an effect on initiation among those individuals considered intermediate/high risk.

Best et al. [ 34 ], also included in the meta-analysis, found that there was an interaction between susceptibility to smoking and ever e-cigarette use with regards to initiation of cigarette smoking (AOR for e-cigarette use and susceptibility interaction of 0.42, 95% CI 0.19–0.94). In other words, there would be greater interaction between e-cigarette use and non-susceptible populations compared with susceptible populations in terms of initiation of cigarette smoking. It is worth noting that although Best et al. refer in their study to susceptibility and not the intent, the questions that respondents answered, i.e., “Do you think you will smoke cigarettes or hand-rolled cigarettes at any time during the next year” and “If one of your friends offered you a cigarette or hand-rolled cigarettes (roll-ups), would you smoke it?” were questions that measured intent.

Lastly, one study by Barrington-Trimis et al. [ 51 , 52 ] investigating initiation of cigarette smoking, with analyses of switching and dual-use, found that the adjusted odds of reporting dual use (at follow-up) among individuals who had ever used e-cigarettes exclusively at baseline (versus individuals who had never used e-cigarettes at baseline) were higher than the odds of reporting switching from baseline exclusive e-cigarette use to exclusive cigarette smoking at follow-up (AOR 7.16, 95% CI 4.47–11.5 vs. AOR 2.67, 95% CI 1.53–4.65, respectively). In another analysis, the authors also found that the odds of reporting dual use among current (past 30-day) e-cigarette users (versus non-current users) were similarly higher than the odds of reporting switching from exclusive e-cigarette use to exclusive cigarette smoking (AOR 8.86, 95% CI 5.08–15.4 vs. AOR 3.84, 95% CI 1.80–8.19, respectively [ 52 ].

Initiation of and progression to regular cigarette smoking (regular e-cigarette use: 2 studies)

Two adjusted studies were identified that provided adjusted analyses of initiation of and progression to regular cigarette smoking in individuals with regular use of e-cigarettes [ 40 , 48 ]. Summary characteristics of these two studies are provided in Table  4 .

Azagba et al. [ 40 ] defined regular e-cigarette use as either every day or someday use. In terms of the transition from experimental to some-day cigarette smoking, no significant association was found between individuals using e-cigarettes every day and individuals who have never used e-cigarettes (AOR 1.31, 95% CI 0.20–8.58), nor between individuals using e-cigarettes some day and individuals who have never used e-cigarettes (AOR 0.48, 95% CI 0.13–1.78). Similarly, no significant associations were found between individuals using e-cigarettes every day and individuals who have never used e-cigarettes (AOR 0.58, 95% CI 0.09–3.93) and individuals using e-cigarettes some day and individuals who have never used e-cigarettes (AOR 1.14, 95% CI 0.42–3.05) in terms of the transition from experimental to daily cigarette smoking. Likewise, in terms of the transition from some-day to daily cigarette smoking, no significant association was found between individuals using e-cigarettes every day and individuals who have never used e-cigarettes (AOR 1.89, 95% CI 0.98–3.66), nor between individuals using e-cigarettes some day and individuals who have never used e-cigarettes (AOR 1.41, 95% CI 0.84–2.39).

Wei et al. [ 48 ] evaluated transitions from non-current, non-established cigarette smoking to either exclusive current-established cigarette smoking or current-established dual use of cigarettes and e-cigarettes, among baseline individuals using e-cigarettes exclusively. The authors found that individuals who have established e-cigarette use were significantly less likely to transition to exclusive current-established cigarette smoking than individuals who have non-established e-cigarette use (AOR 0.13, 95% CI 0.02–0.87); however, no significant association was found between e-cigarette use (established versus non-established) and transitioning to dual use of cigarettes and e-cigarettes (AOR 0.53, 95% CI 0.05–6.25).

Initiation of and progression to regular cigarette smoking (non-regular e-cigarette use: 11 studies)

Eleven adjusted studies examined the potential association between e-cigarette use and initiation and progression to regular cigarette smoking among individuals with non-regular use of e-cigarettes [ 37 , 40 , 45 , 54 , 61 , 65 , 66 , 69 , 72 , 73 , 86 ]. Study characteristics for the 11 included studies are presented in Table  5 .

Sun et al. [ 86 ] used data from Waves 3–5 of the PATH study to investigate the association between e-cigarette use and the progression into regular cigarette smoking—defined as past 12-month use at Wave 4 with established use and at least 20 days use in the past 30 days at Wave 5. The authors show that the association between ever e-cigarette user and progression into regular smoking is non-significant with baseline e-cigarette ever-users having a lower risk of progressing into established regular smoking 0.13% (95% CI − 0.31 to 0.58) versus 0.17% (95% CI − 0.30 to 0.64) for baseline e-cigarette never-users (ARD − 0.03, 95% CI − 0.33 to 0.27; AOR 0.80, 95% CI 0.10–6.49). Similarly, e-cigarette current use was not associated with progression into established regular smoking as evidenced by the absolute risk of 0.47% (95% CI − 1.46 to 2.39) for individuals currently using e-cigs versus 0.15% (95% CI − 0.27 to 0.58) for e-cig non-users (ARD 0.31, 95% CI − 1.36 to 1.99; AOR 3.14, 95% CI 0.13–74.96) [ 86 ].

In addition to applying measures of regular e-cigarette use described previously, Azagba et al. [ 40 ] also applied a non-regular definition of experimental e-cigarette use. Consistent with their findings from their analyses of regular e-cigarette use, no significant associations were found between experimental and e-cigarette never-users in terms of: transitioning from experimental to someday cigarette smoking (AOR 0.98, 95% CI 0.44–2.20); transitioning from experimental to daily cigarette smoking (AOR 0.59, 95% CI 0.26–1.31); and transitioning from some day to daily cigarette smoking (AOR 1.03, 95% CI 0.61–1.75) [ 40 ].

A longitudinal panel study by McMillen et al. [ 72 ] reported inconsistent findings, depending on the measure of e-cigarette use applied. When evaluating ever e-cigarette use (versus e-cigarette non-use), no significant association with progression to current established cigarette smoking was found (AOR 2.5, 95% CI 0.6–10.9); however, current e-cigarette users were found to be significantly more likely to progress to current established cigarette smoking compared to individuals who are not using e-cigarettes (AOR 8.0, 95% CI 2.8–22.7). Another longitudinal panel study by Pierce et al. [ 65 ] evaluated rate of progression to daily cigarette smoking at Wave 4 among ever (but not daily) tobacco product users at Wave 3 of the PATH survey. The authors found that the adjusted risk difference between individuals who have ever used e-cigarettes versus e-cigarette never-users for progression to daily cigarette smoking was 7% (95% CI 6–9%) higher for individuals using e-cigarettes, although statistical significance was not assessed [ 65 ].

Findings from a prospective cohort study by Chaffee et al. [ 54 ] suggested the AOR of progressing to regular smoking (i.e., smoked ≥ 100 cigarettes and smoked in the past 30 days) was statistically significantly higher in individuals who have ever used e-cigarettes compared with individuals who are not using e-cigarettes (AOR 1.80, 95% CI 1.04–3.12); however, no such association was shown for past-30-day e-cigarette users (AOR 1.76, 95% CI 0.92–3.37). A second prospective cohort study by Hammond et al. [ 73 ] reported that progression to regular cigarette smoking was statistically significantly higher in past-30-day e-cigarette users compared with individuals who are not using e-cigarettes (AOR 1.79, 95% CI 1.41–2.28), while findings from a third prospective cohort study by Conner et al. [ 37 ] suggested statistically significantly higher odds of progressing to regular smoking (≥ 1 cigarette per week) at 2 years among individuals who have ever used e-cigarettes compared with individuals who are not using e-cigarettes (AOR 1.27, 95% CI 1.17–1.39). A fourth prospective cohort study, also by Conner et al. [ 61 ], reported statistically significantly higher odds of regular smoking (defined as smoking at least 1 cigarette per week) at Wave 5 among adolescents who first reported e-cigarette use at 13–14 years old (i.e., early users; AOR 1.25, 95% CI 1.16–1.34), and those who first reported e-cigarette use at 14–15 years (i.e., late users; AOR 1.12, 95% CI 1.08–1.16). The final prospective cohort study by Staff et al. [ 66 ] reported that the adjusted odds of reporting frequent smoking by age 17 were significantly higher for individuals using e-cigarettes compared with individuals who are not using e-cigarettes at baseline (AOR 2.91, 95% CI 1.56–5.4). The odds of frequent smoking remained significantly higher for individuals using e-cigarettes when the samples were matched on risk factors using propensity score matching.

Osibogun et al. [ 45 ] evaluated progression to regular cigarette smoking at both 1 and 2 years from baseline, finding that progression at 1 year was significantly associated with e-cigarette use (AOR 5.0, 95% CI 1.9–12.8). However, progression at 2 years was not significantly associated with e-cigarette use (AOR 3.4, 95% CI 1.0–11.5) [ 45 ].

The one cross-sectional study by Friedman et al. [ 69 ] reported statistically significantly lower odds of current established (≥ 100-lifetime cigarettes and past-30-day use) (AOR 0.22 95% CI 0.10–0.50) or daily (AOR 0.22 95% CI 0.06–0.77) cigarette use among individuals who experimented exclusively with e-cigarettes (experimenting before the age of 18 years) compared with individuals who did not experiment with e-cigarettes. Findings from this study also suggested statistically significantly higher odds of reporting current established cigarette smoking among individuals who first experimented with e-cigarettes and then with cigarettes, compared with individuals who did not experiment with e-cigarettes (AOR 1.89 95% CI 1.09–3.27); however, no significant difference in the odds of daily smoking was shown (AOR 0.73 95% CI NR).

Quantitative synthesis of best available evidence

Meta-analyses were performed by calculating pooled ORs from studies presenting AORs on initiation of cigarette smoking among naïve (individuals who never smoked cigarettes) cigarette smokers who either ever used or never used e-cigarettes. A meta-analysis evaluating the association between regular e-cigarette use and initiation of cigarette smoking was not possible, given that only one study reported adjusted outcomes for this association. Additionally, a meta-analysis evaluating e-cigarette use and initiation and progression to regular smoking was not possible, due to differences in definitions of e-cigarette use and/or outcome measures between studies (full results in Supplemental Section 17 : Meta-Analytic Results; all relevant code is publicly available [DOI: https://doi.org/10.5281/zenodo.10927677 ]).

Twelve studies met all the inclusion criteria and were included in the meta-analysis for initiation of cigarette smoking [ 34 , 43 , 52 , 56 , 59 , 63 , 66 , 76 , 77 , 80 , 81 , 84 ]. All 12 studies included individuals who never smoked cigarettes who were evaluated for initiation of cigarette smoking (minimum inclusion criteria = 1 puff). The studies compared an e-cigarette use group (regardless of frequency, volume, and duration) to a control group of e-cigarette never-users. The results from each study controlled for age, gender, race/ethnicity, and other covariates. All studies were longitudinal in design and had a combined analytic sample of 57,730 respondents.

For the 12 studies, the AORs ranged from 1.35 to 7.41. Pooling their results, the overall OR was 3.71 (95% CI 2.86–4.81). The test for the overall effect of the model was noted to be statistically significant ( p  < 0.00001). Heterogeneity tests revealed an I 2 of 76% and a X 2 of 45.18 ( p  < 0.00001) (Fig.  2 ). An assessment of publication bias—via the development of a funnel plot—was generally symmetrical, suggesting an absence of publication bias (Fig.  3 ).

Meta-analysis of odds of initiation of cigarette smoking among individuals who never smoked cigarettes who used e-cigarettes

Funnel plot for publication bias

Additionally, a sensitivity analysis excluding studies with a “Fair” quality rating was conducted—resulting in the exclusion of four studies [ 43 , 63 , 80 , 81 ]. Results of the eight studies with “Good” rating, presented a pooled OR of 3.96 (95% CI 3.10–5.07), with an I 2 of 60% and a X 2 of 17.64 ( p  < 0.00001) (Fig.  4 ).

Sensitivity analysis of odds of initiation of cigarette smoking among individuals who never smoked cigarettes who used e-cigarettes—excluding studies rated as “fair” quality

A sub-group analysis was conducted based on the country where the study was implemented (US-based or outside the US). The sub-group analysis stratified the results of eight studies conducted in the US [ 43 , 52 , 56 , 59 , 63 , 76 , 77 , 81 ] and four studies conducted outside of the US [ 34 , 66 , 80 , 84 ]. In the eight US studies, AORs ranged from 1.35 to 7.41, and the pooled overall OR was 3.63 (95% CI 2.54–5.18). The test for overall effect revealed that the results were significant ( p  < 0.00001), while heterogeneity was noted with I 2 of 79% and X 2 of 32.77 ( p  < 0.0001). In the studies outside the US the AORs ranged from 2.42 to 5.09 and the pooled OR was 3.94 (95% CI 2.62–5.95), with a significant test for overall effect ( p  < 0.00001), and I 2 of 70% and X 2 of 9.96 ( p  < 0.00001). The test for subgroup difference presented an I 2 of 0% and X 2 of 0.09 ( p  = 0.76) (Fig.  5 ).

Sub-group meta-analysis of odds of initiation of cigarette smoking among individuals who never smoked cigarettes who used e-cigarettes from studies conducted in the US and outside the US

As with the main analysis, a sensitivity analysis of the subgroup analysis based on country was performed, excluding studies graded as “Fair” quality, which resulting in the exclusion of three US-based studies [ 43 , 63 , 81 ], and one study from outside the US [ 80 ]. Pooled results from the remaining five US studies revealed a statistically significant pooled OR of 4.01 (95% CI 2.95–5.47; p  < 0.00001) with an I 2 of 47% and a X 2 of 7.54 ( p  = 0.11). In the remaining studies outside the US the AORs ranged from 2.42 to 5.09 and the pooled OR was 3.83 (95% CI 2.29–5.07), with a significant test for overall effect ( p  < 0.00001), and I 2 of 80% and X 2 of 9.94 ( p  < 0.00001). The test for subgroup difference presented an I 2 of 0% and X 2 of 0.02 ( p  = 0.88) (Fig.  6 ).

Sub-group meta-analysis of odds of initiation of cigarette smoking among individuals who never smoked cigarettes who used e-cigarettes from studies conducted in the US and outside the US—excluding studies rated as “fair” quality

The current systematic review identified a number of “good” quality studies (according to the Downs and Black quality metrics [ 29 ]) that evaluated the association between e-cigarette use and initiation of cigarette smoking, and initiation of and progression to regular cigarette smoking. Over half of the included studies controlled for age, gender, and race/ethnicity and reported adjusted results to provide a higher level of evidence. This review focused on such studies in the quantitative and qualitative synthesis of results.

A meta-analysis of 12 studies evaluating initiation of cigarette smoking indicated an increased odds (3.7 times higher) for individuals who have ever used e-cigarettes compared with individuals who are not using e-cigarettes and no indication of publication bias among the studies was observed [ 34 , 43 , 51 , 56 , 59 , 63 , 66 , 76 , 77 , 80 , 81 , 84 ]. These findings are consistent with previously-conducted meta-analyses, all of which reported increased odds of initiation associated with e-cigarettes: O’Brien et al. [ 16 ] reported 4.06 times higher odds among teenagers; Soneji et al. [ 13 ] reported 3.5 times higher odds among a study population of adolescents and young adults; Chan et al. [ 14 ] and Khouja et al. [ 15 ] both reported 2.9 times higher odds, in populations of youth and youth-young adults, respectively; and Baenziger et al. [ 18 ] and Adermark et al. [ 19 ] reported 3.2 and 3.3 times higher odds, respectively, in samples from the general population.

Only one study, also included in the meta-analysis, reported on initiation of cigarette smoking in individuals with regular use of e-cigarettes, providing outcome data for initiation of cigarette smoking based on the frequency of e-cigarette use at baseline (from 1–2 uses/day to everyday use) [ 77 ]. Wills et al. [ 77 ] found an upward trend for the probability of initiation of cigarette smoking and increased e-cigarette use. Thirty-seven adjusted studies not included in the meta-analysis showed a similar trend, with a higher probability or incidence of initiation of cigarette smoking in the e-cigarette user group [ 36 , 37 , 41 , 42 , 44 , 46 , 47 , 49 , 50 , 52 , 53 , 54 , 55 , 57 , 58 , 60 , 61 , 62 , 64 , 67 , 68 , 70 , 71 , 72 , 73 , 74 , 78 , 79 , 82 , 83 , 85 , 86 , 87 , 88 , 89 , 90 , 91 ]. These studies had similar definitions for e-cigarette use, with any or ever use at baseline, any e-cigarette use in the past 12 months, or any use in the past 30 days. All but one of these studies defined cigarette use as any cigarette use at follow-up, while the remaining study evaluated regular smoking, although definition of regular smoking was not provided.

Six studies compared initiation of cigarette smoking with e-cigarette use between study groups that were susceptible or not susceptible to cigarette smoking [ 34 , 52 , 57 , 68 , 90 , 91 ]. E-cigarette use was either not associated with an increase in smoking initiation in individuals using e-cigarettes susceptible to cigarette smoking [ 52 , 90 ], or the effect of e-cigarette use on initiation of cigarette smoking was less in individuals using e-cigarettes susceptible to cigarette smoking [ 34 , 57 , 68 , 91 ].

The limited data from one study evaluating e-cigarettes with or without nicotine pointed to a higher probability of initiating cigarette smoking with nicotine-containing e-cigarettes [ 57 ]. With regards to “switching” or “dual-use” following initiation of cigarette smoking, two studies found that the odds of reporting dual use among exclusive e-cigarette ever users (versus never users) were higher than the odds of reporting switching from exclusive e-cigarette use to exclusive current cigarette smoking [ 52 , 80 ]. In both studies, analyses of current (past 30-day) e-cigarette users reported similarly higher odds of dual-use compared with switching.

Twelve adjusted studies evaluated initiation of and progression to regular cigarette smoking for individuals using e-cigarettes versus individuals who are not using e-cigarettes [ 37 , 40 , 45 , 48 , 54 , 61 , 65 , 66 , 69 , 72 , 73 , 86 ], two of which applied measures of regular e-cigarette use [ 40 , 48 ]. Both studies generally found no significant associations between regular e-cigarette use and progression to regular cigarette smoking; however, one result suggested that established e-cigarette users were significantly less likely to transition to exclusive cigarette smoking than non-established e-cigarette users [ 48 ]. In terms of studies applying definitions of non-regular e-cigarette use, based on the variability in the results, and variations in the definition of a “regular” cigarette smoker, the current data regarding initiation of and progression to regular cigarette smoking does not support drawing conclusions. This is illustrated in the study by Friedman et al. [ 69 ], which reported statistically lower odds of both current established and daily cigarette use among individuals who experimented exclusively with e-cigarettes(non-established use prior to the age of 18 years old) compared with individuals who did not experiment with e-cigarettes. Conversely, this study also found statistically significantly higher odds of current established cigarette use among individuals who experimented with e-cigarettes first, then with cigarettes, compared with individuals who did not experiment with e-cigarettes; however, no significant difference in the odds of daily smoking was found between e-cigarette-then-cigarette experimenters compared with individuals who did not experiment with e-cigarettes.

Finally, only one adjusted study evaluated age of initiation of cigarette smoking [ 75 ]. Notably, although McCabe et al. [ 75 ] reported a significantly lower age among current e-cigarette users, age of regular (daily) cigarette smoking was not significantly different between current and non-current e-cigarette users.

The current systematic review exhibited three major strengths. Firstly, its comprehensive search methodology yielded a large number of studies for review. Secondly, the current review had a clearly defined PICOS, which assured the identification of the strongest evidence relevant to the research question. Thirdly, guidelines for this review ensured that only demographically adjusted and methodologically consistent studies were included in the quantitative syntheses. Finally, the strict adherence to AMSTAR-2 and PRISMA guidelines ensured the transparency and replicability of this review while minimizing any risk of various forms of bias (e.g. individual study design; industry sponsorship) to provide an unbiased and comprehensive synthesis of this evidence base. Collectively, these strengths support the robustness of this review in terms of comprehensiveness and methodological rigor.

Although the meta-analysis indicated a higher odds for initiation of cigarette smoking among individuals using e-cigarettes—a result generally supported by the studies included in the qualitative synthesis—interpretation of the results is limited for many critical reasons. Specifically, the definition of e-cigarette use was not restricted to regular use. While doing so would have provided the strongest evidence on potential associations with the initiation of cigarette smoking, such a restriction would have yielded too few studies. Instead, the review was broadened to include any measure of e-cigarette use, with most studies measuring ever or current (past-30-day) use. Also, few studies examined initiation and/or progression to regular cigarette smoking, instead applying definitions of cigarette smoking that were more consistent with temporary experimentation and not true initiation, such as ever or current (past-30-day) smoking. Further, included studies were not restricted by specific confounding variables representing common liabilities between e-cigarette use and cigarette smoking, as this would have critically reduced the number of included studies in this review. The common-liability model considers the sequencing of drug use initiation, addiction, and addiction severity and posits that there are common sources of variation in the risk for specific addictions [ 11 ]. This model is critical for consideration given the empirical mixed signals that support or contradict the gateway hypothesis. However, the limited number of studies controlling for confounding variables related to common liability highlights the need for more robust studies to effectively measure the causal relationship between e-cigarette use and the initiation of cigarette smoking.

The majority of studies looked at how an e-cigarette-using population, individuals who never smoked cigarettes at baseline, developed cigarette smoking practices at follow-up. Though this information is indeed fundamental, it is equally important to understand the concepts of switching and dual-use. There are two possible trajectories that lead to an outcome of cigarette smoking among individuals using e-cigarettes. Between the baseline and follow-up surveys, (1) the e-cigarette user could begin cigarette smoking simultaneous with his/her e-cigarette use (dual use); or, (2) the e-cigarette user could eventually stop using the e-cigarette and after some time start smoking cigarettes (switchers). Information regarding whether individuals switched or dual used was limited, with only one adjusted study presenting specific data regarding single or dual use [ 52 ].

Further, 49 of 55 included studies reported on “youth”, “adolescent” and/or “young adult” populations, limiting the utility of the conclusions, as studies in youth and/or young adults are not necessarily translatable to older adults. Indeed, there is evidence that cigarette and e-cigarette smoking behaviors differ in different age groups. For example, one study determined that young adults (18–29 years of age) were more likely to be occasional smokers and reported lower daily consumption compared with older individuals who smoke cigarettes (30 years of age or older) [ 95 ]. Moreover, different age groups may vary in terms of their perceptions of and willingness to take risks, views of smoking addiction, perception of relative cigarette and e-cigarette health risks and/or benefits, and responses to behavioral interventions [ 96 ], which may differentially influence smoking behaviors and inherently, smoking cessation.

Finally, the duration of follow-up for the available studies was generally limited with most studies limited to 12 months in duration. This introduces the potentially limitation to observe whether cigarette smoking behavior actually persisted after initiation, i.e., true initiation and not simply temporary experimentation [ 2 ]. This may explain why so few of the included studies evaluated progression to regular cigarette smoking.

In conclusion, more robust studies are required to determine whether there is an association between e-cigarette use and initiation of cigarette smoking and progression to regular smoking. Based on findings from this review, the available studies neither sufficiently measure e-cigarette use—or cigarette smoking—in a manner consistent with examining causality, nor sufficiently account for known or suspected confounding variables to support robust determinations regarding e-cigarette use and cigarette smoking behaviors. Thus, the utility of the evidence base for policymakers, healthcare providers, and researchers is limited.

Availability of data and materials

All data and materials considered in this review are publicly available.

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Acknowledgements

The authors would like to acknowledge Thera-Business (Ontario CANADA) for providing their systematic review expertise to all study activities across all levels of the updated review process. The authors would also like to thank Dr. Geoffrey Curtin, a retired employee of RAI Services Company, for his scientific contributions during the conceptualization of this review.

All study activities were executed by providers external to RAI Services Company (Thera-Business), who were financially compensated for services according to contractual terms with RAI Services Company. RAI Services Company is a wholly owned subsidiary of Reynolds American Inc., whose operating companies manufacture and market tobacco products. The conception, analysis, and writing for this manuscript was a collaboration between Thera-Business and RAI Services Company.

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Mimi M. Kim, Isabella Steffensen, Red Thaddeus D. Miguel, Tanja Babic & Julien Carlone

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MMK conceived the study. MMK, IS, RDM, TB, and JC collected and analysed project data. MMK, IS, and RDM defined the study design, selection of measures, interpretation of data, and co-wrote the manuscript. All authors have read and approved the final article. The corresponding author attests that the listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

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Kim, M.M., Steffensen, I., Miguel, R.T.D. et al. A systematic review and meta-analysis of the association between e-cigarette use among non-tobacco users and initiating smoking of combustible cigarettes. Harm Reduct J 21 , 99 (2024). https://doi.org/10.1186/s12954-024-01013-x

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Received : 01 September 2023

Accepted : 01 May 2024

Published : 22 May 2024

DOI : https://doi.org/10.1186/s12954-024-01013-x

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