Why public health people are more worried than excited over e-cigarettes

BMC Medicine

Charlotta Pisinger¹ 

[1] Research Centre for Prevention and Health, Glostrup Hospital, Building 84/85, Nordre Ringvej 57, Glostrup, DK 2600, Denmark

关键词: Vaping;    Smoking;    Public health;    Harm reduction;    ENDS;    Electronic cigarettes;   

Others  :  1118057
DOI  :  10.1186/s12916-014-0226-y

 received in 2014-11-04, accepted in 2014-11-05,  发布年份 2014

【 摘 要 】

The research field on e-cigarettes is characterized by severe methodological problems, severe conflicts of interest, relatively few and often small studies, inconsistencies and contradictions in results, and a lack of long-term follow-up. Therefore, no firm conclusions can be drawn on the harm of e-cigarettes, but they can hardly be called safe. Experimental studies indicate negative health effects and, amongst others, the major ingredient propylene glycol warrants concern. Growing evidence raises doubt about the efficacy of e-cigarettes as a smoking cessation aid. Unfortunately, it seems that many smokers use e-cigarettes with the intention to quit but switch to long-term use of e-cigarettes or dual use. Use is spreading rapidly to minors, ex-smokers, and never-smokers. It is questionable whether the potential health benefits obtained by some smokers outweigh the potential harm by use of non-smokers, of undermining of complete cessation, smokers’ dual use, and of eventual re-normalization of smoking. Even if e-cigarettes are significantly less harmful than conventional cigarettes, the product may have a very negative impact on public health if its use is spread to a large part of the population.

【 授权许可】

   
2014 Pisinger; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Electronic Nicotine Delivery Systems Report by WHO. Moscow, Russian Federation; 2014 July. Report No.: FCTC/COP/6/10 21 July 2014. Provisional agenda item 4.4.2 2014.
• [2]Changing concepts of sudden infant death syndrome: implications for infant sleeping environment and sleep position. American Academy of Pediatrics. Task Force on Infant Sleep Position and Sudden Infant Death Syndrome.Pediatrics 2000, 105:650–656.
• [3][http://www.usacig.com/faq.aspx] webcite The Electric Cigarette. []; 2014.
• [4][http://www.smokenv.com/faq.html] webcite Smoke NV. []; 2014.
• [5]Pisinger C, Døssing M: A systematic review of health effects of electronic cigarettes. Prev Med 2014, 69:248-260.
• [6]Grana R, Benowitz N, Glantz SA: E-cigarettes: a scientific review. Circulation 2014, 129:1972-1986.
• [7]Park SJ, Walser TC, Perdomo C, Wang T, Pagano PC, Liclican EL, Krysan K, Larsen JE, Minna JD, Lenburg ME, Spira A, Dubinett SM: The effect of e-cigarette exposure on airway epithelial cell gene expression and transformation.Clinical Cancer Research Conference: 3rd AACR-IASLC Joint Conference on the Molecular Origins of Lung Cancer San Diego, CA, USA. 6thto 9thJanuary, 2014.
• [8]Vardavas CI, Anagnostopoulos N, Kougias M, Evangelopoulou V, Connolly GN, Behrakis PK: Short-term pulmonary effects of using an electronic cigarette: impact on respiratory flow resistance, impedance, and exhaled nitric oxide. Chest 2012, 141:1400-1406.
• [9]Marini S, Buonanno G, Stabile L, Ficco G: Short-term effects of electronic and tobacco cigarettes on exhaled nitric oxide. Toxicol Appl Pharmacol 2014, 278:9-15.
• [10]Palamidas A, Gennimata SA, Kaltsakas G, Tsikrika S, Vakali S, Gratziou C, Koulouris N: Acute effect of an e-cigarette with and without nicotine on lung function. Tobacco Induced Dis 2014, 12:A34.
• [11]Gennimata SA, Palamidas A, Kaltsakas G, Tsikrika S, Vakali S, Gratziou C, Koulouris N: Acute effect of e-cigarette on pulmonary function in healthy subjects and smokers. In Thematic Poster Session: Tobacco Dependence and Respiratory Disease. European Respiratory Society, Annual Congress, Munich, Germany, 6th – 10th September; 2014.
• [12]Cervellati F, Muresan XM, Sticozzi C, Gambari R, Montagner G, Forman HJ, Torricelli C, Maioli E, Valacchi G: Comparative effects between electronic and cigarette smoke in human keratinocytes and epithelial lung cells. Toxicol In Vitro 2014, 28:999-1005.
• [13]Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P: Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLoS One 2013, 8:e57987.
• [14]Bahl V, Lin S, Xu N, Davis B, Wang YH, Talbot P: Comparison of electronic cigarette refill fluid cytotoxicity using embryonic and adult models. Reprod Toxicol 2012, 34:529-537.
• [15]Zhang Y, Sumner W, Chen DR: In vitro particle size distributions in electronic and conventional cigarette aerosols suggest comparable deposition patterns. Nicotine Tob Res 2013, 15:501-508.
• [16]Ingebrethsen BJ, Cole SK, Alderman SL: Electronic cigarette aerosol particle size distribution measurements. Inhal Toxicol 2012, 24:976-984.
• [17]Fuoco FC, Buonanno G, Stabile L, Vigo P: Influential parameters on particle concentration and size distribution in the mainstream of e-cigarettes. Environ Pollut 2014, 184:523-529.
• [18]Schober W, Szendrei K, Matzen W, Osiander-Fuchs H, Heitmann D, Schettgen T, Jörres RA, Fromme H: Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers. Int J Hyg Environ Health 2014, 217:628-637.
• [19]Goniewicz ML, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, Prokopowicz A, Jablonska-Czapla M, Rosik-Dulewska C, Havel C, Jacob P 3rd, Benowitz N: Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control 2014, 23:133-139.
• [20]Kim HJ, Shin HS: Determination of tobacco-specific nitrosamines in replacement liquids of electronic cigarettes by liquid chromatography-tandem mass spectrometry. J Chromatogr A 2013, 1291:48-55.
• [21]McAuley TR, Hopke PK, Zhao J, Babaian S: Comparison of the effects of e-cigarette vapor and cigarette smoke on indoor air quality. Inhal Toxicol 2012, 24:850-857.
• [22][http://www.ecita.org.uk/safety.htm] webcite Lauterbach JH, Laugesen M, Ross JD: Suggested Protocol for Estimation of Harmful and Potentially Harmful Constituents in Mainstream Aerosols Generated by Electronic Nicotine Delivery Systems (ENDS). Poster # 1860, Society of Toxicology, San Francisco. The Toxicologist CD, J of the Soc of Toxicology 2012 Mar;126. []
• [23][http://www.healthnz.co.nz/News2012SOTposter1861.pdf] webcite Lauterbach JH, Laugesen M: Comparison of Toxicant Levels in Mainstream Aerosols Generated by Ruyan® Electronic Nicotine Delivery Systems (ENDS) and Conventional Cigarette Products. []
• [24]Kosmider L, Sobczak A, Fik M, Knysak J, Zaciera M, Kurek J, Goniewicz ML: Carbonyl compounds in electronic cigarette vapors-effects of nicotine solvent and battery output voltage. Nicotine Tob Res 2014, 16:1319-1326.
• [25]Hutzler C, Paschke M, Kruschinski S, Henkler F, Hahn J, Luch A: Chemical hazards present in liquids and vapors of electronic cigarettes. Arch Toxicol 2014, 88:1295-1308.
• [26]Czogala J, Goniewicz ML, Fidelus B, Zielinska-Danch W, Travers MJ, Sobczak A: Secondhand exposure to vapors from electronic cigarettes. Nicotine Tob Res 2014, 16:655-662.
• [27]Goniewicz ML, Kuma T, Gawron M, Knysak J, Kosmider L: Nicotine levels in electronic cigarettes. Nicotine Tob Res 2013, 15:158-166.
• [28]Cheah NP, Chong NW, Tan J, Morsed FA, Yee SK: Electronic nicotine delivery systems: regulatory and safety challenges: Singapore perspective. Tob Control 2014, 23:119-125.
• [29]Pellegrino RM, Tinghino B, Mangiaracina G, Marani A, Vitali M, Protano C, Osborn JF, Cattaruzza MS: Electronic cigarettes: an evaluation of exposure to chemicals and fine particulate matter (PM). Ann Ig 2012, 24:279-288.
• [30]Etter JF, Zather E, Svensson S: Analysis of refill liquids for electronic cigarettes. Addiction 2013, 108:1671-1679.
• [31]Schripp T, Markewitz D, Uhde E, Salthammer T: Does e-cigarette consumption cause passive vaping? Indoor Air 2013, 23:25-31.
• [32]Uryupin AB, Peregudov AS, Kochetkov KA, Bulatnikova LN, Kiselev SS, Nekrasov YS: Qualitative and quantitative compositions of fluids for electronic cigarettes. Pharma Chem J 2013, 46:687-692.
• [33]Burstyn I: Peering Through the Mist: What Does the Chemistry of Contaminants in the Electronic Cigarettes Tell us about Health Risks? Technical report. School of Public Health, Drexel University, Philadelphia, USA: Department of Environmental and Occupational Health; 2013.
• [34]Wieslander G, Norback D, Lindgren T: Experimental exposure to propylene glycol mist in aviation emergency training: acute ocular and respiratory effects. Occup Environ Med 2001, 58:649-655.
• [35]Choi H, Schmidbauer N, Sundell J, Hasselgren M, Spengler J, Bornehag CG: Common household chemicals and the allergy risks in pre-school age children. PLoS One 2010, 5:e13423.
• [36]Ponec M, Haverkort M, Soei YL, Kempenaar J, Bodde H: Use of human keratinocyte and fibroblast cultures for toxicity studies of topically applied compounds. J Pharm Sci 1990, 79:312-316.
• [37]Renne RA, Wehner AP, Greenspan HS, Deford HS, Ragan HA, Westerberg RB, Buschbom RL, Burger GT, Hayes AW, Suber RL, Mosberg AT: 2-Week and 13-week inhalation studies of aerosolized glycerol in rats. Inhal Toxicol 1992, 4:95-111.
• [38]Elmore AR: Final report on the safety assessment of aluminum silicate, calcium silicate, magnesium aluminum silicate, magnesium silicate, magnesium trisilicate, sodium magnesium silicate, zirconium silicate, attapulgite, bentonite, Fuller’s earth, hectorite, kaolin, lithium magnesium silicate, lithium magnesium sodium silicate, montmorillonite, pyrophyllite, and zeolite. Int J Toxicol 2003, 22:37-102.
• [39]National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health: The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention; 2014.
• [40]Ballbe M, Martinez-Sanchez JM, Sureda X, Fu M, Perez-Ortuno R, Pascual JA, Saltó E, Fernández E: Cigarettes vs. e-cigarettes: Passive exposure at home measured by means of airborne marker and biomarkers. Environ Res 2014, 135C:76-80.
• [41]Flouris AD, Chorti MS, Poulianiti KP, Jamurtas AZ, Kostikas K, Tzatzarakis MN, Wallace Hayes A, Tsatsakis AM, Koutedakis Y: Acute impact of active and passive electronic cigarette smoking on serum cotinine and lung function. Inhal Toxicol 2013, 25:91-101.
• [42]Etter JF: Electronic cigarettes: a survey of users. BMC Public Health 2010, 10:231. BioMed Central Full Text
• [43]Etter JF, Bullen C: Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction 2011, 106:2017-2028.
• [44]Adkison SE, O’Connor RJ, Bansal-Travers M, Hyland A, Borland R, Yong HH, Cummings KM, McNeill A, Thrasher JF, Hammond D, Fong GT: Electronic nicotine delivery systems: international tobacco control four-country survey. Am J Prev Med 2013, 44:207-215.
• [45]Rapport et avis d’experts sur l’ e-cigarette. Avec le soutien de la Direction générale de la santé. Jeunes Paris 2012 & 2013. Paris: Office Francais de Prévention du Tabagisme; 2013.
• [46]Goniewicz ML, Zielinska-Danch W: Electronic cigarette use among teenagers and young adults in Poland. Pediatrics 2012, 130:e879-e885.
• [47]Dautzenberg B, Birkui P, Noël M, Dorset J, Osman M, Dautzenberg M-D: E-Cigarette: a new tobacco product for schoolchildren in Paris. Open J Respir Dis 2013, 3:21-24.
• [48]CDC: Notes from the field: electronic cigarette use among middle and high school students - United States, 2011–2012.MMWR Morb Mortal Wkly Rep 2013, 62:729–730.
• [49]Czoli CD, Hammond D, White CM: Electronic cigarettes in Canada: prevalence of use and perceptions among youth and young adults. Can J Public Health 2014, 105:e97-e102.
• [50]Camenga DR, Delmerico J, Kong G, Cavallo D, Hyland A, Cummings KM, Krishnan-Sarin S: Trends in use of electronic nicotine delivery systems by adolescents. Addict Behav 2014, 39:338-340.
• [51]Choi K, Fabian L, Mottey N, Corbett A, Forster J: Young adults’ favorable perceptions of snus, dissolvable tobacco products, and electronic cigarettes: findings from a focus group study. Am J Public Health 2012, 102:2088-2093.
• [52]Goniewicz ML, Gawron M, Nadolska J, Balwicki L, Sobczak A: Rise in electronic cigarette use among adolescents in Poland. J Adolesc Health 2014, 5:713-715.
• [53]Proctor RN: Golden Holocaust. Origins of the Cigarette Catastrophe and the Case for Abolition. University of California Press, Berkeley and Los Angeles, CA; 2011.
• [54]Caponnetto P, Auditore R, Russo C, Cappello GC, Polosa R: Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study. Int J Environ Res Public Health 2013, 10:446-461.
• [55]Caponnetto P, Campagna D, Cibella F, Morjaria JB, Caruso M, Russo C, Polosa R: EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as tobacco cigarettes substitute: a prospective 12-month randomized control design study. PLoS One 2013, 8:e66317.
• [56]Kotz D, Brown J, West R: ‘Real-world’ effectiveness of smoking cessation treatments: a population study. Addiction 2014, 109:491-499.
• [57]Borderud SP, Li Y, Burkhalter JE, Sheffer CE, Ostroff JS: Electronic cigarette use among patients with cancer: characteristics of electronic cigarette users and their smoking cessation outcomes. Cancer 2014, 120:3527-3535.
• [58]Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, Walker N: Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 2013, 382:1629-1637.
• [59][http://www.tobaccoharmreduction.org/thr2010ahi.pdf] webcite Heavner K, Dunworth J, Bergen P, Nissen C, Philips CV: Electronic Cigarettes (e-cigarettes) as Potential Tobacco Harm Reduction Products: Results of an Online Survey of e-cigarette Users. []
• [60]Lee S, Grana RA, Glantz SA: Electronic cigarette use among Korean adolescents: a cross-sectional study of market penetration, dual use, and relationship to quit attempts and former smoking. J Adolesc Health 2014, 54:684-690.