Public Health Consequences of E-Cigarettes : A Systematic Review of Biomedical Literature

This report is a comprehensive and systematic review of the literature that evaluates the evidence about e-cigarettes and health. It highlighting gaps that are a priority for future research, and makes recommendations to improve the quality of this research.

The report is by the National Academies of Science, Engineering and Medicine.

A few excerpts from the report

   “Because e-cigarettes have only been on the U.S. market for a relatively brief time— rst imported in 2006, most have entered the market much more recently—it is dif cult to scienti cally compare their health effects to those of combustible tobacco cigarettes, whose health effects were not fully apreciated until after decades of use. However, in contrast to long-term effects, research on short-term health effects of e-cigarettes is now available.

The committee evaluated the current state of knowl- edge on outcomes including dependence and abuse liability, cardiovascular diseases, cancers, respiratory diseases, oral diseases, reproductive and developmen- tal effects, and injuries and poisonings.

Overall, the evidence reviewed by the commit- tee suggests that e-cigarettes are not without biological effects in humans. For instance, use of e-cigarettes results in dependence on the devices, though with apparently less risk and severity than that of combustible tobacco cigarettes. Yet the implications for long-term effects on morbidity and mortality are not yet clear.”

…

CONCLUSION

Although e-cigarettes are not without risk, compared to combustible tobacco cigarettes they contain fewer toxicants; can deliver nicotine in a similar manner; show signi cantly less biological activity in most, but not all, in vitro, animal, and human systems; and might be useful as a cessation aid in smokers who use e-ciga- rettes exclusively. However, young people who begin with e-cigarettes are more likely to transition to com- bustible cigarette use and become smokers who are at risk to suffer the known health burdens of combustible tobacco cigarettes. The net public health outcome of e-cigarette use depends on the balance between pos- itive and negative consequences.

More and better research is needed to help clarify whether e-cigarettes will prove to reduce harm—or induce harm—at the individual and the population levels. The approach taken by the committee to eval- uate the health effects of e-cigarettes in this report is anticipated to provide a generalizable template for future evaluations of the evidence.

Full text of the report may be found here

[News article] California declares electronic cigarettes a health threat

From the 28 January 2015 Met article

SACRAMENTO, Calif. – California health officials say electronic cigarettes are a health threat, especially to children, and should be strictly regulated like tobacco products.

A report released Wednesday by the California Department of Public Health says e-cigarettes emit cancer-causing chemicals and get users hooked on nicotine. California Health Officer Ron Chapman says new generations of young people will become nicotine addicts if the products remain largely unregulated.

E-cigarettes heat liquid nicotine from cartridges into inhalable vapour without tar and other chemicals found in traditional cigarettes. E-cigarette makers say their products are far safer than tobacco.

Related:

• Calgary and Alberta Health Services eye $25K study on e-cigarette regulation
• Ontario bans flavoured tobacco, cracks down on e-cigarettes
• Students want public Edmonton e-cigarette ban

Other states including Oklahoma and Arkansas already have issued advisories cautioning the use of e-cigarettes. California’s advisory comes after a state lawmaker introduced legislation this week to ban e-cigarettes in public places.

Related articles

• E-cigarette Vapors Chemical Levels Up To 15 Times Higher Than Cigarettes
• E-cigarettes in checked luggage may pose fire hazard
• E-cigarettes Not Safer than Ordinary Cigarettes, Contains High Concentration of Formaldehyde
• New Rules for E-Cigarette Users on Airplanes

[News article] Vapor from e-cigarettes triggers changes to cells in lab study

From the 27 January 2015 article at Covering Health – Monitoring the Pulse of Health Journalism by Mary Otto

Photo: Jonny Williams via Flickr
This image is released under Creative Commons. If used, please attribute to http://www.ecigclick.co.uk

Electronic cigarettes, or e-cigarettes are growing in popularity among American adults, and while some states restrict their use by minors, nearly 1.8 million American middle and high school students reported using them one recent year, a federal study found.

…

Manufacturers promote e-cigarettes as safer alternatives to conventional cigarettes and as tools for smoking cessation. Yet researchers point out that there is a dearth of scientific evidence regarding the effects of e-cigarette vapors on the lungs.

A laboratory study published in September suggests vapor from e-cigarettes may cause damage and raise the risk for respiratory infections among young people. In the lab, the vapor triggered a strong immune response in the epithelial cells of tissue samples donated by deceased children and the exposed cells appeared to be more vulnerable to infection by cold-causing rhinovirus, according to the research article, published in PLOS One. According to the study, even nicotine-free vapor increased the risk of infection.

HealthDay News reporter Dennis Thompson, who has been following the research on e-cigarette safety, took a look at the findings this month in a story posted on WebMD.

“Epithelial cells are the first line of defense in our airways,” the study’s lead author, Qun Wu, a lung disease researcher at National Jewish Health in Denver explains in Thompson’s article.

“They protect our bodies from anything dangerous we might inhale. Even without nicotine, this liquid can hurt your epithelial defense system and you will be more likely to get sick.”

Wu and his team placed the human cells in a sterile container in one end of a machine with an e-cigarette at the other end, Thompson notes. “The vapor spurred the release of IL-6, a signalling protein that promotes inflammation and an immune system response. This occurred whether or not the vapor contained nicotine, although nicotine appeared to slightly enhance the release of IL-6, the researchers said.”

An industry group representing e-cigarette manufacturers is stressing the limits of the study, pointing out that the tests involved cells in a lab, not actual e-cigarette users.

“Many in public health agree that the risks of vaping must always be considered in the context of the risks of cigarette smoking and traditional stop-smoking therapies,” Gregory Conley, president of the American Vaping Association observes in Thompson’s article.

….

Related

• Atlanta chapter learns the latest about e-cigarettes

Related articles

• Study Suggests Link Between E-Cigarettes, Respiratory Infections
• There is a link between e-cigarettes and respiratory infections
• Study Suggests Link Between E-Cigarettes, Respiratory Infections
• New cellular pathway triggering allergic asthma response identified
• Life Lessons: Dangers of e-cigarettes

What Should You Know About E-Cigarettes?

Electronic Cigarette Model (Photo credit: planetc1)

On a personal note, my husband is very sensitive to e-cigarette vapors.
He finds he has to leave any room where they are being “smoked”.

 

From the 23 October 2013 ScienceDaily article

 E-cigarettes are becoming increasingly popular and widely available as the use of regular cigarettes drops. Recently, the Centers for Disease Control and Prevention (CDC) reported that e-cigarette use by children doubled from 2011 and 2012. The health effects of e-cigarettes have not been effectively studied and the ingredients have little or no regulation. Mayo Clinic’s Nicotine Dependence Center experts are available to discuss what people should know before trying e-cigarettes

Electronic cigarettes, often called e-cigarettes, are battery-operated devices that provide inhaled doses of a vaporized solution of either propylene glycol or vegetable glycerin along with liquid nicotine. An atomizer heats the solution into a vapor that can be inhaled. The process, referred to as “vaping,” creates a vapor cloud that resembles cigarette smoke. Some liquids contain flavoring, making them more appealing to users.

“As of right now, there is no long-term safety data showing the impact of repeated inhalation of propylene glycol or vegetable glycerin on lung tissue,” cautions Jon Ebbert, M.D., associate director at Mayo Clinic’s Nicotine Dependence Center. “There is some short-term data suggesting that e-cigarettes may cause airway irritation, but until we have long-term safety data, we are not recommending e-cigarettes for use among cigarette smokers to help people stop smoking.”

So, what is known about electronic cigarettes?

*Manufacturers claim that electronic cigarettes are a safe alternative to conventional cigarettes.

*The Food and Drug Administration (FDA) has questioned the safety of these products.

*FDA analysis of two popular brands found variable amounts of nicotine and traces of toxic chemicals, including known cancer-causing substances (carcinogens).

*The FDA has issued a warning about potential health risks associated with electronic cigarettes, but is not yet regulating their use or standards of manufacture.

“It’s an amazing thing to watch a new product like that just kind of appear. There’s no quality control,” says Richard Hurt, M.D., director of Mayo Clinic’s Nicotine Dependence Center. “Many of them are manufactured in China under no control conditions, so the story is yet to be completely told.”

Related articles

• E-cigarette regulation debate heats up (wavy.com)
• Should e-cigs be treated like regular cigarettes? (utsandiego.com)
• Conn. Lawmaker To Propose Ban On E-Cigarettes In Public Places (newyork.cbslocal.com)
• Report Finds Too Many American Children Are Smoking Flavored Cigars (counselheal.com)
• Safer Cigarrettes (powerecigs.wordpress.com)
• Don’t smoke your e-cigarettes indoors, say London’s top restaurateurs (standard.co.uk)
• Cigarette alternatives may not be ‘safe’ tobacco (universityofcalifornia.edu)
• E-Cigarettes Now Being Used To Smoke Marijuana, Worrying Some Health Officials (medicaldaily.com)
• Council bureaucrats to ban “E-Cigarettes” in order to have a “clear policy” towards smoking. (visitscunthorpe.com)

E-Cigarettes May Equal Nicotine Patches for Smoking Cessation

Just one study. However, interesting….

 

From the 9 September 2013 article at Health Day

By Robert Preidt

Monday, September 9, 2013

SATURDAY, Sept. 7 (HealthDay News) — Electronic cigarettes and nicotine patches are equally effective at helping smokers quit, according to findings from what’s thought to be the first clinical trial to compare the two methods.

However, e-cigarettes were more effective in reducing cigarette use among smokers who didn’t quit.

E-cigarettes are battery-powered devices that deliver nicotine, flavorings and other chemicals. They turn these substances into vapor that is inhaled by the user.

The new study included 657 smokers who used either e-cigarettes, fake e-cigarettes (they didn’t contain any nicotine) or nicotine patches for 13 weeks. At the end of the six-month study, about 6 percent of the participants had successfully quit.

Rates of those who successfully quit were 7.3 percent in the e-cigarette group, 5.8 percent in the nicotine patch group and 4.1 percent in the fake e-cigarette group.

These differences were not statistically significant, according to study leader Chris Bullen, director of the National Institute for Health Innovation at the University of Auckland in New Zealand, and colleagues….

Read the entire article here

Related MedlinePlus Page –>Quitting Smoking