Another Article About E‐Cigarettes: Why Should I Care?

Cummings, K. Michael; Morris, Pamela B.; Benowitz, Neal L.

doi:10.1161/jaha.118.009944

Cited by 6 publications

(9 citation statements)

References 16 publications

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“…The use of evidence based pharmacotherapy and nicotine patches that are safe and effective in reducing the dependence on nicotine in cigarettes, combined with counseling, is the only approach for which little therapeutic or health uncertainty exists ( fig 2 ). 191 A supportive environment including counseling has been key to the success of this approach, and smokers should be encouraged to take advantage of complementary community and therapeutic resources. Smokers and ex-smokers using e-cigarettes should be provided with clear information on the uncertainties about health risks and harm reduction and encouraged to participate in complementary counseling using established approaches with a goal of quitting all tobacco products and ultimately reducing nicotine dependency as soon as possible.…”

Section: Challenges and Guidelines For Cliniciansmentioning

confidence: 99%

What are the respiratory effects of e-cigarettes?

Gotts

Jordt

McConnell

et al. 2019

BMJ

392

303

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Electronic cigarettes (e-cigarettes) are alternative, non-combustible tobacco products that generate an inhalable aerosol containing nicotine, flavors, propylene glycol, and vegetable glycerin. Vaping is now a multibillion dollar industry that appeals to current smokers, former smokers, and young people who have never smoked. E-cigarettes reached the market without either extensive preclinical toxicology testing or long term safety trials that would be required of conventional therapeutics or medical devices. Their effectiveness as a smoking cessation intervention, their impact at a population level, and whether they are less harmful than combustible tobacco products are highly controversial. Here, we review the evidence on the effects of e-cigarettes on respiratory health. Studies show measurable adverse biologic effects on organ and cellular health in humans, in animals, and in vitro. The effects of e-cigarettes have similarities to and important differences from those of cigarettes. Decades of chronic smoking are needed for development of lung diseases such as lung cancer or chronic obstructive pulmonary disease, so the population effects of e-cigarette use may not be apparent until the middle of this century. We conclude that current knowledge of these effects is insufficient to determine whether the respiratory health effects of e-cigarette are less than those of combustible tobacco products.

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Section: Challenges and Guidelines For Cliniciansmentioning

confidence: 99%

What are the respiratory effects of e-cigarettes?

Gotts

Jordt

McConnell

et al. 2019

BMJ

392

303

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“…Despite the need for more evidence on their efficacy and long‐term safety, NVPs are now a more popular method for cessation than licensed NRT and prescription stop‐smoking medications in many countries . In light of this, HPs should be prepared to provide balanced information about NVPs, particularly to smokers who are unable to stop smoking with approved cessation therapies, and for those who are requesting guidance regarding NVPs as a smoking cessation aid . Overall, the results from this study have shown that discussions between smokers and HPs about both quitting smoking, and the possible role NVPs could play as a cessation aid, were infrequent in the four countries in 2016.…”

Section: Discussionmentioning

confidence: 92%

“…e‐cigarettes) for smoking cessation is limited . Much of the difficulty in establishing a benefit for NVPs has do with the dearth of randomized control trials demonstrating a benefit for NVPs as cessation aids . While scientists, clinicians and public health organizations have engaged in extensive debate about the uncertainty of the possible risks and benefits of NVPs, several governments have adopted diverse regulatory approaches .…”

Section: Introductionmentioning

confidence: 99%

“…Evidence, mainly from the United States, suggests that as conversations about NVPs have increased in the clinical context , therefore HPs should be prepared to provide a balanced discussion about the possibility of using NVPs for smoking cessation. This may be particularly relevant for smokers who are seeking advice about NVPs, wanting to try/or already using NVPs to quit smoking, or failing repeatedly to quit with medically approved cessation methods . For example, recently released National Institute for Health and Care Excellence (NICE) guidance in England has recommended that practitioners should give advice to allow an informed discussion on using NVPs as a means to quit smoking , as they are less harmful than combustible cigarettes .…”

Section: Introductionmentioning

confidence: 99%

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Discussions between health professionals and smokers about nicotine vaping products: results from the 2016 ITC Four Country Smoking and Vaping Survey

et al. 2019

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Background and Aims: Debate exists about whether health professionals (HPs) should advise smokers to use nicotine vaping products (NVPs) to quit smoking. The objectives were to examine in four countries: (1) the prevalence of HP discussions and recommendations to use an NVP; (2) who initiated NVP discussions; (3) the type of HP advice received about NVPs; and (4) smoker’s characteristics related to receiving advice about NVPs. Design: Cross-sectional study using multivariable logistic regression analyses on weighted data from the 2016 ITC Four Country Smoking and Vaping Survey (ITC 4CV1). Setting: Four countries with varying regulations governing the sale and marketing of NVPs: ‘most restrictive’ (Australia), ‘restrictive’ (Canada) or ‘less restrictive’ (England and United States). Participants: A total of 6615 adult smokers who reported having visited an HP in the last year (drawn from the total sample of 12 294 4CV1 respondents, of whom 9398 reported smoking cigarettes daily or weekly). Respondents were from the United States (n = 1518), England (n = 2116), Australia (n = 1046), and Canada (n = 1935). Measurements: Participants’ survey responses indicated if they were current daily or weekly smokers and had visited an HP in the past year. Among those participants, further questions asked participants to report (1) whether NVPs were discussed, (2) who raised the topic, (3) advice received on use of NVPs and (4) advice received on quitting smoking. Findings: Among the 6615 smokers who visited an HP in the last year, 6.8% reported discussing NVPs with an HP and 2.1% of smokers were encouraged to use an NVP (36.1% of those who had a discussion). Compared with Australia (4.3%), discussing NVPs with an HP was more likely in the United States [8.8%, odds ratio (OR) = 2.15, 95% confidence interval (CI) = 1.41–3.29] and Canada (7.8%, OR = 1.87, 95% CI = 1.26–2.78). Smokers in Australia were less likely to discuss NVPs than smokers in England (6.2%), although this was not statistically significant (OR = 1.47, 95% CI = 0.98–2.20). Overall, the prevalence of HPs recommending NVPs was three times more likely in the United States than in Australia (OR = 3.07, 95% CI = 1.45–6.47), and twice as likely in Canada (OR = 2.28, 95% CI = 1.06–4.87) than in Australia. Australia and England did not differ (OR = 1.76, 95% CI = 0.83–3.74). Just over half (54%) of respondents brought up NVPs themselves; there were no significant differences among countries. Conclusions: Discussions in Australia, Canada, England, and the United States between smokers and health professionals about nicotine vaping products appear to be infrequent, regardless of the regulatory environment. A low percentage of health professionals recommended vaping products. This was particularly evident in Australia, which has the most restrictive regulatory environment of the four countries studied.

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“…As there are an increasing number of new smokers that start with e-cigarettes instead of combustible cigarettes, these individuals should be informed of the potential interconnection between e-cigarettes and cancer (for recommendations on how to inform patients about the potential harmful effects of e-cigarettes see ref. 93). This information about the stimulatory effects of nicotine and other chemicals inhaled from e-cigarettes on cancer initiation, progression, and development of metastases must be especially provided to oncological patients and individuals with a predisposition to cancer.…”

Section: Recommendations For Cliniciansmentioning

confidence: 99%

E-Cigarettes and Cancer Risk

Mravec

Tibenský

Horváthová

et al. 2020

Cancer Prevention Research

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From the time of their introduction, the popularity of ecigarettes (electronic nicotine-delivery systems) has been rising. This trend may reflect the general belief that ecigarettes are a less hazardous alternative to combustible cigarettes. However, the potential cancer-related effects of increased activation of the sympathoadrenal system induced by the inhalation of nicotine, the primary component of the e-cigarettes, are completely overlooked. Therefore, the aim of this review is to describe mechanisms that may connect the use of e-cigarettes and an increased risk for cancer development, as well as their stimulatory effect on cancer progression. Available preclinical data indicate that activation of the sympathetic nervous system by nicotine inhaled from e-cigarettes may stimulate cancer development and growth by several mechanisms. This issue might be especially important for oncological patients as they may have the misconception that compared with combustible cigarettes, e-cigarettes represent a risk-free alternative.

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Another Article About E‐Cigarettes: Why Should I Care?

Cited by 6 publications

References 16 publications

What are the respiratory effects of e-cigarettes?

What are the respiratory effects of e-cigarettes?

Discussions between health professionals and smokers about nicotine vaping products: results from the 2016 ITC Four Country Smoking and Vaping Survey

E-Cigarettes and Cancer Risk

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