Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes?: Review on e-cigarette vapor versus tobacco smoke

Abstract

Objectives/Hypothesis: Development and utilization of electronic cigarettes (ECs) resulted from the search for healthier alternatives to conventional tobacco cigarettes (TCs) and the search for alternative methods for quitting TCs. This review compares the potential disease burden presented by TC smoke to that of EC vapor.Methods: Potential disease burden of EC vapor versus TC smoke was assessed by reviewing clinical studies that measured inhaled components. Chemicals and carcinogens produced by vapor versus smoke were compared.Results: Studies show that EC vapors contain far less carcinogenic particles than TC smoke. Whereas ECs have the ability to reach peak serum cotinine/nicotine levels comparable to that of TCs, ECs do not cause an increase in total white blood cell count; thus, ECs have the potential to lower the risk of atherosclerosis and systemic inflammation. Use of ECs has been shown to improve indoor air quality in a home exposed to TC smoke. This reduces secondhand smoke exposure, thus having the potential to decrease respiratory illness/asthma, middle-ear disease, sudden infant death syndrome, and more. However, some studies claim that propylene glycol (PG) vapor can induce respiratory irritation and increase chances for asthma. To minimize risks, EC manufacturers are replacing PG with distilled water and glycerin for vapor production.Conclusion: Based on the comparison of the chemical analysis of EC and TC carcinogenic profiles and association with health-indicating parameters, ECs impart a lower potential disease burden than conventional TCs.

Trace Metals Derived from Electronic Cigarette (ECIG) Generated Aerosol: Potential Problem of ECIG Devices That Contain Nickel

“…For many ECIG users, vaping is considered safer than smoking because tobacco is not burned; hence the thousands of toxic compounds associated with combustion of tobacco are not inhaled. But safer does not imply harmless and the question of ECIG safety is still under debate (Bhatnagar et al, 2014; Chapman, 2014; Oh and Kacker, 2014; Pisinger, 2014; Abrams and Niaura, 2015). In fact, there is much concern about the detrimental effects of ECIG-generated aerosol as perceived by the public, especially in the wake of two recent and highly publicized articles reporting hidden formaldehyde in ECIG-generated aerosols (Jensen et al, 2015) and DNA strand breaks and cell death induced by ECIG vapor (Yu et al, 2016).…”

Are e-cigarettes a gateway to smoking or a pathway to quitting?

“…Vaping also decreases secondhand smoke exposure and is believed to have the potential to decrease incidence of respiratory illness/asthma, middle-ear disease, sudden infant death syndrome, and other diseases. 56 It is stated that exposure to e-cig vapours results in far less toxicity than exposure to conventional cigarettes that initiate cytotoxicity and a pro-inflammatory profile. 58,59 A study's findings indicate that neither the e-cig liquids nor collected aerosols produce any meaningful toxic effects in vitro, in comparison to conventional cigarettes (which are proven to be cytotoxic and genotoxic).…”

Electronic Cigarettes for Curbing the Tobacco-Induced Burden of Noncommunicable Diseases: Evidence Revisited with Emphasis on Challenges in Sub-Saharan Africa

“…Additionally, the use of e-cigs has been found associated with nose bleeding, change in bronchial gene expression, release of cytokines and proinflammatory mediators, and increase in allergic airway inflammation which can exacerbate asthmatic symptoms, thus by elevating infiltration of inflammatory cells including eosinophils into airways [49–51]. Notwithstanding, all these effects may be lower than those caused by traditional tobacco [52]. …”

“…Two of these measures are protecting people from second-hand smoking and offering help to quit tobacco use [2, 9]. On the basis that e-cigs may facilitate smoking cessation, reduction, or abstinence [10–12, 70–76, 78, 82] and that they may pose only a small fraction of the risks of tobacco cigarettes [13–16, 39, 52, 57, 61, 63, 65–67], it is likely that e-cigs may address the just-cited 2 MPOWER measures, hence contributing to the reduction in the heavy toll driven by tobacco smoking.…”