Electronic cigarette: A recent update of its toxic effects on humans

Huang, Shujie; Xu, Yan‐Ming; Lau, Andy T. Y.

doi:10.1002/jcp.26352

Cited by 40 publications

(20 citation statements)

References 110 publications

(119 reference statements)

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“…Research on the characterization of e-cigarette aerosols and related health effects on humans have been emerging within the last five years as e-cigarettes are becoming vastly popular, especially among young Americans and the worldwide population (Chun et al, 2017; Huang et al, 2017). It is crucial to understand toxicological and chronic health effects of e-cigarettes as it has been introduced and marketed as a healthier alternative to conventional combustible cigarettes.…”

Section: Respiratory Health Effects Of Ends Flavorings: Shortcomings mentioning

confidence: 99%

Mechanisms of toxicity and biomarkers of flavoring and flavor enhancing chemicals in emerging tobacco and non-tobacco products

2018

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Tobacco products containing flavorings, such as electronic nicotine delivery devices (ENDS) or e-cigarettes, cigars/cigarillos, waterpipes, and heat-not-burn devices (iQOS) are continuously evolving. In addition to increasing the exposure of teenagers and adults to nicotine containing flavoring products and flavoring enhancers, chances of nicotine addiction through chronic use and abuse also increase. These flavorings are believed to be safe for ingestion, but little information is available about their effects on the lungs. In this review, we have discussed the in vitro and in vivo data on toxicity of flavoring chemicals in lung cells. We have further discussed the common flavoring agents, such as diacetyl and menthol, currently available detection methods, and the toxicological mechanisms associated with oxidative stress, inflammation, mucociliary clearance, and DNA damage in cells, mice, and humans. Finally, we present potential biomarkers that could be utilized for future risk assessment. This review provides crucial parameters important for evaluation of risk associated with flavoring agents and flavoring enhancers used in tobacco products and ENDS. Future studies can be designed to address the potential toxicity of inhaled flavorings and their biomarkers in users as well as in chronic exposure studies.

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Section: Respiratory Health Effects Of Ends Flavorings: Shortcomings mentioning

confidence: 99%

Mechanisms of toxicity and biomarkers of flavoring and flavor enhancing chemicals in emerging tobacco and non-tobacco products

2018

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“…Second, although smoking is one of the primary sources of Cd exposure in human [17,31], Cd is not the only carcinogens present in cigarettes. In fact, smokers are exposed to a toxic mixture of over 7000 chemicals, in which many are recognized as carcinogens, from cigarette smoking [46].…”

Section: Discussionmentioning

confidence: 99%

Lasting DNA Damage and Aberrant DNA Repair Gene Expression Profile Are Associated with Post-Chronic Cadmium Exposure in Human Bronchial Epithelial Cells

Tan

Liang

Yao

et al. 2019

Cells

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Cadmium (Cd) is a widespread environmental pollutant and carcinogen. Although the exact mechanisms of Cd-induced carcinogenesis remain unclear, previous acute/chronic Cd exposure studies have shown that Cd exerts its cytotoxic and carcinogenic effects through multiple mechanisms, including interference with the DNA repair system. However, the effects of post-chronic Cd exposure remain unknown. Here, we establish a unique post-chronic Cd-exposed human lung cell model (the “CR0” cells) and investigate the effects of post-chronic Cd exposure on the DNA repair system. We found that the CR0 cells retained Cd-resistant property even though it was grown in Cd-free culture medium for over a year. The CR0 cells had lasting DNA damage due to reduced DNA repair capacity and an aberrant DNA repair gene expression profile. A total of 12 DNA repair genes associated with post-chronic Cd exposure were identified, and they could be potential biomarkers for identifying post-chronic Cd exposure. Clinical database analysis suggests that some of the DNA repair genes play a role in lung cancer patients with different smoking histories. Generally, CR0 cells were more sensitive to chemotherapeutic (cisplatin, gemcitabine, and vinorelbine tartrate) and DNA damaging (H2O2) agents, which may represent a double-edged sword for cancer prevention and treatment. Overall, we demonstrated for the first time that the effects of post-chronic Cd exposure on human lung cells are long-lasting and different from that of acute and chronic exposures. Findings from our study unveiled a new perspective on Cd-induced carcinogenesis—the post-chronic exposure of Cd. This study encourages the field of post-exposure research which is crucial but has long been ignored.

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“…There is a prevalent view that ENDS are probably less harmful than combustible tobacco smoking, based in the argument that nothing can be as harmful as inhaling tobacco smoke for long periods. However, ‘less harm’ does not equate to ‘harmless’; basic science and clinical data indicate that ENDS and their constituent ingredients, including flavourings, are not harm‐free, The long‐term effects of regular ENDS use remain unknown, but, akin to combustible tobacco and many other occupational and non‐occupational inhalants, the full effect of low‐dose but prolonged exposure may only manifest decades later. For ENDS toxicity, ‘absence of evidence is not evidence of absence’ …”

Section: Ends Toxicitymentioning

confidence: 99%

Electronic cigarettes in physician practice: a complex debate

Marshall

2019

Internal Medicine Journal

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E‐cigarettes, or electronic nicotine delivery systems (ENDS), have been suggested as a potential aid for smoking cessation, but many questions about their efficacy and safety remain unanswered. Until very recently, the evidence for ENDS in smoking cessation was largely based on observational studies or randomised controlled trials with methodological flaws and did not provide adequate evidence to support strongly ENDS for smoking cessation. Concerns about the uptake of ENDS by nonsmoking populations (such as adolescents) remain. More recent evidence may indicate the effect of ENDS in smoking cessation, but many questions remain unanswered. In this article, we address recent claims that failure to recommend ENDS for smoking cessation represents unethical practice. We strongly dispute this claim, analysing the many complex issues that clinicians working in smoking cessation should consider.

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Electronic cigarette: A recent update of its toxic effects on humans

Cited by 40 publications

References 110 publications

Mechanisms of toxicity and biomarkers of flavoring and flavor enhancing chemicals in emerging tobacco and non-tobacco products

Mechanisms of toxicity and biomarkers of flavoring and flavor enhancing chemicals in emerging tobacco and non-tobacco products

Lasting DNA Damage and Aberrant DNA Repair Gene Expression Profile Are Associated with Post-Chronic Cadmium Exposure in Human Bronchial Epithelial Cells

Electronic cigarettes in physician practice: a complex debate

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