Impact of Electronic Cigarettes on Various Organ Systems

Abstract

The electronic cigarette (e-cigarette) has been regarded by many as a healthier alternative to the combustible cigarette, yet there is a lack of consensus concerning the health consequences and the health benefits associated with e-cigarette use. We review the research on the effects of e-cigarettes on multiple physiological systems, examine the association between e-cigarette use and combustible cigarette uptake and cessation, and highlight research necessary to build consensus. Although the levels of known toxicants and carcinogens tend to be significantly lower in e-cigarettes than in combustible cigarette smoke, toxicants in e-cigarette e-liquid and those that form as part of the vaporization process may produce adverse health consequences in their own right. Acute effects have been noted in the pulmonary, cardiovascular, and immune systems, which highlight the need for research on long-term exposure. The specific chemical constituents and the levels of those constituents that pose harm remain largely uncharacterized. In addition, the efficacy of e-cigarettes for smoking cessation has yet to be established. As the e-cigarette has evolved rapidly, so has the methodology across studies, making cross-study comparisons more difficult to synthesize. The latest generation of e-cigarette devices deliver nicotine and toxicants at higher levels than earlier devices, especially in experienced users. E-cigarettes pose a risk for nicotine exposure, dependence, and combustible cigarette uptake. E-cigarettes and their delivered toxicants appear harmful to multiple organ systems, although the current body of evidence is limited, especially in terms of long-term effects. Further research is warranted with a focus on individual devices, e-liquid constituents, user characteristics, and patterns of use. Any potential benefit of e-cigarettes for smoking cessation must be weighed against the risks. Given the potential longer-term effects, efforts to prevent e-cigarette use in youth are critical.

Electronic cigarettes containing nicotine increase endothelial and platelet derived extracellular vesicles in healthy volunteers

“…A slight increase in platelet derived EVs expressing CD40 ligand reached significance also following e-cigarette inhalation without nicotine. There are several components besides nicotine in the e-cigarette fluid and vapor that may cause adverse and toxic effects, including acetaldehydes, polycyclic aromatic hydrocarbons (PAHs), reactive oxygen species (ROS), metals, volatile organic compounds as well as fine and ultrafine particles [49]. These pro-inflammatory and carcinogenic toxicants have all been found to be present in the e-cigarette vapor and fluid, although mostly in a lesser degree as compared to conventional cigarette smoke [50,51].…”

Electronic Cigarette Aerosol Modulates the Oral Microbiome and Increases Risk of Infection

“…As per a 2014 report, the US FDA detected in one of the cartridges the presence of diethylene glycol, a toxic liquid used in explosives and as an antifreeze agent, in addition to, cancer-causing agents, such as tobacco-specific nitrosamines, aldehydes, metals, volatile organic compounds, phenolic compounds, polycyclic aromatic hydrocarbons, flavors, solvent carriers, tobacco alkaloids, and drugs (amino tadalafil and rimonabant) (Cheng, 2014). Moreover, recent studies showed that nicotine delivery and emission of some toxicant levels from the latest generation of e-cigarettes were comparable to those from tobacco smoke (Eltorai et al, 2019).…”

Acute exposures to e‐cigarettes and heat‐not‐burn products reported to the Czech Toxicological Information Centre over a 7‐year period (2012‐2018)

“…These devices have become increasingly popular, mainly among younger individuals and naïve smokers; they have the potential for rapid dependence development. Indeed, adolescents who used e‐cigarettes were 2.7 times more likely to start smoking combustible cigarettes than adolescents who had never vaped . E‐cigarettes first appeared in China in 2003, while the history of HNBC dates back to 2014, with its origin in Japan and Italy .…”