Αντικρουόμενες απόψεις περί του ηλεκτρονικού καπνίσματος (ή αλλιώς ατμίσματος) έχουμε ακούσει σχεδόν όλοι από τότε που τα ηλεκτρονικά τσιγάρα (1ης 2ης και 3ης γενιάς) έκαναν την εμφάνισή τους στην αγορά (μιλάμε για 2003). Το ζήτημα της υγείας απασχολεί τους ίδιους τους ατμιστές αλλά και τον περίγυρό τους. Και είναι άκρως λογικό καθώς «..Είναι νωρίς ακόμη μές στόν κόσμο αυτόν αγάπη μου...». Οι ιθαγενείς της Αμερικής κάπνιζαν στέλνοντας σήματα καπνού και η πρώτη
νύξη στο PubMed αναφορικά με πιθανόν επιβλαβείς συνέπειες του
καπνίσματος έρχεται το 1845.
Είναι λοιπόν, σαν να βρισκόμαστε ξανά στο 1845. Η επιστήμη χρειάζεται χρόνο, που όμως είναι πολύτιμος για τη δημόσια υγεία. Οι κλινικές έρευνες είναι ακόμα σε πολύ πρώιμο στάδιο για να εξαχθεί ένα ασφαλές συμπέρασμα, χώρια του ότι το κέρδος των βιομηχανιών παρεμβαίνει στην όποια διαφανή ενημέρωση του κοινού. Τα καταστήματα ηλεκτρονικού τσιγάρου φύτρωσαν σαν μανιτάρια μέσα στην τελευταία δεκαετία και η μπίζνα έχει στηθεί πολύ καλά για να πέσει εύκολα κι αναίμακτα.
 |
| Prov Med Surg J. 1845 Oct 8;9(41):612-4. |
Ανακτήθηκαν 2017/10/16 από το PubMed με keywords: electronic cigarettes
(No conflict of interest και τα σχετικά...)
J Am Heart Assoc. 2017 Aug 30;6(9). doi: 10.1161/JAHA.117.006353.
Impact of Electronic Cigarettes on the Cardiovascular System.
Impact of Electronic Cigarettes on the Cardiovascular System.
"E‐cigarettes, also known as vape pens, e‐cigars, or vaping devices, are electronic nicotine delivering systems, which generate an aerosolized mixture containing flavored liquids and nicotine that is inhaled by the user.9 The extensive diversity of e‐cigarettes arises from the various nicotine concentrations present in e‐liquids, miscellaneous volumes of e‐liquids per product, different carrier compounds, additives, flavors, and battery voltage.9 Regardless of the exact design, each e‐cigarette device has a common functioning system, which is composed of a rechargeable lithium battery, vaporization chamber, and a cartridge. The lithium battery functions as the powerhouse; it is connected to the vaporization chamber that contains the atomizer9 (Figure 1). In order to deliver nicotine to the lungs, the user inhales through a mouthpiece, and the airflow triggers a sensor that then switches on the atomizer.9, 10, 11 Finally, the atomizer vaporizes liquid nicotine in a small cartridge (Figure 1) and delivers it to the lungs.9
 |
| Typical e‐cigarette design. E‐cigarettes are usually composed of nicotine cartridge (e‐liquid container), vaporizing chamber, a heating coil (heats e‐liquid) followed by an atomizer (e‐vapor generator), rechargeable battery and voltage controller (which will adjust the amount of nicotine delivered during vaping), microcompressor, and LED indicator—not present in all types—to activate the battery and visually mimic the conventional cigarette, respectively. LED indicates light‐emitting diode. |
As the primary system exposed to vapors from e‐cigarettes, most reported health effects have centered on the pulmonary tract. Recent clinical and animal studies showed that (active or passive) e‐vapors/e‐cigarettes may cause irritation of both the upper and lower respiratory tract, in addition to inducing bronchospasm and cough9, 32, 33, 34; the latter effects may be attributed to a chain of inflammatory reactions through oxidative stress.28
As for effects on other systems, e‐cigarettes also reduce, in mice, the efficiency of the immune system, as reflected by the increased susceptibility to infection with influenza A and Streptococcus pneumonia.29 As for the central nervous system, e‐cigarettes may alter brain functions, which affects the mood, learning abilities, memory, and could even induce drug dependence in both humans and animals.35, 36, 37 E‐cigarettes may also directly damage neurons and cause tremor and muscle spasms.9.
Carcinogenicity, mostly manifested in the lungs, mouth, and throat,30 is another important aspect of the e‐cigarette's negative health profile; this may be linked to nitrosamines, propylene‐glycol (the major carrier in e‐liquids), and even some flavoring agents.9, 31 In fact, one study indicated that after being heated and vaporized, propylene glycol may transform into propylene oxide, which is a class 2B carcinogen. Moreover, e‐liquid exposure was found to exert a direct cytotoxic effect on human embryonic stem cells and mouse neural stem cells, highlighting a potential harm for pregnant females.15, 32 Other adverse effects include nausea, vomiting, and contact dermatitis, as well as eye, mouth, and throat irritation.9, 31 It is noteworthy that the harm related to e‐cigarette usage reaches further beyond “beings” to include fire hazards and explosions; issues the public tends to underestimate.38, 39
Andrea et al showed that heart rate acutely increased after e‐cigarettes use by smokers,41 which was also observed in a separate study.42 Additionally, Yan et al found that e‐cigarettes elevated both diastolic blood pressure and heart rate in smokers, but to a lesser extent when compared with tobacco cigarettes.43
Alternatively, some studies have shown that short‐term exposure to e‐cigarettes has no cardiovascular harm.49, 50, 51 These studies found that acute exposure to e‐cigarettes had no immediate effects on the coronary circulation, myocardial function, and arterial stiffness.10, 49, 50 Another study revealed no significant changes in smokers' heart rate after acute use of e‐cigarettes.52 However, the discrepancy in findings should be examined in the context of evidence indicating that vaping topography (e‐cigarette usage patterns such as inhalation duration and the magnitude of inhaled volume) and user's experience are critical factors in determining the health effects of e‐cigarettes.39, 53
Although much is known about smoking‐induced cardiovascular toxicity, little is known about that of e‐cigarettes. This is an issue that continues to be a subject of debate. Nevertheless, based on the current body of evidence, e‐cigarettes are not emission free (as some believe) and, in fact, they emit various potentially harmful and toxic chemicals. Whether or not the levels of these toxicants are lower than traditional smoking remains controversial."
As for effects on other systems, e‐cigarettes also reduce, in mice, the efficiency of the immune system, as reflected by the increased susceptibility to infection with influenza A and Streptococcus pneumonia.29 As for the central nervous system, e‐cigarettes may alter brain functions, which affects the mood, learning abilities, memory, and could even induce drug dependence in both humans and animals.35, 36, 37 E‐cigarettes may also directly damage neurons and cause tremor and muscle spasms.9.
Carcinogenicity, mostly manifested in the lungs, mouth, and throat,30 is another important aspect of the e‐cigarette's negative health profile; this may be linked to nitrosamines, propylene‐glycol (the major carrier in e‐liquids), and even some flavoring agents.9, 31 In fact, one study indicated that after being heated and vaporized, propylene glycol may transform into propylene oxide, which is a class 2B carcinogen. Moreover, e‐liquid exposure was found to exert a direct cytotoxic effect on human embryonic stem cells and mouse neural stem cells, highlighting a potential harm for pregnant females.15, 32 Other adverse effects include nausea, vomiting, and contact dermatitis, as well as eye, mouth, and throat irritation.9, 31 It is noteworthy that the harm related to e‐cigarette usage reaches further beyond “beings” to include fire hazards and explosions; issues the public tends to underestimate.38, 39
Andrea et al showed that heart rate acutely increased after e‐cigarettes use by smokers,41 which was also observed in a separate study.42 Additionally, Yan et al found that e‐cigarettes elevated both diastolic blood pressure and heart rate in smokers, but to a lesser extent when compared with tobacco cigarettes.43
Alternatively, some studies have shown that short‐term exposure to e‐cigarettes has no cardiovascular harm.49, 50, 51 These studies found that acute exposure to e‐cigarettes had no immediate effects on the coronary circulation, myocardial function, and arterial stiffness.10, 49, 50 Another study revealed no significant changes in smokers' heart rate after acute use of e‐cigarettes.52 However, the discrepancy in findings should be examined in the context of evidence indicating that vaping topography (e‐cigarette usage patterns such as inhalation duration and the magnitude of inhaled volume) and user's experience are critical factors in determining the health effects of e‐cigarettes.39, 53
Although much is known about smoking‐induced cardiovascular toxicity, little is known about that of e‐cigarettes. This is an issue that continues to be a subject of debate. Nevertheless, based on the current body of evidence, e‐cigarettes are not emission free (as some believe) and, in fact, they emit various potentially harmful and toxic chemicals. Whether or not the levels of these toxicants are lower than traditional smoking remains controversial."
Ther Adv Drug Saf. 2014 Apr; 5(2): 67–86. doi: 10.1177/2042098614524430.
Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review
Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review
"ECs are a revolutionary product in tobacco harm reduction. Although they emit vapor, which resembles smoke, there is literally no fire (combustion) and no ‘fire’ (suspicion or evidence that they may be the cause for disease in a similar way to tobacco cigarettes). Due to their unique characteristics, ECs represent a historical opportunity to save millions of lives and significantly reduce the burden of smoking-related diseases worldwide.
Although evaluating the effects of passive vaping requires further work, based on the existing evidence from environmental exposure and chemical analyses of vapor, it is safe to conclude that the effects of EC use on bystanders are minimal compared with conventional cigarettes."
Although evaluating the effects of passive vaping requires further work, based on the existing evidence from environmental exposure and chemical analyses of vapor, it is safe to conclude that the effects of EC use on bystanders are minimal compared with conventional cigarettes."
Curr Allergy Asthma Rep. 2017 Oct 5;17(11):79. doi: 10.1007/s11882-017-0747-5.
Electronic Cigarettes: Their Constituents and Potential Links to Asthma
Electronic Cigarettes: Their Constituents and Potential Links to Asthma
"Occupational inhalation of some common food-safe flavoring agents is reported to cause occupational asthma and worsen asthmatic symptoms. Moreover, workplace inhalation exposures to the flavoring agent diacetyl have caused irreversible obstructive airway disease in healthy workers. Additionally, recent studies report that thermal decomposition of propylene glycol (PG) and vegetable glycerin (VG), the base constituents of e-liquids, produces reactive carbonyls, including acrolein, formaldehyde, and acetaldehyde, which have known respiratory toxicities. Furthermore, recent nicotine studies in rodents reveal that prenatal nicotine exposures lead to epigenetic reprogramming in the offspring, abnormal lung development, and multigenerational transmission of asthmatic-like symptoms."
Nat Rev Cardiol. 2017 Oct 12. doi: 10.1038/nrcardio.2017.154. [Epub ahead of print]
Epidemiology of cardiovascular disease in young individuals
Epidemiology of cardiovascular disease in young individuals
"The longterm cardiovascular consequences of e-cigarette use, and whether the cardiovascular risks of e-cigarette use are possibly lower than the risks of conventional cigarette smoking, remain to be determined."
Current Allergy and Asthma Reports 2017 Oct 5. doi: https://doi.org/10.1007/s11882-017-0747-5.
Electronic Cigarettes: Their Constituents and Potential Links to Asthma
Electronic Cigarettes: Their Constituents and Potential Links to Asthma
"Flavored e-cig liquids (e-liquids) and e-cig aerosols contain airway irritants and toxicants that have been implicated in the pathogenesis and worsening of lung diseases."
