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*[https://sci-hub.se/10.1007/s11739-019-02247-5 PDF Version]
*[https://sci-hub.se/10.1007/s11739-019-02247-5 PDF Version]


===2016: [https://pubmed.ncbi.nlm.nih.gov/27011045/ Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes]===
===2016: [https://www.discoverymedicine.com/Riccardo-Polosa/2016/02/persisting-long-term-benefits-of-smoking-abstinence-and-reduction-in-asthmatic-smokers-who-have-switched-to-electronic-cigarettes/ Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes]===
*This prospective study confirms that EC use ameliorates objective and subjective asthma outcomes and shows that these beneficial effects may persist in the long term. EC use can reverse harm from tobacco smoking in asthma patients who smoke. The evidence-based notion that substitution of conventional cigarettes with EC is unlikely to raise significant respiratory concerns, can improve counseling between physicians and their asthmatic patients who are using or intend to use ECs.
*This prospective study confirms that EC use ameliorates objective and subjective asthma outcomes and shows that these beneficial effects may persist in the long term. EC use can reverse harm from tobacco smoking in asthma patients who smoke. The evidence-based notion that substitution of conventional cigarettes with EC is unlikely to raise significant respiratory concerns, can improve counseling between physicians and their asthmatic patients who are using or intend to use ECs.


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==COPD==
==COPD==


===2023: [https://www.tandfonline.com/doi/full/10.1080/17476348.2023.2167716 Health impact of e-cigarettes and heated tobacco products in chronic obstructive pulmonary disease: Current and emerging evidence]===
===[https://safernicotine.wiki/mediawiki/index.php/Copd See our COPD page for more info]===
*Compared with conventional cigarettes, HTPs and ECs offer substantial reduction in exposure to toxic chemicals and have the potential to reduce harm from cigarette smoke when used as tobacco cigarette substitutes. In this review, we examine the available clinical studies and population surveys on the respiratory health effects of ECs and HTPs in COPD patients.
*As many COPD smokers prefer to smoke, conventional cigarette substitution should be considered as a valuable solution to the persistent problem of smoking, and combustion-free nicotine delivery technologies should be weight as a component of this strategy.
*Our analysis of existing human studies on the respiratory health impact of ECs/HTPs substitution for COPD patients who smoke, fails to reach a clear conclusion because of the discordant findings and unreliable interpretations driven from surveys and clinical studies of modest quality.
*This review article highlights the need for large, carefully designed, adequately controlled, long- term follow-up clinical trials to assess the true potential of combustion-free nicotine delivery technologies for sustained smoking cessation and reducing risk of harm from smoking, particularly among smokers with chronic obstructive pulmonary disease (COPD).
 
===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9526897/ Association of tobacco product use with chronic obstructive pulmonary disease (COPD) prevalence and incidence in Waves 1 through 5 (2013–2019) of the Population Assessment of Tobacco and Health (PATH) Study]===
*E-cigarettes and all use categories involving cigarettes were associated with higher COPD prevalence compared to never use, reflecting, in part, the high burden of cigarette exposure in these groups. Cigarette—but not exclusive e-cigarette—use was also strongly associated with higher COPD incidence. Compared to cigarette use, only quitting tobacco was protective against COPD development.
 
===2022: [https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-021-00284-0 Electronic cigarettes as a harm reduction strategy among patients with COPD: protocol for an open-label two arm randomized controlled pilot trial]===
*A harm reduction approach with the goal of achieving CC switching may be a more pragmatic approach, making EC use particularly appropriate with COPD. EC represent a potentially effective harm reduction tool that is safer than smoking CC [18, 23, 24]. Smokers with COPD, however, tend to be older and may have a higher level of addiction to nicotine than the average smoker and the feasibility and preliminary effectiveness of an EC harm-reduction strategy in a COPD population has not been explored.
*Our study protocol has a few limitations. First, as a pilot study the protocol is not powered to detect small differences in CPD or CAT Scores between the NRT and EC arms. Second, CAT Score is not the gold standard for the assessment of respiratory health.
 
===2021: [https://link.springer.com/article/10.1007/s11739-021-02674-3 Health outcomes in COPD smokers using heated tobacco products: a 3-year follow-up]===
*This study is the first to describe the long-term health effects of HTP use in COPD patients. Consistent improvements in respiratory symptoms, exercise tolerance, quality of life, and rate of disease exacerbations were observed in patients with COPD who abstained from smoking or substantially reduced their cigarette consumption by switching to HTP use.
*Nearly 60% of COPD patients using HTPs abstained completely from cigarette smoking throughout the duration of the study, whereas those continuing to smoke (dual users) showed a consistent decline in their daily cigarette consumption from the baseline of at least 70% at all study visits.
 
===2020: [https://journals.sagepub.com/doi/full/10.1177/2040622320961617 COPD smokers who switched to e-cigarettes: health outcomes at 5-year follow up]===
*The present study suggests that EC use may ameliorate objective and subjective COPD outcomes, and that the benefits gained appear to persist long term. EC use for abstinence and smoking reduction may ameliorate some of the harm resulting from tobacco smoking in COPD patients.
 
===2018: [https://www.dovepress.com/health-effects-in-copd-smokers-who-switch-to-electronic-cigarettes-a-r-peer-reviewed-fulltext-article-COPD Health effects in COPD smokers who switch to electronic cigarettes: a retrospective-prospective 3-year follow-up]===
*The present study suggests that EC use may ameliorate objective and subjective COPD outcomes and that the benefits gained may persist long-term. EC use may reverse some of the harm resulting from tobacco smoking in COPD patients.
 
===2018: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5799303/ In vitro RNA-seq-based toxicogenomics assessment shows reduced biological effect of tobacco heating products when compared to cigarette smoke]===
*The relationship between the identified RNA features and gene ontologies were mapped showing a strong association with stress response, xenobiotics metabolism, and COPD-related terms for 3R4F [combustible cigarette]. In contrast, fewer ontologies were found enriched for the THPs [heated tobacco product] aerosols. “Response to wounding” was a common COPD-related term over-represented for the two THPs but at a reduced significance. Quantification of a cytokine panel post-exposure confirmed a pro-inflammatory effect of cigarette smoke but not for THPs. In conclusion, THPs have a reduced impact on gene expression compared to 3R4F.
 
===2017: [https://www.dovepress.com/e-cigarettes-in-patients-with-copd-current-perspectives-peer-reviewed-fulltext-article-COPD E-cigarettes in patients with COPD: current perspectives]===
*Although ECs are not risk free, they are much less harmful than conventional tobacco smoking. The emerging clinical evidence suggests that ECs are unlikely to raise significant health concerns for the respiratory tract under normal conditions of use, even in smokers with preexisting lung disease. In particular, recent studies in COPD and chronic asthma suggest that substitution of conventional tobacco cigarettes for ECs can ameliorate subjective and objective disease-related outcomes and exacerbation rates as well as improving success in abstaining from smoking long term.
 
===2016: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5162097/ Evidence for harm reduction in COPD smokers who switch to electronic cigarettes]===
*Conclusion: “These findings suggest that ECs use may aid smokers with COPD reduce their cigarette consumption or remain abstinent, which results in marked improvements in annual exacerbation rate as well as subjective and objective COPD outcomes.”


==Lung Cancer/Lung Cancer Screening==
==Lung Cancer/Lung Cancer Screening==
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*Even if they should not be considered as risk-free products, however, HTPs and ECs lead to an appreciable risk reduction in comparison to cigarettes, both for cancer and non-cancer diseases. According to the current knowledge, and more specifically to the data presented here, HTPs and ECs might be considered as an acceptable reduced risk substitute for cigarettes for legal-age smokers who would otherwise continue smoking cigarettes.
*Even if they should not be considered as risk-free products, however, HTPs and ECs lead to an appreciable risk reduction in comparison to cigarettes, both for cancer and non-cancer diseases. According to the current knowledge, and more specifically to the data presented here, HTPs and ECs might be considered as an acceptable reduced risk substitute for cigarettes for legal-age smokers who would otherwise continue smoking cigarettes.
*A more pronounced cancer risk reduction was observed when comparing the mean lifetime cancer risk for the considered ECs with that for cigarette smoke. This reduction was about two orders of magnitude (ratio of 0.009 and 0.014) with 2.42·10–4 and 3.95·10–4 for ECs compared to 2.73·10–2 for cigarettes. In terms of consumers, this would mean that 1 out of 36 cigarette smokers vs. 1 out of 4132 or 1 out of 2531 EC consumers may develop a cancer if the cancer root cause would be only associated with exposure to the considered HPHCs.
*A more pronounced cancer risk reduction was observed when comparing the mean lifetime cancer risk for the considered ECs with that for cigarette smoke. This reduction was about two orders of magnitude (ratio of 0.009 and 0.014) with 2.42·10–4 and 3.95·10–4 for ECs compared to 2.73·10–2 for cigarettes. In terms of consumers, this would mean that 1 out of 36 cigarette smokers vs. 1 out of 4132 or 1 out of 2531 EC consumers may develop a cancer if the cancer root cause would be only associated with exposure to the considered HPHCs.
===2018 [https://www.sciencedirect.com/science/article/abs/pii/S0021850217301155 Measurements of electronic cigarette-generated particles for the evaluation of lung cancer risk of active and passive users]===
*In this study, we have demonstrated that no clinically relevant, product-related safety findings were observed for smokers of Combustible Cigarettes (CC) switching to an [[Special:MyLanguage/Abbreviations|Electronic Vapor Product (EVP)]] for 12 weeks under real-life settings. Adverse Effects (AEs) reported by subjects switching to the EVP occurred primarily within the first week after switching, and only 1.3% of all AEs reported were considered to be almost definitely related to the product. Up to a third of all reported AEs in the EVP group were related to nicotine withdrawal symptoms, which were observed to decrease after the first two weeks from product switch. EVP use was associated with significant decreases in exposure to nicotine and other chemicals such as benzene and acrolein, typically found in CC smoke. Changes were also observed in the level of WBC, haemoglobin, RBC and LDL cholesterol, which although minor, were consistent with those observed after smoking cessation. The data presented in this study shows the potential that EVPs may offer to smokers looking for an alternative to CCs.
*[https://sci-hub.se/10.1016/j.jaerosci.2017.10.006 PDF Version]


===2017: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429854/ Reduced biological effect of e-cigarette aerosol compared to cigarette smoke evaluated in vitro using normalized nicotine dose and RNA-seq-based toxicogenomics]===
===2017: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429854/ Reduced biological effect of e-cigarette aerosol compared to cigarette smoke evaluated in vitro using normalized nicotine dose and RNA-seq-based toxicogenomics]===
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==General==
==General==
===2024: [https://pubmed.ncbi.nlm.nih.gov/39112772/ The association of vaping and electronic cigarette use with postoperative hypoxemia and respiratory complications: a retrospective cohort analysis]===
*Conclusion: Vaping/e-cigarette use was neither associated with clinically significant hypoxemia during the first hour in the postanesthesia care unit nor with an increase in pulmonary complications.
**Citation: Saab R, Rivas E, Yalcin EK, Chen L, Montalvo M, Almonacid-Cardenas F, Shah K, Ruetzler K, Turan A. The association of vaping and electronic cigarette use with postoperative hypoxemia and respiratory complications: a retrospective cohort analysis. Can J Anaesth. 2024 Aug 7. English. doi: 10.1007/s12630-024-02801-6. Epub ahead of print. PMID: 39112772.
***Online ahead of print. - No funding/COI information is listed at this time.


===2021: [https://www.sciencedirect.com/science/article/abs/pii/S2213260021000229 Effect of an electronic nicotine delivery system with 0, 8, or 36 mg/mL liquid nicotine versus a cigarette substitute on tobacco-related toxicant exposure: a four-arm, parallel-group, randomised, controlled trial]===
===2021: [https://www.sciencedirect.com/science/article/abs/pii/S2213260021000229 Effect of an electronic nicotine delivery system with 0, 8, or 36 mg/mL liquid nicotine versus a cigarette substitute on tobacco-related toxicant exposure: a four-arm, parallel-group, randomised, controlled trial]===
*Use of an ENDS with cigarette-like nicotine delivery can reduce exposure to a major pulmonary carcinogen, NNAL, even with concurrent smoking.  
*Use of an ENDS with cigarette-like nicotine delivery can reduce exposure to a major pulmonary carcinogen, NNAL, even with concurrent smoking.


===2020: [https://www.nber.org/papers/w27507 E-Cigarettes and Respiratory Disease: A Replication, Extension, and Future Directions]===
===2020: [https://www.nber.org/papers/w27507 E-Cigarettes and Respiratory Disease: A Replication, Extension, and Future Directions]===
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*Collectively, the results predict that room air levels and exposure of the selected analytes to non-users were relatively low and several-fold below regulatory PELs and AIHA limit under the modeled space and use conditions.
*Collectively, the results predict that room air levels and exposure of the selected analytes to non-users were relatively low and several-fold below regulatory PELs and AIHA limit under the modeled space and use conditions.
*...room air levels of nicotine, formaldehyde, acrolein, and acetaldehyde levels were significantly below OSHA PELs or American Industrial Hygiene Association (AIHA) limit...
*...room air levels of nicotine, formaldehyde, acrolein, and acetaldehyde levels were significantly below OSHA PELs or American Industrial Hygiene Association (AIHA) limit...
===2020: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504617/ Comparative Indoor Pollution from Glo, Iqos, and Juul, Using Traditional Combustion Cigarettes as Benchmark: Evidence from the Randomized SUR-VAPES AIR Trial]===
*Glo, Iqos, and Juul have significantly less intense and persistent effects on indoor pollution in comparison to combustible tobacco cigarettes.


===2018: [https://academic.oup.com/ntr/article/21/10/1371/5040053 Characterization of the Spatial and Temporal Dispersion Differences Between Exhaled E-Cigarette Mist and Cigarette Smoke]===
===2018: [https://academic.oup.com/ntr/article/21/10/1371/5040053 Characterization of the Spatial and Temporal Dispersion Differences Between Exhaled E-Cigarette Mist and Cigarette Smoke]===
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*This study, although conducted under very high exposure conditions in a small, non-ventilated vape shop with many employees and customers vaping and clouds of vapor visible, did not document any dangerous levels of exposure to any hazardous chemical. Nicotine exposure was essentially non-existent. *Formaldehyde exposure was no different than in many indoor and outdoor environments at baseline. Acetone, acetoin, other aldehydes, toluene, benzene, and xylene were not detected. Chemicals that have been associated with "popcorn lung" were also not detected by the standard method.
*This study, although conducted under very high exposure conditions in a small, non-ventilated vape shop with many employees and customers vaping and clouds of vapor visible, did not document any dangerous levels of exposure to any hazardous chemical. Nicotine exposure was essentially non-existent. *Formaldehyde exposure was no different than in many indoor and outdoor environments at baseline. Acetone, acetoin, other aldehydes, toluene, benzene, and xylene were not detected. Chemicals that have been associated with "popcorn lung" were also not detected by the standard method.
*This study adds to the evidence that under real-life conditions, "secondhand vaping" does not appear to pose any significant health risks.
*This study adds to the evidence that under real-life conditions, "secondhand vaping" does not appear to pose any significant health risks.
===2015: [https://sci-hub.se/10.1016/j.chroma.2015.07.094 A rapid method for the chromatographic analysis of volatile organic compounds in exhaled breath of tobacco cigarette and electronic cigarette smokers]===
*Tobacco cigarette smoke provided the samples containing highest concentrations of all compounds analyzed. Besides nicotine it contained benzene, toluene, xylenes, ethylbenzene and naphthalene in high abundance as well as other compounds such as isoprene, pent-1-ene, n-pentane, n-hexane, n-heptane and others.
*This composition was in strong contrast with that of vapor from the e-cigarettes in which all these compounds were virtually absent except nicotine


===2014: [https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-18 Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks]===
===2014: [https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-18 Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks]===
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*There was no evidence of potential for exposures of e-cigarette users to contaminants that are associated with risk to health at a level that would warrant attention if it were an involuntary workplace exposures.
*There was no evidence of potential for exposures of e-cigarette users to contaminants that are associated with risk to health at a level that would warrant attention if it were an involuntary workplace exposures.
*Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern.
*Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern.
===2012: [https://www.tandfonline.com/doi/abs/10.3109/08958378.2012.724728?scroll=top&needAccess=true&journalCode=iiht20 Comparison of the effects of e-cigarette vapor and cigarette smoke on indoor air quality]===
*Comparisons of pollutant concentrations were made between e-cigarette vapor and tobacco smoke samples. Pollutants included VOCs, carbonyls, PAHs, nicotine, TSNAs, and glycols.
*Non-cancer risk analysis revealed “No Significant Risk” of harm to human health for vapor samples from e-liquids.
*With regard to cancer risk analysis, no vapor sample from e-liquids exceeded the risk limit for either children or adults.


=Misinformation About Nicotine and Lung Health=
=Misinformation About Nicotine and Lung Health=
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===2021: [https://pubmed.ncbi.nlm.nih.gov/27543458/ Lung function and respiratory symptoms in a randomized smoking cessation trial of electronic cigarettes]===
===2021: [https://pubmed.ncbi.nlm.nih.gov/27543458/ Lung function and respiratory symptoms in a randomized smoking cessation trial of electronic cigarettes]===
*[https://sci-hub.se/10.1042/CS20160268 PDF Full version]
*[https://sci-hub.se/10.1042/CS20160268 PDF Full version]
===2024: [https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00530-3/fulltext Functionally important respiratory symptoms and continued cigarette use versus e-cigarette switching: population assessment of tobacco and health study waves 2-6]===


=More Information=
=More Information=
*Click on the category link below for more studies by topic on ENDS and Nicotine.
*Click on the category link below for more studies by topic on ENDS and Nicotine.
[[Category:Studies, Surveys, and Papers]]
[[Category:Studies, Surveys, and Papers]]
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