ENDS Public Health: Difference between revisions

In 2018, 34 million U.S. adults were current smokers, and 55 million were former cigarette smokers for any duration (5). E-cigarette use was highest among current smokers and former smokers who quit cigarettes within the past year and those who quit 1–4 years ago. The percentages who had ever used an e-cigarette or who were current e-cigarette users declined among former smokers who had gone longer without smoking cigarettes and was lowest among those who never smoked cigarettes.  

In a small sample of young-adult never-smoking, daily EC users who were carefully followed for approximately 3½ years, we found no decrements in spirometric indices, development of respiratory symptoms, changes in markers of lung inflammation in exhaled air or findings of early lung damage on HRCT, when compared with a carefully matched group of never-smoking non-EC users. Even the heaviest EC users failed to exhibit any evidence of emerging lung injury as reflected in these physiologic, clinical or inflammatory measures. Moreover, no changes were noted in blood pressure or heart rate. Since the EC users who we studied were never smokers, potential confounding by inhalation of combustion products of tobacco were obviated.

While the sample size was small, the results of this study may provide some preliminary evidence that long-term use of ECs is unlikely to raise significant health concerns in relatively young users

Visible vaping was commonly reported by interviewees who typically interpreted such vaping as indicating that the individual was seeking to reduce or cease his or her smoking. Whilst the sight of someone using an e-cigarette could stimulate curiosity on the part of non-smokers as to what the experience of vaping was like there was little indication that our sample of non-smokers were intending taking up vaping on a regular basis. There were indications from our interviews that visible vaping had resulted in either no change in what individuals assessed as their likelihood of to smoke and for a minority of interviewees visible vaping had resulted in a reduced likelihood of smoking as assessed by interviewees.

To the extent that electronic cigarette use remains distinguishable from smoking combustible cigarettes there is a possibility that vaping may be associated with further denormalization of smoking.

In this study, the proportion of US adults who incorrectly perceived e-cigarettes as equal to, or more, harmful than cigarettes increased steadily regardless of smoking or vaping status. Current adult smokers appear to be poorly informed about the relative risks of e-cigarettes yet have potentially the most to gain from transitioning to these products. The findings of this study emphasise the urgent need to accurately communicate the reduced relative risk of e-cigarettes compared to continued cigarette smoking and clearly differentiate absolute and relative harms.

The lack of accurate and consistent messaging from both public health agencies and the media may be contributing to public, and more specifically adult smokers’, perceptions about the relative risk of nicotine when decoupled from combustion and tobacco smoke.

There is a decreasing trend in the proportion of individuals who perceive e-cigarettes to be less harmful than conventional cigarettes across the UK, Europe and the US.

For every 1% decrease in the mean prevalence of current tobacco smokers who endorsed the belief that e-cigarettes are less harmful than combustible cigarettes, the mean prevalence of e-cigarette use decreased by 0.48%  

In this large sample of dedicated EC users, it seems that ECs are used as long-term substitutes to smoking. They can be effective even in subjects who are highly dependent on smoking and are heavy smokers. Mild temporary side-effects and significant benefits are reported by this population. Motivation for using ECs comes from their expected less harmful potential compared to smoking.

“Propylene glycol, the primary ingredient in the electronic cigarette cartridge, may be a powerful deterrent against pneumonia, influenza, and other respiratory diseases when vaporized and inhaled according to a study by Dr. Oswald Hope Robertson. Decades before the e cigarette was invented, a study was conducted by Dr. Robertson of the University of Chicago's Billings Hospital in 1942 on inhalation of vaporized propylene glycol in laboratory mice. A more in-depth article was printed in the 1942 issue of TIME Magazine http://www.time.com/time/magazine/article/0,9171,932876,00.html for November 16th. "Dr. Robertson placed groups of mice in a chamber and sprayed its air first with propylene glycol, then with influenza virus. All the mice lived. Then he sprayed the chamber with virus alone. All the mice died."”

The researchers also found that "the propylene glycol itself was a potent germicide. One part of glycol in 2,000,000 parts of air would--within a few seconds--kill concentrations of air-suspended pneumococci, streptococci and other bacteria numbering millions to the cubic foot."