ENDS Public Health: Difference between revisions

*This page is for referencing the possible benefits of [[Abbreviations|'''ENDS''']] products vs. smoking cigarettes from a Public Health standpoint. (Electronic Nicotine Delivery Systems are also known as vapor technology, ecigarettes, ecigs, EVP, etc.)

*If you'd prefer someone else to add a study to a topic, there is a subject section called "Suggested studies to add to this page". You may put the link in that section for one of the regular page editors to address.

===2018: Characterization of the Spatial and Temporal Dispersion Differences Between Exhaled E-Cigarette Mist and Cigarette Smoke===

===2017 Dr. Michael Siegel  - Vape Shop Air Sampling by California State Health Department Suggests that Second Hand Vape Exposure is Minimal===  

With regard to cancer risk analysis, no vapor sample from e-liquids exceeded the risk limit for either children or adults.

===2020: E-cigarettes and their impact on health: from pharmacology to clinical implications===

Despite many areas of ambiguity, current evidence suggest that e-cigarettes are less harmful than combustible products, but this only applies to smokers who completely switched to e-cigarettes. Thus, e-cigarettes still hold a great potential to reduce incidences of tobacco-related diseases and could be a part of the strategy to reduce the damage caused by smoking. Therefore, mechanisms should be developed to protect young people from using e-cigarettes but support smokers in their decisions to quit smoking with e-cigarettes.

===2020: The ethics of tobacco harm reduction: An analysis of e-cigarette availability from the perspectives of utilitarianism, bioethics, and public health ethics===

===2016: Obsolete tobacco control themes can be hazardous to public health: the need for updating views on absolute product risks and harm reduction===

Implications of updating the leading themes for regulation, policymaking and advocacy in tobacco control are proposed as an important next step. A new reframing can align action plans to more powerfully and rapidly achieve population-level benefit and minimize harm to eliminate in our lifetime the use of the most deadly combustible tobacco products and thus prevent the premature deaths of 1 billion people projected to occur worldwide by 2100

===2016: Withholding differential risk information on legal consumer nicotine/tobacco products: The public health ethics of health information quarantines===  

Concerns for some adverse public health effects of harm reduction products such as SLT (Smokeless Tobacco) and vape are reasonable and worth trying to minimize, but there is no current evidence that such products actually represent an imminent danger to public health overall.  

Efforts to discourage the use of tobacco/nicotine products need not be reduced, but should be done in a harm-proportionate way. Telling consumers that all product options are as bad as cigarettes is untrue and almost certainly as deadly for users as telling at-risk populations that condom use affords no protection.

===2016: Ethical considerations of e-cigarette use for tobacco harm reduction===

Current evidence suggests that e-cigarettes have the potential to make significant public health gains through their role as tobacco harm reduction devices. In clinical practice, physicians have an ethical duty to provide their patients with evidence-based comparative risk assessments to allow them to make informed choices with respect to their smoking status. At its core, the objective of the smoking cessation agenda should be to improve population health, which will likely require some concessions in the form of harm reduction. This entails a willingness to negotiate the tensions between utilitarian and liberal ethics in designing policy that upholds autonomy while protecting broader public health interests.

===2014: Estimating the Harms of Nicotine-Containing Products Using the MCDA Approach===

[[File:Risk-map.jpg|800px|frame|center|Risk Graph]]

===2020: Dependence on e‐cigarettes and cigarettes in a cross‐sectional study of US adults===

The highest level of e‐cigarette dependence was among e‐cigarette users who had stopped smoking.

Use of e‐cigarettes appears to be consistently associated with lower nicotine dependence than cigarette smoking.

===2017: A comparison of nicotine dependence among exclusive E-cigarette and cigarette users in the PATH study===

E-cig users report less dependence on their product than cigarette smokers. E-cig users report a longer time-to-first-use after waking.

These results are consistent with previous studies, in finding that exclusive daily e-cigarette users are less dependent on their respective product than comparable cigarette smokers.

===2017: Evaluating nicotine dependence levels in e-cigarette users===

Results showed that e-cigarette users scored lower than cigarette smokers in both FTND (Fagerström test for nicotine dependence) and all NDSS (nicotine dependence syndrome scale) subscales. Our findings extend previous research on e-cigarette use and nicotine addiction and suggest that e-cigarette users are less dependent on nicotine than current tobacco cigarette smokers.

===2012: Dependence on Tobacco and Nicotine Products: A Case for Product-Specific Assessment===

Conclusion: “The other suggestion made is that when the totality of the dependence is measured, different forms of tobacco/nicotine products probably have different potential for dependence development. There might be a continuum of dependence where in one end, we find the cigarette and in the other end, NR products and particularly the patch formulation. If a particular product is far from cigarettes and close to NR on the continuum of harm and at the same time closer to cigarettes than NR on the continuum of dependence, this product may have considerable success in reducing the public health costs associated with cigarette use.”

===2012: Clinical laboratory assessment of the abuse liability of an electronic cigarette===

Electronic cigarettes can deliver clinically significant amounts of nicotine and reduce cigarette abstinence symptoms and appear to have lower potential for abuse relative to traditional tobacco cigarettes.

We conclude that electronic cigarettes show tremendous promise in the fight against tobacco-related morbidity and mortality. By dramatically expanding the potential for harm reduction strategies to achieve substantial health gains, they may fundamentally alter the tobacco harm reduction debate.

===2019 Article: New smoking statistics shows ‘gray vaping’ is on the rise in the UK===  

2019 PDF of Study (43 pages) NHS Statistics on Smoking

===2020: E-cigarette use and associated factors among smokers with severe mental illness===

Among participants, mean age was 46 years, the majority (70.3%) had tried an e-cigarette. Among those who had ever tried an e-cigarette, over half (54.6%) reported the reason was to quit smoking, while 13.9% reported that the reason was to reduce smoking.

===2020: A qualitative study of the views about smoking, licensed cessation aids and e-cigarettes in people with schizophrenia spectrum disorders===

===2011: Smoking Cessation with E-Cigarettes in Smokers with a Documented History of Depression and Recurring Relapses===

The most important message from this case series is that these individuals were able to quit and to remain abstinent for at least 6 months after taking up an electronic cigarette. This is the first time that objective measures of smoking cessation are reported in smokers, suffering from depression, who quit after experimenting with the e-cigarette. This is quite outstanding in consideration of the fact that this result was accomplished by highly addicted smokers who repeatedly failed professional smoking cessation assistance without the support of recommended nicotine dependence treatments and smoking cessation counselling.

===See Also===

*[[Nicotine_therapeutic_benefits|Mental Health under: Nicotine Therapeutic Benefits]]

===2020: Electronic Cigarette Use Among U.S. Adults, 2018===

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.

===2020: Potential effects of using non-combustible tobacco and nicotine products during pregnancy: a systematic review===

This review demonstrates that the evidence does not support denying pregnant women the use of smoke-free products if the alternative is that she would continue to smoke.

===2020: Addressing and Overcoming Barriers to E-Cigarette Use for Smoking Cessation in Pregnancy: A Qualitative Study===

Smoking in pregnancy causes considerable harm, including increased risk of low birthweight, preterm delivery and stillbirth.  

Positive beliefs about vaping, particularly in comparison to smoking and becoming a confident vaper, were viewed as ways to overcome potential or experienced barriers to vaping. Our research findings may help develop interventions to assist women who have tried to stop smoking but have not quit and would otherwise continue to smoke during pregnancy.

===2020: Smoking and use of electronic cigarettes (vaping) in relation to preterm birth and small-for-gestational-age in a 2016 U.S. national sample===

These findings suggest that vapers during pregnancy had similar risk of preterm as non-users but still had elevated risk for restricted fetal growth.

===2020: Electronic cigarettes and obstetric outcomes: a prospective observational study===

The birthweight of infants born to EC users is similar to that of non‐smokers, and significantly greater than cigarette smokers. Dual users of both cigarettes and EC have a birthweight similar to that of smokers.

===2019: E-cigarette minimum legal sale age laws and traditional cigarette use among rural pregnant teenagers===  

Our panel model results suggest that adoption of a comprehensive indoor vaping restriction increased prenatal smoking by 2.0 percentage points.

Places with indoor e-cigarette restrictions slowed the downward trend in tobacco cigarette use in pregnant women by 30 percent compared to places with no e-cigarette restrictions.

===2017: Correlates of Electronic Cigarettes Use Before and During Pregnancy===

The study also shows that electronic cigarettes are commonly used as a smoking cessation aid in women of reproductive age. The greater likelihood of electronic cigarette use compared to proven adjunctive smoking treatments suggests that electronic cigarettes should be examined as a potential aid to cessation in this population.

===2020: Perception of the relative harm of electronic cigarettes compared to cigarettes amongst US adults from 2013 to 2016: analysis of the Population Assessment of Tobacco and Health (PATH) study data===

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.

Confusion may potentially be discouraging adult smokers from using alternative, less hazardous products which may ultimately result in a missed opportunity to positively impact health at both an individual and population level.

===2020: Association between changes in harm perceptions and e-cigarette use among current tobacco smokers in England: a time series analysis===

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%  

Between 2014 and 2019 in England, at the population level, monthly changes in the prevalence of accurate harm perceptions among current tobacco smokers were strongly associated with changes in e-cigarette use.

===2020: [https://link.springer.com/article/10.1007/s11166-020-09329-2 NEWS THAT TAKES YOUR BREATH AWAY: RISK PERCEPTIONS DURING AN OUTBREAK OF VAPING-RELATED LUNG INJURIES]===

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.

===2009: Propylene glycol in e cigarettes might keep us healthy, says researchers===  

“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."

===1942: THE BACTERICIDAL ACTION OF PROPYLENE GLYCOL VAPOR ON MICROORGANISMS SUSPENDED IN AIR. I===  

===2018: Lack of Substantial Post-Cessation Weight Increase in Electronic Cigarettes Users===

“Conclusion: Within the study limitations, EC use may help smokers attenuate cigarette consumption or remain abstinent, as well as reduce their post-cessation weight increase. The potential role of the e-vapour category for harm minimization in relation to tobacco and/or food abuse requires confirmation from larger prospective studies. Moreover, the observed lack of post-cessation weight gain in those who reduced substantially cigarette consumption by switching to ECs (i.e., dual users) is an interesting finding and calls for further research investigating the role of nicotine in weight control. Meanwhile, these preliminary findings should be communicated to smokers and particularly to weight-conscious smokers intending to quit.

By combining substantial reduction of smoking with prevention of post-cessation weight gain, EC-based interventions may promote an overall improvement in quality of life. Considering that the negative effects of weight increase could overshadow the health benefits of smoking abstinence, it is important to stimulate more research in this area.”  

===2018: E-cigarettes and Weight Loss—Product Design Innovation Insights From Industry Patents===

Obesity is set to overtake tobacco smoking in many countries as the primary cause of several high-cost diseases. Tobacco smoking mitigates weight gain through nicotine’s effect on the brain and metabolism.

There have been some reports among vapers that vaping is helping to mitigate weight gain after stopping smoking and or vaping is helping them to control their weight. There are several potential mechanisms by which vaping, in addition to the direct effects of nicotine, could facilitate weight control, these include taste perception, physical mouthfeel, and sensation and behavioral replacement.  

===See Also===

*[[https://safernicotine.wiki/mediawiki/index.php/Nicotine_therapeutic_benefits#Weight_Loss_.2F_Appetite_Control_.2F_Metabolism_.2F_Obesity|Weight Weight: Nicotine Therapeutic Benefits]]