Clinical impact of vaping on cardiopulmonary function and lung cancer development: an update

Abstract

The word 'vaping' is used to define the usage of electronic cigarettes or other instruments to inhale a wide variety of heated and aerosolized substances. Although proposed as a less dangerous and oncogenic alternative than standard nicotine products, e-cigarettes and vaping devices are quite far from being considered benign. In fact, although vaping devices do not generate carcinogenic agents as polycyclic aromatic hydrocarbons produced by the combustion of standard cigarettes and their liquids do not present tobacco-related carcinogens like nitrosamines, there is nowadays clear evidence that they produce dangerous products during their use. Several different molecular mechanisms have been proposed for the oncogenic impact of vaping fluids -by means of their direct chemical action or derivative products generated by pyrolysis and combustion ranging from epithelialmesenchymal transition, redox stress and mitochondrial toxicity to DNA breaks and fragmentation. In this review we focus on vaping devices, their potential impact on lung carcinogenesis, vaping-associated lung injury and other clinical implications on cardiovascular, cerebrovascular and respiratory diseases, as well as on the psychological implication of e-cigarettes both on heavy smokers trying to quit smoking and on younger non-smokers approaching vaping devices because they are considered as a less dangerous alternative to tobacco cigarettes. European

Toxicological Aspects Associated with Consumption from Electronic Nicotine Delivery System (ENDS): Focus on Heavy Metals Exposure and Cancer Risk

“…The lung is the main target organ of volatile toxicants and there is growing concern that e-cig consumption may increase the risk of lung cancer, although the relationship is still not well established, and the long-term effects will take years to develop [ 132 ]. The putative oncogenicity associated with e-cig consumption has been attributed to several distinct molecular pathways, including oxidative stress, the epithelial–mesenchymal transition, and mitochondrial DNA genotoxicity [ 133 ]. Data from the literature suggest that some metals, such as Ni, Cd, Cr, and As detected in the e-cig mainstream, can play a key role in lung cancer etiology or contribute to its progression [ 53 ].…”

Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk

“…Although vaping devices are marketed as safer than nicotine products, the correlation between ECs vaping and lung oncogenicity is still unknown [ 23 ]. It is documented that nitrosamine compounds attain adequate local concentrations within the distal bronchioles and alveoli, thus potentiating adduct formation and DNA damage [ 15 ].…”

“…There is growing concern that EVPs consumption may increase the risk of LC because EVPs contain several proven carcinogenic compounds [ 15 ]. However, the relationship between EVPs and LC is not well established, and the long-term effects will take years to develop [ 15 , 23 ].…”

“…The oncogenicity of EVPs has been attributed to several distinct molecular pathways. The direct chemical reactions or carcinogenic products generated by combustion and pyrolysis could induce oxidative stress, epithelial-mesenchymal transition, and mitochondrial DNA genotoxicity [23]. A recent study detected more than 500 chemicals in tested vaping cartridges, and most were categorized as carcinogens [24].…”