E-cigarettes, heated tobacco and other novel nicotine-containing products: a help to smokers or a public health threat?

Pisinger, Charlotta; Κatsaounou, Paraskevi; Ravara, Sofía Belo; Vestbo, Jørgen

doi:10.1183/2312508x.10002120

Cited by 4 publications

(5 citation statements)

References 81 publications

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“…Nonetheless, the study with the most participants supporting that was based on an online survey [ 99 ], thus there are serious concerns of a possible selection bias. These conclusions correspond with those of recently published systematic reviews with meta-analyses [ 93 , 100 , 101 ], and other comprehensive studies [ 123 , 124 ].…”

Section: Discussionsupporting

confidence: 92%

“…Finally, three reviews that investigated the effectiveness of EC as a tool for smoking cessation in different groups of patients stated that the evidence on the use of EC as potential cessation tool is inconclusive, as few studies have been able to demonstrate an impact of EC use on harm reduction related to combustible cigarettes, which however does not address nicotine addiction, and that additional research was needed for patients with pulmonary diseases, including asthma [ 61 , 64 , 122 ]. Current evidence is inconclusive to recommend ECs as effective or safe smoking-cessation tools [ 123 , 124 ]. Importantly, ECs’ safety has not been proven and as they are increasingly used by young people or people not previously addicted to tobacco cigarette, they may prove to be a significant future health burden as far as nicotine addiction [ 123 , 124 ].…”

Section: Resultsmentioning

confidence: 99%

“…Current evidence is inconclusive to recommend ECs as effective or safe smoking-cessation tools [ 123 , 124 ]. Importantly, ECs’ safety has not been proven and as they are increasingly used by young people or people not previously addicted to tobacco cigarette, they may prove to be a significant future health burden as far as nicotine addiction [ 123 , 124 ].…”

Section: Resultsmentioning

confidence: 99%

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Electronic Cigarettes and Asthma: What Do We Know So Far?

Kotoulas

Κatsaounou

Riha

et al. 2021

JPM

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Electronic cigarettes (EC) are a novel product, marketed as an alternative to tobacco cigarette. Its effects on human health have not been investigated widely yet, especially in specific populations such as patients with asthma. With this review, we use the existing literature in order to answer four crucial questions concerning: (1) ECs’ role in the pathogenesis of asthma; (2) ECs’ effects on lung function and airway inflammation in patients with asthma; (3) ECs’ effects on asthma clinical characteristics in asthmatics who use it regularly; and (4) ECs’ effectiveness as a smoking cessation tool in these patients. Evidence suggests that many EC compounds might contribute to the pathogenesis of asthma. Lung function seems to deteriorate by the use of EC in this population, while airway inflammation alters, with the aggravation of T-helper-type-2 (Th2) inflammation being the most prominent but not the exclusive effect. EC also seems to worsen asthma symptoms and the rate and severity of exacerbations in asthmatics who are current vapers, whilst evidence suggests that its effectiveness as a smoking cessation tool might be limited. Asthmatic patients should avoid using EC.

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Section: Discussionsupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Electronic Cigarettes and Asthma: What Do We Know So Far?

Kotoulas

Κatsaounou

Riha

et al. 2021

JPM

Self Cite

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“…27 Many people in the public health community continue to argue for caution until more is known about the potential harms of e-cigarettes. 28,29 However, although much has been written about a binary divide between 'enthusiasts' who wish to harness the potential of e-cigarettes for cessation and 'opponents' who see e-cigarettes as a threat to young people, 30 in reality, positions are often more nuanced. Many people are both enthusiastic about the role of e-cigarettes in cessation, while taking seriously the need to prevent use by children and young people.…”

Section: E-cigarettes and Smoking Cessationmentioning

confidence: 99%

Impacts of EU Tobacco Products Directive regulations on use of e-cigarettes in adolescents in Great Britain: a natural experiment evaluation

Moore

Hallingberg

Brown

et al. 2023

Public Health Research

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Background E-cigarettes are a popular smoking-cessation tool. Although less harmful than tobacco, use of e-cigarettes by non-smokers should be prevented. There is concern about the use of e-cigarettes by young people and that e-cigarettes may renormalise smoking. In May 2016, Tobacco Products Directive regulations aimed to reduce e-cigarettes’ appeal to young people. Aims To examine the effects of the Tobacco Products Directive regulations on young people’s use of e-cigarettes, and the role of e-cigarettes in renormalising smoking. Design A mixed-method natural experimental evaluation combining secondary analyses of survey data, with process evaluation, including interviews with young people, policy stakeholders, retailers and trading standards observers, and observations of retail settings. Settings Wales, Scotland and England. Participants Survey participants were aged 13–15 years, living in England, Scotland or Wales and participated in routinely conducted surveys from 1998 to 2019. Process evaluation participants included 14- to 15-year-olds in England, Scotland and Wales, policy stakeholders, trading standards offices and retailers. Intervention Regulation of e-cigarettes, including bans on cross-border advertising, health warnings and restrictions on product strength. Comparison group Interrupted time series design, with baseline trends as the comparator. Main outcome measures The primary outcome was ever e-cigarette use. Secondary outcomes included regular use, ever and regular smoking, smoking attitudes, alcohol and cannabis use. Data capture and analysis Our primary statistical analysis used data from Wales, including 91,687 young people from the 2013–19 Health Behaviour in School-aged Children and School Health Research Network surveys. In Scotland, we used the Scottish Schools Adolescent Lifestyle and Substance Use Survey and in England we used the Smoking Drinking and Drug Use surveys. The process evaluation included interviews with 73 young people in 2017 and 148 young people in 2018, 12 policy stakeholders, 13 trading standards officers and 27 retailers. We observed 30 retail premises before and after implementation. Data were integrated using the Medical Research Council’s process evaluation framework. Results Ever smoking continued to decline alongside the emergence of e-cigarettes, with a slight slowing in decline for regular use. Tobacco Products Directive regulations were described by stakeholders as well implemented, and observations indicated good compliance. Young people described e-cigarettes as a fad and indicated limited interaction with the components of the Tobacco Products Directive regulations. In primary statistical analyses in Wales [i.e. short (to 2017) and long term (to 2019)], growth in ever use of e-cigarettes prior to Tobacco Products Directive regulations did not continue after implementation. Change in trend was significant in long-term analysis, although of similar magnitude at both time points (odds ratio 0.96). Data from England and Scotland exhibited a similar pattern. Smoking followed the opposite pattern, declining prior to the Tobacco Products Directive regulations, but plateauing as growth in e-cigarette use stalled. Limitations Alternative causal explanations for changes cannot be ruled out because of the observational design. Conclusions Young people’s ever and regular use of e-cigarettes appears to have peaked around the time of the Tobacco Products Directive regulations and may be declining. Although caution is needed in causal attributions, findings are consistent with an effect of regulations. Our analysis provides little evidence that e-cigarettes renormalise smoking. More recent data indicate that declines in smoking are plateauing. Future work International comparative work to understand differences in use of e-cigarettes, and tobacco, within varying regulatory frameworks is a priority. Study registration This study is registered as ResearchRegistry4336. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 11, No. 5. See the NIHR Journals Library website for further project information.

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“…It goes on to discuss tobacco use as a dependence and a chronic, often relapsing disorder, focusing on nicotine addiction and the harms of nicotine/tobacco beyond addiction [17]. A chapter dedicated to novel tobacco and nicotine products discusses whether they really do help smokers to quit and reduce tobacco harm, or whether they have the contrary effect, and undermine tobacco control [18].…”

Section: @Erspublicationsmentioning

confidence: 99%