Review of Health Consequences of Electronic Cigarettes and the Outbreak of Electronic Cigarette, or Vaping, Product Use-Associated Lung Injury

Cao, Dazhe; Aldy, Kim; Hsu, Stephanie; McGetrick, Molly; Verbeck, Guido F.; Silva, Imesha W. De; Feng, Sing Yi

doi:10.1007/s13181-020-00772-w

Cited by 110 publications

(98 citation statements)

References 82 publications

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“…Although these devices may function as nicotine delivery systems to help adult cigarette smokers quit, they may also serve as a means to initiate or perpetuate nicotine addiction in adults and the youth. In addition, the potential dangers and health consequences of e-cigarette use were illustrated by the outbreak of e-cigarette, or vaping, associated lung injury (EVALI) [7,8]. Although many patients who developed EVALI used products containing tetrahydrocannabinol, some used devices containing only nicotine [9].…”

Section: Introductionmentioning

confidence: 99%

Improved Documentation of Electronic Cigarette Use in an Electronic Health Record

Jose

Hays

Warner

2020

IJERPH

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The use of electronic cigarettes (e-cigarettes) can affect patient health and clinical care. However, the current documentation of e-cigarette use in the electronic health records (EHR) is inconsistent. This report outlines how the ambulatory clinical practices of a large U.S. hospital system optimized its electronic health records (EHR) framework to better record e-cigarettes used by patients. The new EHR section for e-cigarette information was implemented for outpatient appointments. During a 30-week evaluation period post-implementation, 638,804 patients (12 yrs and older) completed ambulatory appointments within the health system; of these, the new section contained e-cigarette use information for 37,906 (6%) patients. Among these patients, 1005 (2.7%) were identified as current e-cigarette users (current every day or current some day e-cigarette use), 941 (2.5%) were reported as former e-cigarette users, and 35,960 (94%) had never used e-cigarettes. A separate EHR section to document e-cigarette use is feasible within existing clinical practice models. Utilization of the new section was modest in routine clinical practice, indicating the need for more intensive implementation strategies that emphasize the health effects of e-cigarette use, and how consistent ascertainment could improve clinical practice.

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Section: Introductionmentioning

confidence: 99%

Improved Documentation of Electronic Cigarette Use in an Electronic Health Record

Jose

Hays

Warner

2020

IJERPH

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“…In addition, α-tocopheryl acetate, was analyzed in the study but found absent in tobacco and cigarette smoke. This compound has been associated with EVALI (Electronic Cigarette, or Vaping, product use-Associated Lung Injury), and was reported in certain counterfeit products (37)(38)(39). However, there is no report of α-tocopheryl acetate or similar compounds in legitimate commercial e-vaping products (37).…”

Section: Resumementioning

confidence: 99%

Analysis of α-Tocopherol in Tobacco and Cigarette Smoke

Moldoveanu

2020

Contributions to Tobacco &Amp; Nicotine Research

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Summaryα-Tocopherol, a type of vitamin E, has been known to be present in tobacco for many years. The compound is an antioxidant protecting cell membranes from oxidants. α-Tocopherol is transferred from tobacco into cigarette smoke, where it is also present. Analysis of α-tocopherol has been reported in a number of studies and in various matrices including tobacco and tobacco smoke. However, no recent publication describes a method for quantitative analysis of tocopherol in tobacco and in cigarette smoke, and many methods reported from previous studies were not published and only presented at conferences or communicated in internal company publications.The goal of this study was to quantitate α-tocopherol and, if present, α-tocopheryl acetate in tobacco and in tobacco smoke. For this analysis, an original HPLC technique was developed and is described in this report. Both UV and MS/MS (MRM mode) were used as detection procedure for the analysis. The results obtained using UV detection were in very good agreement with the results obtained using MS/MS detection. The method has been applied for the analysis of a number of tobaccos, as well as the total particulate matter (TPM) from cigarettes made with the same tobaccos. Depending on tobacco type, the levels of α-tocopherol vary in tobacco between about 200 μg/g up to about 900 μg/g (“dry weight basis”). For ISO type smoking, the levels of α-tocopherol vary in TPM between about 2 μg/mg up to slightly above 4 μg/mg of TPM. For a cigarette generating TPM of about 10 mg/cig, the α-tocopherol is between about 20 μg/cig up to about 40 μg/cig. A relatively good correlation was obtained between the level of α-tocopherol in smoke (ISO type smoking) and the level of the compound in tobacco. α-Tocopheryl acetate was absent in tobacco.

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“…2,3 Since then, they have assumed different names, including ciga-likes, e-hookahs, electronic delivery systems (ENDS), mods, vapes, vape pens, sub-ohms, tank systems. 1,4 Their success is largely due to originally being marketed to traditional cigarette smokers as a healthier alternative because they expose users to fewer chemical species. 4 Traditional cigarette products contain over 600 chemical species, which increases to over 7000 species when heated due to the formation of combustion products.…”

Section: Introductionmentioning

confidence: 99%

“…1,4 Their success is largely due to originally being marketed to traditional cigarette smokers as a healthier alternative because they expose users to fewer chemical species. 4 Traditional cigarette products contain over 600 chemical species, which increases to over 7000 species when heated due to the formation of combustion products. 5 At least 69 of these resultant species are known to cause carcinogenic effects.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, electronic liquids (e-liquids and e-juices) generally contain fewer chemical species overall. 6,7 The compositions of different e-liquids vary; however, propylene glycol (PG) 4 E-cigarettes may also be used to deliver many additives including tetrahydrocannabinol (THC), cannabidiol (CBD), and butane hash oils. 4,8,9 However, unlike cigarettes where the chemical composition of different products has been clearly established (i.e.…”

Section: Introductionmentioning

confidence: 99%

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Chemistry Review of Vaping Products and Respiratory Injury

2020

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Background: While the Public Health Agency of Canada notes 19 cases from May 2019 to February 2020 relating to e-cigarette or vaping product use-associated lung injury (EVALI) in Canada, there are likely many more unreported cases, including non-hospitalized and asymptomatic cases. E-cigarette use or vaping exposes users to numerous aerosolized chemical species, some of which have proven to be deleterious to health. These chemical species can include vitamin E acetate (VEA), flavourants, base / solvents (propylene glycol or vegetable glycerin), psychoactive substances, pesticides, endotoxins, metals, and pyrolysis by-products from e-cigarette heating coils. Objectives: We aim to review current findings related to EVALI from the standpoint of known chemical species currently used in vaping products. We specifically examine the toxicological profiles of these chemical species and the mechanisms through which they cause lung injury. Methods: A comprehensive literature search was performed with MEDLINE for EVALI-related human studies that were published between January 1, 2010, and May 15, 2020. This search strategy identified 832 case reports, case series, clinical trials, and in-vitro laboratory studies. From this group, 71 records were examined in greater detail. Results and Conclusions: Although the chemical composition and toxicology of vaping products have largely been characterized, the physiological effects of the chemical interactions between various constituents of vaping products and the generation of new species remain inconclusive. Given the rapid increase in the popularity of vaping and e-cigarettes, there is a need for further research. Developing a comprehensive understanding of the chronic health effects of vaping through randomized controlled trials and physiological studies is prudent and necessary to reduce the long-term impacts on users and the health care system.

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Review of Health Consequences of Electronic Cigarettes and the Outbreak of Electronic Cigarette, or Vaping, Product Use-Associated Lung Injury

Cited by 110 publications

References 82 publications

Improved Documentation of Electronic Cigarette Use in an Electronic Health Record

Improved Documentation of Electronic Cigarette Use in an Electronic Health Record

Analysis of α-Tocopherol in Tobacco and Cigarette Smoke

Chemistry Review of Vaping Products and Respiratory Injury

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