“Vaping”- a Trojan Horse Against Fight Toward Tobacco Use and Cancer: A Systematic Review of the Existing Evidence

Abstract

The purpose of this systematic review is to understand many aspects of vaping, like what is vaping, why it is more enticing to adolescents and young adults, what makes it more harmful than regular smoked tobacco products, subsequent health consequences, and what measures are currently being taken against this activity. A literature search was conducted in online database PubMed using search string “(((((Lung injury*[Title/Abstract]) AND Vaping[Title/Abstract]) OR electronic nicotine delivery device[Title/Abstract]) OR electronic cigarette*[Title/Abstract]) AND e-cigarettes liquid) AND electronic cigars and search filter used were “published in the last 5 years” and “Human Studies.” Similar search terms were used to search EMBASE, Web of Science, Google Scholar, and the CENTRAL database of the Cochrane Library with the help of Boolean terms. Thirty-six articles were included for a final systematic review. Many of the known brands use additives such as flavoring and thickening agents that, when used even for the short term, can cause toxicity to human lung tissues. This toxicity depends not only on the extent of the habit, but also on the variable susceptibility to lung damage, dual use with cigarettes, variability in the product design of different brands, and the liquid content used in them. Vaping may be linked with significant health issues, including respiratory diseases such as asthma, very severe forms of bronchitis such as popcorn lung, or E-cigarette, or vaping, product use-associated lung injury, and cardiovascular illnesses such as atherosclerotic plaque and myocardial ischemia. From the current systematic review, we would like to emphasize that no long-term toxicological and health studies have been carried out in humans using these vaping products and their constituents to date. Although cessation should be strongly encouraged in smokers for better quality of life, it is uncertain whether it is a universally safer option to replace cigarettes with these vaping devices.

Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations

“…Twenty-five systematic reviews including one meta-analysis were deemed eligible for inclusion in our study. Chemical profiles of ECs were investigated in twenty [6,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] and the toxicity of ECs was covered in fourteen reviews [13,15,18,19,21,23,26,28,30,[32][33][34][35][36]. Nine reviews investigated both outcomes [13,15,18,19,21,23,26,28,30].…”

“…Chemical profiles of ECs were investigated in twenty [6,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] and the toxicity of ECs was covered in fourteen reviews [13,15,18,19,21,23,26,28,30,[32][33][34][35][36]. Nine reviews investigated both outcomes [13,15,18,19,21,23,26,28,30]. Table 1 presents the characteristics of the included reviews.…”

“…Federal 11 [6,14,18,19,22,23,[27][28][29]33,35] Non-Tobacco Affiliated Organization 4 [19,28,31,36] Tobacco Affiliated Organization 3 [18,20,25] No Specific Grant from Any Funding Agency 5 [13,15,21,30,34] Not…”

“…Human Cells 13 [13,15,18,19,21,23,26,28,[32][33][34][35][36] Animal Cells 6 [15,19,21,26,32,35] Not stated 1 [30] A detailed summary of the included reviews can be found in Supplementary Tables S2 and S3.…”

“…Twenty reviews investigated the chemical composition of e-liquids and EC aerosols [6,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Results were generally reported without a clear stratification between constituents found in e-liquid vs. EC aerosols.…”