The Adverse Vascular Effects of E-Cigarettes: Smoke Without the Fire.

Abstract

SEE PAGE 2722 E lectronic nicotine delivery systems (e-cigarettes) and vaping have been presented as alternatives to traditional combustible cigarettes for the delivery of nicotine. To deliver nicotine, glycerol or propylene glycol-based solutions known as e-liquids are typically utilized and often flavored with a variety of solutions. Although e-cigarettes are known to contain many of the harmful components of tobacco smoke, the lower content has led some to claim increased safety with usage. However, little is known about the potential toxicology of the components of e-cigarettes that are distinct from combustible cigarettes, such as flavorings. Recently, data has emerged suggesting that e-cigarette use induces an increased inflammatory response in lung epithelium, similar to tobacco smoke (1). The question as to the safety of e-cigarettes is not trivial. Globally, in 2015 the estimated prevalence among adults was 15.2% for daily tobacco smoking, with attributable disability-adjusted life-years of 170.9 million, surpassing alcohol and illicit drugs (2). Additionally, substance-attributable mortality rates were highest for tobacco smoking (110.7 deaths per 100,000 people) (2). Although touted as beneficial in smoking cessation, there is growing alarm at the rate of use amongst teens and adults and increasing concerns that e-cigarette products are, in fact, a gateway to future tobacco abuse. Compounding the risk is the