Stephens William E
Tob Control. 2017 Aug 4. doi: 10.1136/tobaccocontrol-2017-053808.
Quantifying relative harm caused by inhaling the aerosol emissions of vapourised nicotine products compared with smoking combustible tobacco is an important issue for public health.
The cancer potencies of various nicotine-delivering aerosols are modelled using published chemical analyses of emissions and their associated inhalation unit risks. Potencies are compared using a conversion procedure for expressing smoke and e-cigarette vapours in common units. Lifetime cancer risks are calculated from potencies using daily consumption estimates.
The aerosols form a spectrum of cancer potencies spanning five orders of magnitude from uncontaminated air to tobacco smoke. E-cigarette emissions span most of this range with the preponderance of products having potencies<1% of tobacco smoke and falling within two orders of magnitude of a medicinal nicotine inhaler; however, a small minority have much higher potencies. These high-risk results tend to be associated with high levels of carbonyls generated when excessive power is delivered to the atomiser coil. Samples of a prototype heat-not-burn device have lower cancer potencies than tobacco smoke by at least one order of magnitude, but higher potencies than most e-cigarettes. Mean lifetime risks decline in the sequence: combustible cigarettes >> heat-not-burn >> e-cigarettes (normal power)≥nicotine inhaler.
Optimal combinations of device settings, liquid formulation and vaping behaviour normally result in e-cigarette emissions with much less carcinogenic potency than tobacco smoke, notwithstanding there are circumstances in which the cancer risks of e-cigarette emissions can escalate, sometimes substantially. These circumstances are usually avoidable when the causes are known.
与吸食可燃烟草相比，量化吸入雾化尼古丁产品的气溶胶排放所造成的相对危害是一个重要的公共卫生问题。
利用已发表的排放物化学分析及其相关吸入单位风险，对各种输送尼古丁的气溶胶的致癌效力进行建模。使用一种转换程序将烟雾和电子烟蒸汽转换为通用单位来比较效力。根据效力和每日消费估计值计算终生癌症风险。
气溶胶形成了一个致癌效力范围，从未受污染的空气到烟草烟雾，跨越五个数量级。电子烟排放涵盖了这个范围的大部分，大多数产品的效力<烟草烟雾的1%，且在药用尼古丁吸入器的两个数量级范围内；然而，少数产品的效力要高得多。这些高风险结果往往与向雾化器线圈输送过多功率时产生的高羰基水平有关。一种原型加热不燃烧装置的样品的致癌效力比烟草烟雾至少低一个数量级，但比大多数电子烟的效力高。平均终生风险按以下顺序下降：可燃香烟>>加热不燃烧>>电子烟（正常功率）≥尼古丁吸入器。
装置设置、液体配方和吸电子烟行为的最佳组合通常会使电子烟排放的致癌效力远低于烟草烟雾，尽管在某些情况下，电子烟排放的癌症风险可能会上升，有时甚至大幅上升。当知道原因时，这些情况通常是可以避免的。
