Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Yale University School of Medicine, New Haven, Connecticut.
Respir Care. 2019 Mar;64(3):328-336. doi: 10.4187/respcare.06300. Epub 2018 Nov 6.
The electronic cigarette (e-cigarette) has been regarded by many as a healthier alternative to the combustible cigarette, yet there is a lack of consensus concerning the health consequences and the health benefits associated with e-cigarette use. We review the research on the effects of e-cigarettes on multiple physiological systems, examine the association between e-cigarette use and combustible cigarette uptake and cessation, and highlight research necessary to build consensus. Although the levels of known toxicants and carcinogens tend to be significantly lower in e-cigarettes than in combustible cigarette smoke, toxicants in e-cigarette e-liquid and those that form as part of the vaporization process may produce adverse health consequences in their own right. Acute effects have been noted in the pulmonary, cardiovascular, and immune systems, which highlight the need for research on long-term exposure. The specific chemical constituents and the levels of those constituents that pose harm remain largely uncharacterized. In addition, the efficacy of e-cigarettes for smoking cessation has yet to be established. As the e-cigarette has evolved rapidly, so has the methodology across studies, making cross-study comparisons more difficult to synthesize. The latest generation of e-cigarette devices deliver nicotine and toxicants at higher levels than earlier devices, especially in experienced users. E-cigarettes pose a risk for nicotine exposure, dependence, and combustible cigarette uptake. E-cigarettes and their delivered toxicants appear harmful to multiple organ systems, although the current body of evidence is limited, especially in terms of long-term effects. Further research is warranted with a focus on individual devices, e-liquid constituents, user characteristics, and patterns of use. Any potential benefit of e-cigarettes for smoking cessation must be weighed against the risks. Given the potential longer-term effects, efforts to prevent e-cigarette use in youth are critical.
电子烟（e-cigarette）被许多人视为比可燃香烟更健康的替代品，但关于电子烟使用的健康后果和健康益处，尚未达成共识。我们回顾了电子烟对多个生理系统的影响，研究了电子烟使用与可燃香烟摄入和戒烟之间的关联，并强调了建立共识所需的研究。尽管电子烟中的已知有毒物质和致癌物质的水平通常明显低于可燃香烟烟雾，但电子烟烟液中的有毒物质以及作为蒸发过程一部分形成的有毒物质本身可能会产生不良健康后果。在肺部、心血管和免疫系统中已经注意到急性影响，这凸显了对长期暴露进行研究的必要性。特定的化学成分以及构成危害的那些成分的水平在很大程度上仍未得到充分描述。此外，电子烟戒烟的效果尚未确定。随着电子烟的迅速发展，研究中的方法也在不断发展，使得跨研究的比较更难以综合。最新一代的电子烟设备以比早期设备更高的水平输送尼古丁和有毒物质，尤其是在有经验的用户中。电子烟会导致尼古丁暴露、依赖和可燃香烟摄入的风险。电子烟及其输送的有毒物质似乎对多个器官系统有害，尽管目前的证据有限，尤其是在长期影响方面。需要进一步研究，重点关注个体设备、烟液成分、用户特征和使用模式。电子烟在戒烟方面的任何潜在益处都必须与风险权衡。鉴于潜在的长期影响，努力防止青少年使用电子烟至关重要。
