Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.
TRICARE Area Office - Eurasia Africa, Defense Health Agency, Kaiserslautern, Germany.
Am J Prev Med. 2019 Jan;56(1):167-178. doi: 10.1016/j.amepre.2018.09.010.
E-cigarettes or or electronic nicotine delivery systems (ENDS) have rapidly gained popularity in the U.S. Controversy exists about the safety and efficacy of ENDS. The American College of Preventive Medicine's Prevention Practice Committee undertook a consensus-based evidence review process to develop a practice statement for the American College of Preventive Medicine.
A rapid review of the literature was performed through June 2017 to identify efficacy, patient-oriented harms, and the impact on population health.
On an individual level, limited evidence suggests that ENDS may be effective at reducing cigarette use among adult smokers intending to quit. There is insufficient evidence addressing potential long-term harms of ENDS, and limited evidence is available about short-term harms of ENDS and the impact of secondhand exposure. Although ENDS appear safer than combustible cigarettes, they are not without risk. Among youth there is no known benefit and significant concern for harm. On a population level, there may be significant harms associated with ENDS, particularly among youth nonsmokers. The long-term balance of potential benefits versus harms from the individual and population perspectives are unclear.
The American College of Preventive Medicine developed practice recommendations that include encouraging screening for ENDS use, strategies to prevent the initiation of ENDS use in nonsmokers, particularly in youth, adoption of a harm reduction model for smokers intending to quit in those who refuse or fail to quit with evidence-based smoking-cessation methods, recommendations on policy and regulatory strategies to decrease public use of ENDS and regulation of their components, and future research needs.
电子烟或电子尼古丁传送系统（ENDS）在美国迅速普及。关于 ENDS 的安全性和有效性存在争议。美国预防医学学院的预防实践委员会进行了基于共识的循证审查，为美国预防医学学院制定了一份实践声明。
通过 2017 年 6 月进行了文献快速审查，以确定疗效、以患者为中心的危害以及对人群健康的影响。
在个体层面上，有限的证据表明，ENDS 可能有助于减少打算戒烟的成年吸烟者的吸烟量。关于 ENDS 的潜在长期危害的证据不足，关于 ENDS 的短期危害和二手暴露的影响的证据有限。尽管 ENDS 似乎比可燃香烟更安全，但它们并非没有风险。对于年轻人，目前尚不清楚其是否有任何益处，但存在很大的危害风险。在人群层面上，ENDS 可能会带来重大危害，尤其是在青年非吸烟者中。从个人和人群角度来看，长期潜在利益与危害的平衡尚不清楚。
美国预防医学学院制定了实践建议，包括鼓励对 ENDS 使用情况进行筛查，采取策略防止非吸烟者（尤其是年轻人）开始使用 ENDS，对于那些拒绝或未能通过基于证据的戒烟方法戒烟的吸烟者，采用旨在减少危害的模式来帮助他们戒烟，制定减少公众使用 ENDS 和监管其成分的政策和监管策略的建议，以及未来的研究需求。
