Amato Laura, Cruciani Fabio, Solimini Renata, Barca Alessandra, Pacifici Roberta, Davoli Marina
Dipartimento di Epidemiologia del SSR del Lazio-ASL Roma 1.
Centro Nazionale Dipendenze e Doping, Istituto Superiore di Sanità, Roma.
Recenti Prog Med. 2020 Jan;111(1):30-43. doi: 10.1701/3294.32651.
In recent years there has been an enormous development in the use of electronic cigarettes (e-cig). In Italy, in the 2019, the users of e-cig are about 900.000. E-cig users tend to overlook the absolute risk of the e-cig product in favor of the relative risk compared to traditional ones. This is also due to the fact that at the moment there are large knowledge gaps on the health effects of using e-cig. Recently reports have emerged regarding serious health adverse effects (AE) related to their use. As of December 2019, the American Centers for Disease Control and Prevention (CDC) reported 2409 cases of lung disease associated with the use of e-cig, and 52 deaths.
To summarize the available evidence on the health effects of electronic cigarettes.
We searched systematic reviews (SR) of the literature published up to September 2019.
The systematic searches led to the identification of 14 SRs (1037 studies included of which 77 provided useful information for this review) that met the inclusion criteria. Given the heterogeneity of the comparisons and of the outcome measures considered, the results are described narratively. Effects on the respiratory system: cough, phlegm, asthma and bronchitis symptoms, cases of chronic bronchitis and COPD have also been reported. Effects on the oropharyngeal system: lesions in the oral cavity, villous black tongue, allergic reactions, endogenous formation of carcinogens, development of oral cancer. Effects on the cardiovascular system: increased heart rate, increased systolic and diastolic pressure. Effects on skin and annexes: squamous and pruritic dermatitis. Any adverse effect: the most frequently reported AEs are cough, dry mouth, shortness of breath, irritation of the mouth and throat and headache. Effects of exposure to e-cig passive smoking: increase in cotinine levels in exposed environments.
These results, based on evidence from very low to moderate, show a series of possible risks linked to the use of e-cig. However, there is a need for further well-conducted studies with longer follow-up periods to confirm these results.
近年来，电子烟的使用有了巨大发展。在意大利，2019年电子烟使用者约有90万。电子烟使用者倾向于忽视电子烟产品的绝对风险，而更关注与传统香烟相比的相对风险。这也归因于目前在使用电子烟对健康影响方面存在很大的知识空白。最近出现了关于使用电子烟导致严重健康不良反应的报道。截至2019年12月，美国疾病控制与预防中心（CDC）报告了2409例与使用电子烟相关的肺病病例以及52例死亡病例。
总结关于电子烟对健康影响的现有证据。
我们检索了截至2019年9月发表的文献的系统评价（SR）。
系统检索确定了14篇符合纳入标准的系统评价（共纳入1037项研究，其中77项为本综述提供了有用信息）。鉴于所考虑的比较和结局指标的异质性，结果采用叙述方式描述。对呼吸系统的影响：还报告了咳嗽、咳痰、哮喘和支气管炎症状、慢性支气管炎和慢性阻塞性肺疾病（COPD）病例。对口咽系统的影响：口腔病变、绒毛状黑舌、过敏反应、致癌物的内源性形成、口腔癌的发生。对心血管系统的影响：心率加快、收缩压和舒张压升高。对皮肤及附属器的影响：鳞状和瘙痒性皮炎。任何不良反应：最常报告的不良反应是咳嗽、口干、呼吸急促、口腔和喉咙刺激以及头痛。接触电子烟二手烟的影响：暴露环境中可替宁水平升高。
这些基于低至中等证据水平的结果显示了一系列与使用电子烟相关的可能风险。然而，需要进一步开展随访期更长的高质量研究来证实这些结果。
