Pipe Andrew L, Mir Hassan
Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Can J Cardiol. 2022 Sep;38(9):1395-1405. doi: 10.1016/j.cjca.2022.08.001.
The introduction of e-cigarettes, or electronic nicotine delivery systems (ENDS), has been accompanied by controversy regarding their safety and effectiveness as a cessation aid and by an explosion in their use by youth. Their use does not involve the combustion of tobacco and the creation of harmful combustion products; they have been seen as a "harm reduction" tool that may be of assistance in promoting smoking cessation. Recognition that ENDS can deliver an array of chemicals and materials with known adverse consequences has spurred more careful examination of these products. Nicotine, nitrosamines, carbonyl compounds, heavy metals, free radicals, reactive oxygen species, particulate matter, and "emerging chemicals of concern" are among the constituents of the heated chemical aerosol that is inhaled when ENDS are used. They raise concerns for cardiovascular and respiratory health that merit the attention of clinicians and regulatory agencies. Frequently cited concerns include evidence of disordered respiratory function, altered hemodynamics, endothelial dysfunction, vascular reactivity, and enhanced thrombogenesis. The absence of evidence of the consequences of their long-term use is of additional concern. Their effectiveness as cessation aids and beneficial impact on health outcomes continue to be examined. It is important to ensure that their production and availability are thoughtfully regulated to optimise their safety and permit their use as harm reduction devices and potentially as smoking-cessation aids. It is equally vital to effectively prevent them from becoming ubiquitous consumer products with the potential to rapidly induce nicotine addiction among large numbers of youth. Clinicians should understand the nature of these products and the implications of their use.
电子烟，即电子尼古丁传送系统（ENDS）的引入，引发了关于其作为戒烟辅助工具的安全性和有效性的争议，同时青少年对其使用也呈爆发式增长。其使用不涉及烟草燃烧及有害燃烧产物的产生；它们被视为一种“减少危害”的工具，可能有助于促进戒烟。认识到电子烟能释放一系列具有已知不良后果的化学物质和材料，促使人们对这些产品进行更仔细的审视。尼古丁、亚硝胺、羰基化合物、重金属、自由基、活性氧、颗粒物以及“新出现的令人担忧的化学物质”都是使用电子烟时吸入的加热化学气溶胶的成分。它们引发了对心血管和呼吸系统健康的担忧，值得临床医生和监管机构关注。经常被提及的担忧包括呼吸功能紊乱、血流动力学改变、内皮功能障碍、血管反应性以及血栓形成增加的证据。长期使用电子烟后果的证据缺失更是令人担忧。它们作为戒烟辅助工具的有效性及其对健康结果的有益影响仍在持续研究中。重要的是要确保对其生产和供应进行审慎监管，以优化其安全性，并允许将其用作减少危害的设备以及潜在的戒烟辅助工具。同样至关重要的是，要有效防止它们成为普遍存在的消费品，避免有可能迅速导致大量青少年尼古丁成瘾。临床医生应了解这些产品的性质及其使用的影响。
