Department of Research on Smoking and COPD.
Respiratory Intensive Care Unit, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.
Rev Invest Clin. 2023;75(3):158-168. doi: 10.24875/RIC.23000117.
The tobacco epidemic has been one of the biggest public health threats, and smoking is one of the world's largest preventable causes of premature death. An estimated 15.4% of all deaths in the world are attributable to tobacco smoking. The present review aims to describe addiction to tobacco smoking and vaping. Tobacco and vaping devices contain nicotine, a highly addictive drug, which explains why smoking is so prevalent and persistent. Electronic cigarettes are a group of novel nicotine or tobacco products that have rapidly gained popularity in recent years. Electronic cigarette devices allow for the use of other drugs, including THC, while the lax regulation may allow for the introduction of toxic compounds that can lead to acute or subacute toxicity, such as the e-cigarette- or vaping-associated lung injury that has been linked to vitamin E acetate. In addition, regular vapers and heated tobacco devices emit toxins, although at lower concentrations than burned tobacco. However, more and more side effects have been identified. No new effective treatment for nicotine addiction has been developed recently, despite its huge adverse impact on overall health and other outcomes. As for the primary line of medications, the last one started in 2006, the varenicline, demonstrating a low interest in developing new medications against smoking, an unacceptable state of affairs, given the huge impact of smoking on morbidity and mortality.
烟草流行是全球最大的公共卫生威胁之一,吸烟是全球可预防的导致早逝的最大原因之一。据估计,全球所有死亡人数的 15.4%可归因于吸烟。本综述旨在描述对吸烟和蒸气吸入的成瘾性。烟草和蒸气吸入装置含有尼古丁,这是一种高度成瘾的药物,这解释了为什么吸烟如此普遍和持久。电子烟是近年来迅速流行起来的一组新型尼古丁或烟草产品。电子烟装置允许使用其他药物,包括大麻,而宽松的监管可能会允许引入有毒化合物,导致急性或亚急性毒性,如与电子烟或蒸气吸入相关的肺损伤,与维生素 E 醋酸盐有关。此外,经常吸食电子烟和加热烟草装置会释放毒素,尽管其浓度低于燃烧烟草。然而,越来越多的副作用已经被发现。尽管吸烟对整体健康和其他结果有巨大的负面影响,但最近并没有开发出针对尼古丁成瘾的新的有效治疗方法。至于一线药物,最后一种药物是 2006 年开始使用的伐尼克兰,这表明开发新的戒烟药物的兴趣不大,这种情况令人无法接受,因为吸烟对发病率和死亡率的影响巨大。