Caution urged on vaping

A ‘State of the Art’ review in the British Medical Journal (doi.org/10.1136/bmj.l5275) is urging health professionals to be cautious in their recommendations to patients around e-cigarettes.

According to the authors, no long-term vaping toxicological/safety studies have been done in humans and without these data, saying with certainty that e-cigarettes are safer than combustible cigarettes is impossible.

In the summer, several hundred cases of acute respiratory illness associated with e-cigarette use were reported in the USA, prompting investigations by the Centers for Disease Control and Prevention (CDC). Seven deaths have been attributed to e-cigarette use and investigations are ongoing.

Trying to unpick the potential causes of any adverse effects of vaping is confounded by the very large range of devices, strengths, flavours and content of the vaping solutions, according to the review. The picture is further confused by the devices being used to vape tetrahydrocannabinols (THC).

Decades of chronic smoking are needed for development of lung diseases such as lung cancer or chronic obstructive pulmonary disease, so the population effects of e-cigarette use may not be apparent until the middle of this century.

The use of evidence-based pharmacotherapy and nicotine replacement therapy are the only approaches that have a strong evidence base in helping patients to quit smoking, it says.

Smokers and ex-smokers using e-cigarettes should be provided with clear information on the uncertainties about health risks and harm reduction and encouraged to use established approaches with a goal of quitting all tobacco products and ultimately reducing nicotine dependency as soon as possible.

Trends in Urology and Men’s Health has recently published a blog on the safety of e-cigarettes that can be accessed here.

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