The emerging phenomenon of electronic cigarettes

Centro per la Prevenzione e Cura del Tabagismo, Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele, Università di Catania, Catania, Italy.
Expert Review of Respiratory Medicine 02/2012; 6(1):63-74. DOI: 10.1586/ers.11.92
Source: PubMed


The need for novel and more effective approaches to tobacco control is unquestionable. The electronic cigarette is a battery-powered electronic nicotine delivery system that looks very similar to a conventional cigarette and is capable of emulating smoking, but without the combustion products accountable for smoking's damaging effects. Smokers who decide to switch to electronic cigarettes instead of continuing to smoke would achieve large health gains. The electronic cigarette is an emerging phenomenon that is becoming increasingly popular with smokers worldwide. Users report buying them to help quit smoking, to reduce cigarette consumption, to relieve tobacco withdrawal symptoms due to workplace smoking restrictions and to continue to have a 'smoking' experience but with reduced health risks. The focus of the present article is the health effects of using electronic cigarettes, with consideration given to the acceptability, safety and effectiveness of this product to serve as a long-term substitute for smoking or as a tool for smoking cessation.

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Available from: Pasquale Caponnetto, Oct 23, 2014
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    • "CE marking, there are no standard regulations relating to characterisation of the emissions and their impact on biological systems. E-cigarettes appear to be much safer than cigarettes, but further studies are required to fully assess their safety for long-term use (Caponnetto et al., 2012). Concerns regarding the possible adverse effects have been raised (Etter, 2010; McQueen et al., 2011; Chen, 2013; Goniewicz et al., 2013). "
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    ABSTRACT: Development of physiologically relevant test methods to analyse potential irritant effects to the respiratory tract caused by e-cigarette aerosols is required. This paper reports the method development and optimization of an acute in vitro MTT cytotoxicity assay using human 3D reconstructed airway tissues and an aerosol exposure system. The EpiAirway(TM) tissue is a highly differentiated in vitro human airway culture derived from primary human tracheal/bronchial epithelial cells grown at the air-liquid interface, which can be exposed to aerosols generated by the VITROCELL(®) smoking robot. Method development was supported by understanding the compatibility of these tissues within the VITROCELL(®) system, in terms of airflow (L/min), vacuum rate (mL/min) and exposure time. Dosimetry tools (QCM) were used to measure deposited mass, to confirm the provision of e-cigarette aerosol to the tissues. EpiAirway(TM) tissues were exposed to cigarette smoke and aerosol generated from two commercial e-cigarettes for up to 6 hrs. Cigarette smoke reduced cell viability in a time dependent manner to 12% at 6 hrs. E-cigarette aerosol showed no such decrease in cell viability and displayed similar results to that of the untreated air controls. Applicability of the EpiAirway(TM) model and exposure system was demonstrated, showing little cytotoxicity from e-cigarette aerosol and different aerosol formulations when compared directly with reference cigarette smoke, over the same exposure time. Copyright © 2015. Published by Elsevier Ltd.
    Toxicology in Vitro 06/2015; 29(7). DOI:10.1016/j.tiv.2015.05.018 · 2.90 Impact Factor
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    • "Electronic cigarettes are a relatively new form of nicotine delivery and their popularity is increasing worldwide (Regan et al. 2011; Caponnetto et al. 2012; Brown et al. 2014; King et al. 2014). However, due in part to the absence of appropriate product regulations, there are concerns about the accuracy of product labelling with the nicotine concentration varying from product to product, including being present Received 27 March 2015; accepted 28 April 2015. "
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    ABSTRACT: Electronic cigarettes (e-cigarettes) are a new form of nicotine delivery device and their popularity is increasing rapidly. One key concern about the safety of e-cigarette use is the quality control during their manufacturing and whether the nicotine content in e-cigarette matches the label claim. We developed an assay to evaluate nicotine content in e-cigarettes. For nicotine extraction, the e-cigarette cartridge consisting of fibrous pad was removed from the cartridge chamber. Ten microlitres of deuterated nicotine (nicotine-d4; 1 μg) solution, used as external standard, was spiked onto the fibrous pad and allowed to penetrate into the matrix. The pad was placed in an Erlenmeyer flask with 50 mL of 50% (v/v) methanol in deionised water as extraction solvent. The flask was placed in an ultra-sound bath for 15 min at ambient temperature. After sonication, the extract was further diluted in Milli-Q water and then analysed using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The recovery of nicotine-d4 extracted from the e-cigarette cartridge was 81.5% ± 3.7 (mean ± SD). Taking into account recovery, nicotine amount in the e-cigarette cartridge samples was 11.9 ± 1.3 mg (mean ± SD), which was lower than the content claimed by the manufacture (16 mg). The nicotine amount did not vary significantly between cartridges within one pack or between packs. The content of nicotine in the e-cigarette cartridges can be effectively determined by UPLC-MS/MS assay. Differences between content and the label claimed for nicotine in e-cigarette could be a potential determinant of clinical trials.
    Analytical Letters 06/2015; 48(17). DOI:10.1080/00032719.2015.1048349 · 1.03 Impact Factor
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    • "Smoking continues to be the most preventable cause of morbidity and mortality contributing to around half a million deaths every month, a situation that is likely to worsen in the future [1]. Electronic cigarette (e-Cigarette (EC)) is an emerging phenomenon that is becoming increasingly popular with smokers worldwide [2,3]. EC may be considered a lower risk substitute for factory-made cigarettes [4]. "
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    ABSTRACT: Background Electronic cigarette (EC) is an emerging phenomenon that is becoming increasingly popular with smokers worldwide. There is a lack of data concerning the evaluation of research productivity in the field of EC originating from the world. The main objectives of this study were to analyse worldwide research output in EC field, and to examine the authorship pattern and the citations retrieved from the Scopus database. Methods Data were searched for documents with specific words regarding EC as “keywords” in the title. Scientific output was evaluated based on the methodology developed and used in other bibliometric studies by investigation: (a) total and trends of contributions in EC research during all previous years up to the date of data analysis (June 13, 2014); (b) authorship patterns and research productivity; (c) countries contribution; and (d) citations received by the publications. Results Three hundred and fifty-six documents were retrieved comprising 31.5% original journal articles, 16% letters to the editor, 7.9% review articles, and 44.6% documents that were classified as other types of publications, such as notes or editorials or opinions. The retrieved documents were published in 162 peer-reviewed journals. All retrieved documents were published from 27 countries. the largest number of publications in the field of EC was from the United States of America (USA); (33.7%), followed by the United Kingdom (UK); (11.5%), and Italy (8.1%). The total number of citations at the time of data analysis was 2.277, with an average of 6.4 citations per document and median (interquartile range) of 0.0 (0.0–5.0). The h-index of the retrieved documents was 27. The most productive institutions were Food and Drug Administration, USA (4.2% of total publications) followed by Universita degli Studi di Catania, Italy (3.9%), University of California, San Francisco, USA (3.7%). Conclusions This bibliometric study is a testament to the progress in EC research from the world over the last few years. More effort is needed to bridge the gap in EC-based research and to promote better evaluation of EC, risks, health effects, or control services worldwide.
    BMC Public Health 06/2014; 14(1):667. DOI:10.1186/1471-2458-14-667 · 2.26 Impact Factor
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