How does the potential disease burden presented by tobacco cigarette (TC) smoke compare to that of electronic cigarette (EC) vapor?
Background: ECs are a fairly new concept lacking set regulations for manufacturing and use, and it is difficult currently to assess long-term health effects on users and nonusers. Effects of acute or chronic and active or passive vaping on complete blood count, lung function, and myocardial function were investigated in this study.
Study design: Clinical study review.
Setting: Department of Otolaryngology, Cornell Weill Medical College, New York City.
Synopsis: In combustion versus vaporization: TCs produce 4,000 chemicals, of which 100 have been identified as known carcinogens during combustion, while ECs do not require combustion to deliver TC-comparable doses of nicotine. Continuous monitoring of the indoor air environment during EC vaping did not detect any significant increase in formaldehyde concentration. Active TC smokers and nonsmokers exposed to TC smoke showed a significant increase in white blood cell count, lymphocyte, and granulocyte count; active and passive EC vaping showed no significant changes. In lung function parameters: Studies show that acute active and chronic passive EC vaping generated smaller changes in lung function compared to acute active and passive TC smoking for both current smokers and nonsmokers. In effects on myocardial function and associated potential disease burden: TC smokers presented data indicative of acute impairment of left ventricular function, while EC users showed no signs of alterations from baseline levels. Limitations included manufacturing variances that affect clinical effects, unknown effects of heating the metal and silicate components of the EC device, and an unknown long-term EC disease burden.
Bottom line: ECs impart a lower potential disease burden than conventional TCs based on the comparison of the chemical analysis of carcinogenic profiles and association with health-indicating parameters.