Abstract
Electronic cigarettes (ECs) are a modern nicotine delivery system that rapidly grew in widespread use, particularly in younger populations. Given the long history of the comorbidity of alcohol and nicotine use, the rising prevalence of ECs raises the question as to their role in the consumption of alcohol. Of the numerous models of ECs available, JUUL is the most popular. This narrative review aims to determine current trends in literature regarding the relationship between EC and alcohol dual use, as well as hypothesize potential pathogenic tissue damage and summarize areas for future study, including second-hand vapor exposure and calling for standardization among studies. In summary, EC users are more likely to participate in hazardous drinking and are at higher risk for alcohol use disorder (AUD). We surmise the pathogenic damage of dual use may exhibit an additive effect, particularly in pathogen clearance from the lungs, increased inflammation and decreased immune response, physical damage to epithelial cells, and exacerbation of chronic obstructive pulmonary disease (COPD)-like illnesses. A better understanding of pathogenic damages is critical to understand the risks placed on dual users when exposed to respiratory pathogens, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Highlights
Dual Substance Use of Electronic Cigarettes and AlcoholElectronic cigarettes (ECs) are a modern nicotine delivery system that rapidly grew in widespread use, in younger populations
The use of traditional cigarettes is one of the largest influencers of public health, contributing to more deaths per year than HIV, illicit drug use, alcohol use, motor vehicle injuries, and firearm-related injuries combined (Centers for Disease Control and Prevention, 2018)
Given the relative newness of Electronic cigarettes (ECs), there is a limited body of literature detailing the role ECs play in alcohol consumption, how inaccurate perceptions of ECs contribute to risk-taking behaviors related to alcohol consumption, and the pathogenic damages that occur during dual use
Summary
Electronic cigarettes (ECs) are a modern nicotine delivery system that rapidly grew in widespread use, in younger populations. Of the numerous models of ECs available, JUUL is the most popular. This narrative review aims to determine current trends in literature regarding the relationship between EC and alcohol dual use, as well as hypothesize potential pathogenic tissue damage and summarize areas for future study, including second-hand vapor exposure and calling for standardization among studies. EC users are more likely to participate in hazardous drinking and are at higher risk for alcohol use disorder (AUD). We surmise the pathogenic damage of dual use may exhibit an additive effect, in pathogen clearance from the lungs, increased inflammation and decreased immune response, physical damage to epithelial cells, and exacerbation of chronic obstructive pulmonary disease (COPD)-like illnesses. A better understanding of pathogenic damages is critical to understand the risks placed on dual users when exposed to respiratory pathogens, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
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