Abstract
Since e-cigarettes appeared in the mid-2000s, some practitioners, researchers, and policy makers have embraced them as a safer alternative to conventional cigarettes and an effective way to stop smoking. While e-cigarettes deliver lower levels of carcinogens than do conventional cigarettes, they still expose users to high levels of ultrafine particles and other toxins that may substantially increase cardiovascular and noncancer lung disease risks, which account for more than half of all smoking-caused deaths, at rates similar to conventional cigarettes. Moreover, rather than stimulating smokers to switch from conventional cigarettes to less dangerous e-cigarettes or quitting altogether, e-cigarettes are reducing smoking cessation rates and expanding the nicotine market by attracting youth.
Highlights
Cigarettes are a highly effective way of delivering the addictive drug nicotine
The similarities between the effects of e-cigarettes and those of conventional cigarettes on determinants of cardiovascular and lung disease make it likely that e-cigarettes will impose similar long-term cardiovascular and pulmonary risks as those associated with conventional cigarettes
Cardiovascular and noncancer pulmonary diseases account for about two-thirds of smokers’ premature deaths from tobacco-induced diseases (Figure 4), so it would not be surprising if e-cigarettes impose half of the overall long-term risks as those from conventional cigarettes
Summary
The Annual Review of Public Health is online at publhealth.annualreviews.org https://doi.org/10.1146/annurev- publhealth040617- 013757 Copyright c 2018 Stanton A. Glantz & David W. Bareham. This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See credit lines of images or other third-party material in this article for license information Keywords smoking initiation, smoking cessation, cancer, cardiovascular disease, lung disease
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