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Review
. 2014 Sep;151(3):381-93.
doi: 10.1177/0194599814536847. Epub 2014 Jun 4.

Electronic nicotine delivery systems ("e-cigarettes"): review of safety and smoking cessation efficacy

Paul Truman Harrell  1 , Vani Nath Simmons  2 , John Bernard Correa  2 , Tapan Ashvin Padhya  3 , Thomas Henry Brandon  2
Affiliations
Review

Electronic nicotine delivery systems ("e-cigarettes"): review of safety and smoking cessation efficacy

Paul Truman Harrell et al. Otolaryngol Head Neck Surg. 2014 Sep.

Abstract

Background and objectives: Cigarette smoking is common among cancer patients and is associated with negative outcomes. Electronic nicotine delivery systems ("e-cigarettes") are rapidly growing in popularity and use, but there is limited information on their safety or effectiveness in helping individuals quit smoking.

Data sources: The authors searched PubMed, Web of Science, and additional sources for published empirical data on safety and use of electronic cigarettes as an aid to quit smoking.

Review methods: We conducted a structured search of the current literature up to and including November 2013.

Results: E-cigarettes currently vary widely in their contents and are sometimes inconsistent with labeling. Compared to tobacco cigarettes, available evidence suggests that e-cigarettes are often substantially lower in toxic content, cytotoxicity, associated adverse effects, and secondhand toxicity exposure. Data on the use of e-cigarettes for quitting smoking are suggestive but ultimately inconclusive.

Conclusions: Clinicians are advised to be aware that the use of e-cigarettes, especially among cigarette smokers, is growing rapidly. These devices are unregulated, of unknown safety, and of uncertain benefit in quitting smoking.

Implications for practice: In the absence of further data or regulation, oncologists are advised to discuss the known and unknown safety and efficacy information on e-cigarettes with interested patients and to encourage patients to first try FDA-approved pharmacotherapies for smoking cessation.

Keywords: carcinogens; e-cigarettes; electronic nicotine delivery systems; nicotine; personal vaporizers; smoking; toxicity; vapers; vaping.

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Conflict of interest statement

DECLARATION OF INTEREST

The other authors report no conflict of interest.

Figures

Figure 1
Figure 1
Typical components of an electronic cigarette. Source: Reprinted from Foulds et al. 2011 with permission from John Wiley and Sons, © 2011 Blackwell Publishing Ltd.
Figure 2
Figure 2
Flow diagram of literature search, screening, and selection.
See this image and copyright information in PMC

References

    1. U.S. Department of Health and Human Services. The Health Consequences of Smoking – 50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. - PubMed
    1. Blot WJ, McLaughlin JK, Winn DM, et al. Smoking and drinking in relation to oral and pharyngeal cancer. Cancer research. 1988;48(11):3282–3287. - PubMed
    1. Hashibe M, Brennan P, Chuang SC, et al. Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev. 2009;18(2):541–550. - PMC - PubMed
    1. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004;328(7455):1519. - PMC - PubMed
    1. Duffy SA, Ronis DL, McLean S, et al. Pretreatment health behaviors predict survival among patients with head and neck squamous cell carcinoma. J Clin Oncol. 2009;27(12):1969–1975. - PMC - PubMed

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