Risk and safety profile of electronic nicotine delivery systems (ENDS)

Asfar T, Jebai R, Li W, et al. Risk and safety profile of electronic nicotine delivery systems (ENDS): an umbrella review to inform ENDS health communication strategies. Tobacco Control. Published Online First: 08 September 2022. doi: 10.1136/tc-2022-057495 “We found high-level evidence that ENDS exposes users to toxic substances; increases the risk of respiratory disease; leads to nicotine dependence; causes serious injuries due to explosion or poisoning; increases smoking cessation in clinical trials but not in observational studies; increases combustible cigarette initiation, and exposure to ENDS marketing increases its use/intention to use. Evidence was moderate for ENDS association with mental health and substance use, limited-suggestive for cardiovascular, and limited-not-conclusive for cancer, ear, ocular and oral diseases, and pregnancy outcomes.

Conclusions: As evidence accumulates, ENDS communication can focus on high-level evidence on ENDS association with toxicity, nicotine addiction, respiratory disease, ENDS-specific harm (explosion, poisoning), and anti-ENDS industry sentiment.”

Comment: Evidence that ENDS are unsafe accumulates through evidence of acute effects in humans and suggestive long-term dangers. Initial limited chemical findings inside and outside biological samples are giving way to longitudinal epidemiological results that show present and future likely health damage.
Stephen Hamann

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