Summary
Introduction:
This article provides an in-depth analysis of the effects of e-cigarettes on the brain and lungs, focusing on the role of nicotine. The authors discuss the current debate surrounding the safety of e-cigarettes and their usefulness as smoking cessation tools. They also examine the impact of nicotine on cellular function and underlying behaviors associated with e-cigarette use.
Key Points:
* E-cigarettes are widely perceived as a safer alternative to tobacco smoking, but public health specialists have offered differing opinions regarding their safety and usefulness as smoking cessation tools.
* Nicotine is an alkaloid found in e-cigarettes that binds to nicotinic acetylcholine receptors (naChRs) in the brain and lungs, causing excitatory effects and altering cell signaling pathways.
* Chronic nicotine exposure can lead to near-permanent changes in neurons and neuronal networks, affecting brain regions such as the amygdala and mesolimbic reward pathway.
* Nicotine can inhibit CFTR function in the lungs, leading to decreased Cl− secretion, decreased ciliary beating, and decreased airway hydration.
* Chronic nicotine exposure can also lead to deficits in dopamine transmission, contributing to decreased brain reward function and nicotine withdrawal symptoms.
* E-cigarettes contain nicotine salt, rather than nicotine freebase, and its effects on the airways, brain, and other organs are poorly understood.
* The interplay between peripheral and central effects of nicotine, such as how nicotine can directly alter cell signaling pathways both centrally and peripherally and how peripheral alterations can trigger maladaptive changes in specific regions of the lungs and brain, is an important area of future study.
Main Message:
The article highlights the need for further research on the impact of e-cigarette-delivered nicotine on the brain and lungs. While e-cigarettes are often perceived as a safer alternative to tobacco smoking, the long-term health effects of vaping are unknown, and there is no evidence that they are safer than tobacco. The study emphasizes the importance of understanding the interplay between peripheral and central effects of nicotine, as well as the need for standard e-liquids and exposure protocols in future research. Ultimately, the article suggests that vaping needs to be studied by multi-disciplinary teams that include pulmonary and neuro physiologists as well as behaviorists and addiction specialists to fully understand their impact on human physiology.
Citation
herman M, Tarran R. E-cigarettes, nicotine, the lung and the brain: multi-level cascading pathophysiology. The Journal of physiology. 2020;598(22):5063-5071. doi:10.1113/JP278388
