Electronic Cigarette Use, Misuse, and harm.

Introduction:
This text provides an in-depth analysis of electronic cigarette use, misuse, and harm, highlighting the impact on respiratory health and tobacco control policy. The author discusses the epidemiology of vaping, device evolution, e-liquid components, and the role of e-cigarettes in smoking cessation. The text also covers e-cigarette-or-vaping, product use-associated lung injury (EVaLI) and regulatory matters. Readers will gain a comprehensive understanding of electronic cigarettes and their implications on public health.

Key Points:

* E-cigarette use among adults has declined, but youth e-cigarette use has increased in 2020 and 2021, with 2.06 million youths using e-cigarettes.
* E-cigarette devices have evolved over time, from first-generation cig-a-likes to fourth-generation pod-mods, with each generation having unique features affecting nicotine delivery and aerosol production.
* E-liquid components include nicotine, flavorings, and additives, with varying health risks. The use of nicotine salts in newer e-cigarettes allows higher nicotine concentrations with less throat irritation.
* Some studies suggest reduced harm from e-cigarette use compared with smoking, but further study is needed. The combination of e-cigarettes and cigarettes is more harmful than using either product alone.
* Clinicians should strongly advise youth and nonsmokers against initiating e-cigarettes and educate individuals on the health effects of dual use of e-cigarettes and cigarettes.
* EVaLI is a severe lung injury associated with e-cigarette use, primarily linked to vitamin E acetate in ThC-containing e-cigarettes.
* The text emphasizes the need for stricter regulations, particularly on flavored tobacco products, which are a major driver for youth tobacco use.

Main Message:
The text underscores the importance of understanding the complex and still-evolving landscape of electronic cigarette use, misuse, and harm. The potential benefits of e-cigarettes in smoking cessation must be weighed against the risks of nicotine addiction, dual use, and health effects such as EVaLI. Regulatory measures, particularly related to flavored tobacco products, are crucial to protect the public, especially youth, from the potential harm caused by electronic cigarettes. In summary, the text emphasizes the need for evidence-based policies and continued research to ensure public health and safety.

Kathuria h. Electronic Cigarette Use, Misuse, and harm. The Medical clinics of North america. 2022;106(6):1081-1092. doi:10.1016/j.mcna.2022.07.009