Summary
Introduction:
This summary will provide an overview of an umbrella review examining the chemical profiles and toxicity of electronic cigarettes (ECs). The review includes 25 systematic reviews and aims to summarize the main findings, conclusions, and recommendations, while critically assessing the methodological quality and highlighting limitations of current research.
Key Points:
* The review found that while most reviews concluded that ECs were likely less harmful than cigarettes, there was hesitancy to draw clear conclusions due to variable analytical procedures and inconsistent findings among the included studies.
* Chemical profiles widely varied across studies, which was mainly attributed to the lack of standardized protocols in investigating the constituents and differences in EC devices and e-liquids tested.
* Metals were more abundant in some EC aerosols than cigarettes, while carbonyls were typically found at lower levels.
* There was consistent evidence of in vitro toxicity from EC aerosol and e-liquid exposure.
* The aMSTaR-2 assessment revealed important limitations across reviews, including a lack of written protocols prior to conducting the review, inadequate risk of bias assessments, and insufficient reporting of funding sources and conflicts of interest.
Main Message:
The main message of this umbrella review is that while the majority of systematic reviews suggest that ECs are likely less harmful than cigarettes, there is a need for improved methodology and reporting in future systematic reviews to adequately inform tobacco regulatory actions. The review highlights the importance of standardized protocols for investigating the chemical profiles of ECs and emphasizes the need for further research to better understand the potential health effects of EC use. Overall, the review underscores the need for caution in promoting ECs as a safer alternative to cigarettes, and the importance of continued research and regulation in this area.
Citation
Travis N, Knoll M, Cook S, et al. Chemical Profiles and Toxicity of Electronic Cigarettes: an Umbrella Review and Methodological Considerations. International journal of environmental research and public health. 2023;20(3). doi:10.3390/ijerph20031908
