Cardiovascular Perspective of the Promises and Perils of E-Cigarettes

Introduction:
This text provides an analysis of the promises and perils of e-cigarettes from a cardiovascular perspective. The author discusses the current state of tobacco regulation, the potential benefits and drawbacks of e-cigarettes, and the implications of their widespread use. The reader will learn about the complexities of the health effects of tobacco and tobacco-related disease, as well as the need for evidence-based policy making.

Key Points:

* Smoking continues to be the leading cause of preventable death worldwide, and cardiovascular disease is the major cause of premature mortality in smokers.
* Despite the high disease burden, there is little understanding of the mechanisms by which smoking affects cardiovascular health, and few major funding agencies support a large portfolio of smoking-related cardiovascular research.
* The Family Smoking Prevention and Control act of 2009 gave the US Food and Drug administration (FDa) the authority to regulate the manufacture, distribution, and marketing of tobacco products, but there is a lack of knowledge about which constituents, ingredients, and additives contribute to the toxicity of tobacco products.
* E-cigarettes, which aerosolize a solution of nicotine by heating, produce no carbon monoxide, little tar, and only trace levels of carcinogenic nitrosamines.
* Some argue that e-cigarettes are much less harmful than conventional cigarettes and could meaningfully lessen the burden of smoking-related death, disease, and disability.
* however, others worry that e-cigarette emissions contain harmful levels of fine particles and toxic aldehydes, that acceptance of e-cigarettes might renormalize smoking, promote dual use, and increase nicotine dependence, and that the use of a plethora of flavors and additives could lead to new diseases.
* There is a need for regulations to minimize the risk of fires and explosions, ensure that bottles containing nicotine have child-proof packaging, and prohibit free sampling.
* Companies should not be permitted to claim that their devices are cessation aids unless they present rigorous, convincing data supporting their claims.

Main Message:
The text emphasizes the need for further research and evidence-based policy making in the area of tobacco regulation, particularly with regard to e-cigarettes. The author argues that the current lack of knowledge about the health effects of tobacco and tobacco-related disease, as well as the lack of regulation of tobacco products, presents a significant public health challenge. The text calls for minimal regulations to ensure that the use of e-cigarettes does not result in unintended harm, and for ongoing research to understand how tobacco products inflict injury and which ingredients, components, and constituents contribute to this risk. Ultimately, the author argues that whatever actions are taken, they must proceed urgently, but with care, caution, and responsibility, because over the next decades, they could impact over a billion lives.

Bhatnagar, aruni. “Cardiovascular Perspective of the Promises and Perils of E-Cigarettes.” Circulation Research 118, no. 12 (June 10, 2016): 1872–75. https://doi.org/10.1161/CIRCRESaha.116.308723.