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Clinical Review State of the Art Review

What are the respiratory effects of e-cigarettes?

BMJ 2019; 366 doi: (Published 30 September 2019) Cite this as: BMJ 2019;366:l5275

Rapid Response:

Re: What are the respiratory effects of e-cigarettes?

The “vaping associated respiratory syndrome” [1] is a new phenomenon that needs further research and rethinking. Prima facie it seemed that, being devoid of tar and other noxious components of the tobacco qualm, e-cigarettes would be not carcinogenic and less harmful for the airways than combustible cigarettes. The argument in favour of the use and sale of e-cigarettes is simple: they are safer than cigarettes, and, potentially, they can help smokers to quit [2]. As a stress coping strategy, an e-cigarette seems to be preferable to other tobacco products and, in some circumstances, to an alcoholic drink [3]. The fact that e-cigarettes are promoted by the tobacco industry does not necessarily mean that they are harmful. Excessively restrictive policies on e-cigarettes up to prohibitions in some countries are hardly justified.

A significant disadvantage of e-cigarettes is a potential relapse of the nicotine dependence i.e. that some former smokers would restart, which might be associated with cardiovascular and other health risks especially for aged individuals. Moreover, e-cigarette use among young people is a risk factor for subsequent initiation of combustible cigarettes [1]. For people with nicotine dependence combined with chronic respiratory diseases, a change from tobacco smoking to e-cigarettes may be favourable bearing in mind the final goal of smoking cessation [4].

1. Gotts JE, Jordt S-E, McConnell R, Tarran R. What are the respiratory effects of e-cigarettes? BMJ 2019;366:l5275.
2. Allwood B. Electronic cigarettes: The potential benefits outweigh the risks. S Afr Med J 2013;103(11):883.
3. Jargin SV. Re: Big Tobacco lights up e-cigarettes. BMJ Rapid Response 03 June 2013
4. Jargin SV. Electronic cigarettes: pros and cons. Ukrainian Med J online 2017 (in Russian)

Competing interests: No competing interests

01 October 2019
Sergei Jargin
medical reviewer
Clementovski per 6-82