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Electronic Cigarettes – Task Force report from the European Respiratory Society

Robert Bals, Jeanette Boyd, Susanna Esposito, Robert Foronjy, Pieter S. Hiemstra, Carlos A. Jiménez-Ruiz, Paraskevi Katsaounou, Anne Lindberg, Carlos Metz, Wolfgang Schober, Avrum Spira, Francesco Blasi
European Respiratory Journal 2018; DOI: 10.1183/13993003.01151-2018
Robert Bals
1Department of Internal Medicine V – Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
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Jeanette Boyd
2European Lung Foundation (ELF), Sheffield, United Kingdom
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Susanna Esposito
3Pediatric Clinic, Department of Surgical and Biomedical Sciences, Università degli Studi di Perugia, Perugia, Italy
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Robert Foronjy
4Pulmonary and Critical Care Medicine, SUNY Downstate Medical Center, New York
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Pieter S. Hiemstra
5Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
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Carlos A. Jiménez-Ruiz
6Smoking Cessation Service, Region of Madrid, Spain
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Paraskevi Katsaounou
71rst ICU Evangelismos Hospital, National Kapodistrian University of Athens, Greece
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Anne Lindberg
8Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden
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Carlos Metz
1Department of Internal Medicine V – Pulmonology, Allergology and Critical Care Medicine, Saarland University, Homburg, Germany
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Wolfgang Schober
9Bavarian Health and Food Safety Authority, Department of Chemical Safety and Toxicology, Munich, Germany
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Avrum Spira
10Boston University School of Medicine, Boston, MA
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Francesco Blasi
11Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Internal Medicine Department, Respiratory Unit and Regional Adult Cystic Fibrosis Center, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Abstract

There is a marked increase in the development and use of electronic nicotine delivery systems (ENDS) or electronic cigarettes (ECIGs). This statement covers electronic cigarettes (ECIGs), defined as “electrical devices that generate an aerosol from a liquid” and thus excludes devices that contain tobacco. Database searches identified published articles that were used to summarise the current knowledge on: the epidemiology of ECIG use; their ingredients and accompanied health effects; secondhand exposure; use of ECIGs for smoking cessation; behavioural aspects of ECIGs and social impact, in vitro and animal studies; and user perspectives.

ECIG aerosol contains potentially toxic chemicals. As compared to conventional cigarettes, these are fewer and generally in lower concentrations. Second-hand exposures to ECIG chemicals may represent a potential risk, especially to vulnerable populations. There is not enough scientific evidence to support that ECIGs are an aid to smoking cessation due to a lack of controlled trials, including those that compare ECIGs with licensed stop-smoking treatments. So far, there is conflicting data that use of ECIGs results in a renormalisation of smoking behaviour or for the gateway hypothesis. Experiments in cell cultures and animal studies show that ECIGs can have multiple negative effects. The long-term effects of ECIGs use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term. Negative health effects cannot, based on the current knowledge, be ruled out.

Footnotes

This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Bals reports grants and personal fees from AstraZeneca, grants and personal fees from Boehringer Ingelheim, personal fees from GlaxoSmithKline, personal fees from Grifols, grants and personal fees from Novartis, personal fees from CSL Behring, grants from German Federal Ministry of Education and Research (BMBF) Competence Network Asthma and COPD (ASCONET), grants from Sander Stiftung, grants from Schwiete Stiftung, grants from Krebshilfe, from Mukoviszidose eV, outside the submitted work.

Conflict of interest: Dr. Boyd is an employee of the ERS.

Conflict of interest: Dr. ESPOSITO has nothing to disclose.

Conflict of interest: Dr. Foronjy reports other from European Respiratory Society, during the conduct of the study.

Conflict of interest: Dr. Hiemstra reports grants from European Respiratory Society, during the conduct of the study; grants from Galapagos N.V., grants from Boehringer Ingelheim, outside the submitted work.

Conflict of interest: Dr. Jiménez-Ruiz has nothing to disclose.

Conflict of interest: Dr. KATSAOUNOU reports grants and personal fees from GSK, grants and personal fees from Pfizer, grants and personal fees from Menarini, grants and personal fees from Chiesi, grants and personal fees from BI, outside the submitted work.

Conflict of interest: Dr. Lindberg reports personal fees from AstraZeneca, personal fees from Boehringer-Ingelheim, personal fees from Novartis, personal fees from Active Care, outside the submitted work.

Conflict of interest: Dr. Metz has nothing to disclose.

Conflict of interest: Dr. Schober has nothing to disclose.

Conflict of interest: Dr. Spira reports personal fees from Veracyte Inc, personal fees from Johnson and Johnson, outside the submitted work.

Conflict of interest: Dr. BLASI reports grants and personal fees from ASTRAZENECA, grants and personal fees from BAYER, personal fees from CHIESI, personal fees from GSK, personal fees from GUIDOTTI, grants and personal fees from GRIFOLS, grants from INSMED, personal fees from MENARINI, personal fees from NOVARTIS, grants and personal fees from PFIZER, personal fees from TEVA, personal fees from ZAMBON, outside the submitted work.

Conflict of interest: Dr. Vardavas has nothing to disclose.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Copyright ©ERS 2018
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Electronic Cigarettes – Task Force report from the European Respiratory Society
Robert Bals, Jeanette Boyd, Susanna Esposito, Robert Foronjy, Pieter S. Hiemstra, Carlos A. Jiménez-Ruiz, Paraskevi Katsaounou, Anne Lindberg, Carlos Metz, Wolfgang Schober, Avrum Spira, Francesco Blasi
European Respiratory Journal Jan 2018, 1801151; DOI: 10.1183/13993003.01151-2018

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Electronic Cigarettes – Task Force report from the European Respiratory Society
Robert Bals, Jeanette Boyd, Susanna Esposito, Robert Foronjy, Pieter S. Hiemstra, Carlos A. Jiménez-Ruiz, Paraskevi Katsaounou, Anne Lindberg, Carlos Metz, Wolfgang Schober, Avrum Spira, Francesco Blasi
European Respiratory Journal Jan 2018, 1801151; DOI: 10.1183/13993003.01151-2018
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