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E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies

BACKGROUND: Use of electronic cigarettes (e-cigarettes) is prevalent among adolescents and young adults, but there has been limited knowledge about health consequences in human populations. We conduct a systematic review and meta-analysis of results on respiratory disorders from studies of general-p...

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Autores principales: Wills, Thomas A., Soneji, Samir S., Choi, Kelvin, Jaspers, Ilona, Tam, Elizabeth K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817920/
https://www.ncbi.nlm.nih.gov/pubmed/33154031
http://dx.doi.org/10.1183/13993003.01815-2019
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author Wills, Thomas A.
Soneji, Samir S.
Choi, Kelvin
Jaspers, Ilona
Tam, Elizabeth K.
author_facet Wills, Thomas A.
Soneji, Samir S.
Choi, Kelvin
Jaspers, Ilona
Tam, Elizabeth K.
author_sort Wills, Thomas A.
collection PubMed
description BACKGROUND: Use of electronic cigarettes (e-cigarettes) is prevalent among adolescents and young adults, but there has been limited knowledge about health consequences in human populations. We conduct a systematic review and meta-analysis of results on respiratory disorders from studies of general-population samples and consider the mapping of these results to findings about biological processes linked to e-cigarettes in controlled laboratory studies. METHOD: We conducted a literature search and meta-analysis of epidemiological studies on the association of e-cigarette use with asthma and with COPD. We discuss findings from laboratory studies about effects of e-cigarettes on four biological processes: cytotoxicity, oxidative stress/inflammation, susceptibility to infection and genetic expression. RESULTS: Epidemiological studies, both cross-sectional and longitudinal, show a significant association of e-cigarette use with asthma and COPD, controlling for cigarette smoking and other covariates. For asthma (n=15 studies), the pooled adjusted odds ratio (aOR) was 1.39 (95% CI 1.28–1.51); for COPD (n=9 studies) the aOR was 1.49 (95% CI 1.36–1.65). Laboratory studies consistently show an effect of e-cigarettes on biological processes related to respiratory harm and susceptibility to illness, with e-cigarette conditions differing significantly from clean-air controls, although sometimes less than for cigarettes. CONCLUSIONS: The evidence from epidemiological studies meets established criteria for consistency, strength of effect, temporality, and in some cases a dose–response gradient. Biological plausibility is indicated by evidence from multiple laboratory studies. We conclude that e-cigarette use has consequences for asthma and COPD, which is of concern for respirology and public health.
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spelling pubmed-78179202021-01-21 E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies Wills, Thomas A. Soneji, Samir S. Choi, Kelvin Jaspers, Ilona Tam, Elizabeth K. Eur Respir J State of the Art BACKGROUND: Use of electronic cigarettes (e-cigarettes) is prevalent among adolescents and young adults, but there has been limited knowledge about health consequences in human populations. We conduct a systematic review and meta-analysis of results on respiratory disorders from studies of general-population samples and consider the mapping of these results to findings about biological processes linked to e-cigarettes in controlled laboratory studies. METHOD: We conducted a literature search and meta-analysis of epidemiological studies on the association of e-cigarette use with asthma and with COPD. We discuss findings from laboratory studies about effects of e-cigarettes on four biological processes: cytotoxicity, oxidative stress/inflammation, susceptibility to infection and genetic expression. RESULTS: Epidemiological studies, both cross-sectional and longitudinal, show a significant association of e-cigarette use with asthma and COPD, controlling for cigarette smoking and other covariates. For asthma (n=15 studies), the pooled adjusted odds ratio (aOR) was 1.39 (95% CI 1.28–1.51); for COPD (n=9 studies) the aOR was 1.49 (95% CI 1.36–1.65). Laboratory studies consistently show an effect of e-cigarettes on biological processes related to respiratory harm and susceptibility to illness, with e-cigarette conditions differing significantly from clean-air controls, although sometimes less than for cigarettes. CONCLUSIONS: The evidence from epidemiological studies meets established criteria for consistency, strength of effect, temporality, and in some cases a dose–response gradient. Biological plausibility is indicated by evidence from multiple laboratory studies. We conclude that e-cigarette use has consequences for asthma and COPD, which is of concern for respirology and public health. European Respiratory Society 2021-01-21 /pmc/articles/PMC7817920/ /pubmed/33154031 http://dx.doi.org/10.1183/13993003.01815-2019 Text en The content of this work is not subject to copyright. Design and branding are copyright ©ERS 2021 http://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
spellingShingle State of the Art
Wills, Thomas A.
Soneji, Samir S.
Choi, Kelvin
Jaspers, Ilona
Tam, Elizabeth K.
E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies
title E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies
title_full E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies
title_fullStr E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies
title_full_unstemmed E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies
title_short E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies
title_sort e-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies
topic State of the Art
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817920/
https://www.ncbi.nlm.nih.gov/pubmed/33154031
http://dx.doi.org/10.1183/13993003.01815-2019
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