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Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations

Background: Electronic cigarettes (ECs) are often marketed as a safer alternative to combustible tobacco products. The global EC market has rapidly expanded since their introduction, creating an urgent need for research describing the toxicity and chemical composition of ECs. We conducted an umbrell...

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Autores principales: Travis, Nargiz, Knoll, Marie, Cook, Steven, Oh, Hayoung, Cadham, Christopher J., Sánchez-Romero, Luz María, Levy, David T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914618/
https://www.ncbi.nlm.nih.gov/pubmed/36767274
http://dx.doi.org/10.3390/ijerph20031908
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author Travis, Nargiz
Knoll, Marie
Cook, Steven
Oh, Hayoung
Cadham, Christopher J.
Sánchez-Romero, Luz María
Levy, David T.
author_facet Travis, Nargiz
Knoll, Marie
Cook, Steven
Oh, Hayoung
Cadham, Christopher J.
Sánchez-Romero, Luz María
Levy, David T.
author_sort Travis, Nargiz
collection PubMed
description Background: Electronic cigarettes (ECs) are often marketed as a safer alternative to combustible tobacco products. The global EC market has rapidly expanded since their introduction, creating an urgent need for research describing the toxicity and chemical composition of ECs. We conducted an umbrella review to summarize the evidence from existing systematic reviews (SRs). Methods: The search for SRs was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. Results: Twenty-five SRs were included in our umbrella review. Chemical profiles widely varied across studies included in the reviews, which was mainly attributed to the lack of standardized protocols 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. AMSTAR-2 revealed important limitations across reviews. Conclusions: 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. Future SRs with improved methodology and reporting are needed to adequately inform tobacco regulatory actions.
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spelling pubmed-99146182023-02-11 Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations Travis, Nargiz Knoll, Marie Cook, Steven Oh, Hayoung Cadham, Christopher J. Sánchez-Romero, Luz María Levy, David T. Int J Environ Res Public Health Review Background: Electronic cigarettes (ECs) are often marketed as a safer alternative to combustible tobacco products. The global EC market has rapidly expanded since their introduction, creating an urgent need for research describing the toxicity and chemical composition of ECs. We conducted an umbrella review to summarize the evidence from existing systematic reviews (SRs). Methods: The search for SRs was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. Results: Twenty-five SRs were included in our umbrella review. Chemical profiles widely varied across studies included in the reviews, which was mainly attributed to the lack of standardized protocols 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. AMSTAR-2 revealed important limitations across reviews. Conclusions: 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. Future SRs with improved methodology and reporting are needed to adequately inform tobacco regulatory actions. MDPI 2023-01-20 /pmc/articles/PMC9914618/ /pubmed/36767274 http://dx.doi.org/10.3390/ijerph20031908 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Travis, Nargiz
Knoll, Marie
Cook, Steven
Oh, Hayoung
Cadham, Christopher J.
Sánchez-Romero, Luz María
Levy, David T.
Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations
title Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations
title_full Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations
title_fullStr Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations
title_full_unstemmed Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations
title_short Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations
title_sort chemical profiles and toxicity of electronic cigarettes: an umbrella review and methodological considerations
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9914618/
https://www.ncbi.nlm.nih.gov/pubmed/36767274
http://dx.doi.org/10.3390/ijerph20031908
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