Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking

Abstract Background Although the harm to health from electronic nicotine delivery systems (ENDS) compared to smoked tobacco remains highly uncertain, society and governments still need to know the likely range of the relative harm to inform regulatory policies for ENDS and smoking. Methods We identi...

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Autores principales: Nick Wilson, Jennifer A. Summers, Driss Ait Ouakrim, Janet Hoek, Richard Edwards, Tony Blakely
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Publicado: BMC 2021
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spelling oai:doaj.org-article:8ed9843918fe4501b7d05bf5dd4542122021-11-14T12:14:52ZImproving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking10.1186/s12889-021-12103-x1471-2458https://doaj.org/article/8ed9843918fe4501b7d05bf5dd4542122021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12103-xhttps://doaj.org/toc/1471-2458Abstract Background Although the harm to health from electronic nicotine delivery systems (ENDS) compared to smoked tobacco remains highly uncertain, society and governments still need to know the likely range of the relative harm to inform regulatory policies for ENDS and smoking. Methods We identified biomarkers with specificity of association with different disease groupings e.g., volatile organic compound (VOCs) for chronic obstructive pulmonary disease; and tobacco-specific N´-nitrosamines (TSNAs) and polycyclic aromatic hydrocarbons (PAHs) for all cancers. We conducted a review of recent studies (post January 2017) that compared these biomarkers between people exclusively using ENDS and those exclusively smoking tobacco. The percentage differences in these biomarkers, weighted by study size and adjusted for acrolein from other sources, were used as a proxy for the assumed percentage difference in disease harm between ENDS and smoking. These relative differences were applied to previously modelled estimates of smoking-related health loss (in health-adjusted life-years; HALYs). Results The respective relative biomarker levels (ENDS vs smoking) were: 28% for respiratory diseases (five results, three studies); 42% for cancers (five results, four studies); and 35% for cardiovascular (seven results, four studies). When integrated with the HALY impacts by disease, the overall harm to health from ENDS was estimated to be 33% that of smoking. Conclusions This analysis, suggests that the use of modern ENDS devices (vaping) could be a third as harmful to health as smoking in a high-income country setting. But this estimate is based on a limited number of biomarker studies and is best be considered a likely upper level of ENDS risk given potential biases in our method (i.e., the biomarkers used being correlated with more unaccounted for toxicants in smoking compared to with using ENDS).Nick WilsonJennifer A. SummersDriss Ait OuakrimJanet HoekRichard EdwardsTony BlakelyBMCarticleElectronic nicotine delivery systemsVapingSmokingBiomarkersRelative harmPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-10 (2021)
institution DOAJ
collection DOAJ
language EN
topic Electronic nicotine delivery systems
Vaping
Smoking
Biomarkers
Relative harm
Public aspects of medicine
RA1-1270
spellingShingle Electronic nicotine delivery systems
Vaping
Smoking
Biomarkers
Relative harm
Public aspects of medicine
RA1-1270
Nick Wilson
Jennifer A. Summers
Driss Ait Ouakrim
Janet Hoek
Richard Edwards
Tony Blakely
Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking
description Abstract Background Although the harm to health from electronic nicotine delivery systems (ENDS) compared to smoked tobacco remains highly uncertain, society and governments still need to know the likely range of the relative harm to inform regulatory policies for ENDS and smoking. Methods We identified biomarkers with specificity of association with different disease groupings e.g., volatile organic compound (VOCs) for chronic obstructive pulmonary disease; and tobacco-specific N´-nitrosamines (TSNAs) and polycyclic aromatic hydrocarbons (PAHs) for all cancers. We conducted a review of recent studies (post January 2017) that compared these biomarkers between people exclusively using ENDS and those exclusively smoking tobacco. The percentage differences in these biomarkers, weighted by study size and adjusted for acrolein from other sources, were used as a proxy for the assumed percentage difference in disease harm between ENDS and smoking. These relative differences were applied to previously modelled estimates of smoking-related health loss (in health-adjusted life-years; HALYs). Results The respective relative biomarker levels (ENDS vs smoking) were: 28% for respiratory diseases (five results, three studies); 42% for cancers (five results, four studies); and 35% for cardiovascular (seven results, four studies). When integrated with the HALY impacts by disease, the overall harm to health from ENDS was estimated to be 33% that of smoking. Conclusions This analysis, suggests that the use of modern ENDS devices (vaping) could be a third as harmful to health as smoking in a high-income country setting. But this estimate is based on a limited number of biomarker studies and is best be considered a likely upper level of ENDS risk given potential biases in our method (i.e., the biomarkers used being correlated with more unaccounted for toxicants in smoking compared to with using ENDS).
format article
author Nick Wilson
Jennifer A. Summers
Driss Ait Ouakrim
Janet Hoek
Richard Edwards
Tony Blakely
author_facet Nick Wilson
Jennifer A. Summers
Driss Ait Ouakrim
Janet Hoek
Richard Edwards
Tony Blakely
author_sort Nick Wilson
title Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking
title_short Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking
title_full Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking
title_fullStr Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking
title_full_unstemmed Improving on estimates of the potential relative harm to health from using modern ENDS (vaping) compared to tobacco smoking
title_sort improving on estimates of the potential relative harm to health from using modern ends (vaping) compared to tobacco smoking
publisher BMC
publishDate 2021
url https://doaj.org/article/8ed9843918fe4501b7d05bf5dd454212
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AT drissaitouakrim improvingonestimatesofthepotentialrelativeharmtohealthfromusingmodernendsvapingcomparedtotobaccosmoking
AT janethoek improvingonestimatesofthepotentialrelativeharmtohealthfromusingmodernendsvapingcomparedtotobaccosmoking
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