Electronic Cigarettes and Their Impact on Allergic Respiratory Diseases: A Work Group Report of the AAAAI Environmental Exposures and Respiratory Health Committee

Abstract

The explosive rise in popularity of electronic cigarette (e-cig) devices over the past decade has led to controversies over the role of these devices in smoking cessation and harm reduction from combustible cigarette smoking. Increased recognition of potential direct harms of e-cigs, including life-threatening and fatal cases of e-cig and vaping product use-associated lung injury, has emphasized the need to curb use until safety can be established. Of particular concern is the steep rise in e-cig use among teenagers and young adults who have never smoked and among individuals with underlying lung disease, such as asthma. In this report, we describe the different types of e-cig devices available, summarize the available data on the potential health benefits and detriments of e-cig use, and highlight the findings of studies examining e-cigs as smoking cessation tools. Because e-cigs have only gained popularity in the last few years, very few studies have been able to demonstrate an impact of e-cig use on harm reduction related to combustible cigarettes. Moreover, the health effects of e-cigs at a population level must be balanced against the harms of e-cig use, which include nicotine dependence and promoting initiation of cigarette use amongst "never smokers." With respect to smoking cessation, e-cigs appear to serve as switching products that may help individuals reduce or quit cigarette use, but do not address nicotine addiction. Finally, we discuss our recommendations for ways that health care providers can screen and counsel patients on e-cig use. The goal of this report is to provide health care providers with the most recent information on this topic so that they can educate patients on the potential pros and cons of e-cig use.

Keywords: Adolescents; Asthma; E-cig; EVALI; JUUL; Pod; Smoking cessation; Vaping; Young adults; Youth.