Abstract: The impact of electronic cigarette use on population health is strongly influenced by the harms and risks of e-cigarettes. The harm from cigarette smoking is to a great extent caused by toxic products of tobacco combustion. E-cigarettes deliver nicotine in an inhalable aerosol without combustion. E-cigarettes do deliver propylene glycol, vegetable glycerin, various flavoring chemicals and their various thermal breakdown products, as well as particles; some of these chemicals are potentially toxic. E-cigarettes vary considerably in design, and the risk is almost certainly greater with those with bigger batteries that operate at higher temperatures. The long-term safety of e-cigarettes is unknown at this time. Major current health concerns in the U.S. relate to e-cigarette use by youth, particularly with respect to impaired adolescent brain development, development of nicotine addiction and serving as a gateway to cigarette and other drug use. Short-term adverse effects include increased respiratory symptoms and asthma, although in smokers with chronic lung disease who switch completely to e-cigarettes their respiratory symptoms improve. Other health concerns include cardiovascular toxicity (particularly in people with pre-existing heart disease) and reproductive toxicity during pregnancy. Direct nicotine toxicity from ingestion of nicotine-containing liquids can occur, particularly in children, but is uncommon.
Speaker Biography: Neal L. Benowitz, MD, is Emeritus Professor of Medicine and Bioengineering & Therapeutic Sciences at the University of California, San Francisco (UCSF). He was Chief of the Division of Clinical Pharmacology and Experimental Therapeutics at UCSF for 35 years. He received his medical degree from the University of Rochester School of Medicine in 1969, following which he served as a resident in internal medicine at the Bronx Municipal Hospital Center from 1969 to 1971. He then completed a postdoctoral fellowship in clinical pharmacology at UCSF and joined the faculty in 1974. His research interests have focused primarily on the human pharmacology and toxicology of nicotine. He has published more than 700 research papers. Dr Benowitz maintains an active clinical practice in cardiovascular medicine and medical toxicology. Dr Benowitz was a scientific editor of the 1988 United States Surgeon General’s Report on Smoking and Health: Nicotine Addiction; a scientific editor of the 2001 NCI Monograph 13 Report on Risks Associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine; and served as section editor for the 2010 Surgeon General’s Report on How Tobacco Smoke Causes Disease. He has served as a member of the National Institutes of Health Pharmacology Study Section and the FDA Nonprescription Drug and Tobacco Products Science Advisory Committees. He has served as President of the American Society for Clinical Pharmacology and Therapeutics and as President of the Society for Research on Nicotine and Tobacco. Dr Benowitz has received the Ove Ferno, Alton Ochsner, and Rawls-Palmer Progress in Medicine awards, and the Oscar B. Hunter Memorial Award in Therapeutics for his research on nicotine, tobacco, and health, and was the 2002 UCSF Annual Distinguished Clinical Research Lecturer.
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