Commentary on Brose et al. (2015): Protecting individual and public health by regulating electronic cigarette nicotine delivery.
Commentary on Brose et al. (2015): Protecting individual and public health by regulating electronic cigarette nicotine delivery.
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DOI：
10.1111/add.12955
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发表时间：
2015-07
期刊：
影响因子：
--
通讯作者：
Eissenberg T
中科院分区：
文献类型：
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作者：
Blank MD;Eissenberg T
Brose and colleagues [1] used a national data set from Great Britain to demonstrate that, in current tobacco cigarette smokers, daily but not non-daily electronic cigarette (e-cig) use shows a significant association with increased tobacco smoking cessation attempts and reductions in smoking behavior. However, e-cig use was not shown in this study to be associated significantly with tobacco smoking cessation. Taken together, this new study [1] and the extant literature (eg [2, 3]) provide little empirical support for the contention that ecig use leads reliably to smoking cessation for the majority of users.Tobacco cigarette smokers self-administer the stimulant drug nicotine with every puff that they inhale, and most of them are dependent on the drug [4]. This dependence makes cessation difficult, in part because of an aversive abstinence syndrome that occurs during a cessation attempt (eg [5]). Nicotine replacement medications act by delivering nicotine to the user and thus suppressing at least some aversive abstinence symptoms: the more nicotine, the greater the symptom suppression (eg [6]). E-cigs are not marketed as medications in many countries, but are a class of products that use an electric heater to aerosolize a liquid that usually contains some combination of propylene glycol, vegetable glycerin, flavorants and nicotine. Despite not being marketed as medications, many smokers are attempting to quit tobacco cigarettes by using e-cigs daily; however, there is little information regarding the long-term health risks associated with daily e-cig use. Putting aside that concern, if daily e-cig use is to lead to smoking cessation for the majority of users, then e-cigs will probably need to deliver nicotine in doses necessary to suppress abstinence symptoms as effectively as a tobacco cigarette. Unfortunately, there is wide variability in ecig nicotine delivery: 10 puffs from an e-cig may, for example [7], or may not [8], result in reliable nicotine delivery to the user’s blood. Differences across studies can be explained by a combination of factors, including characteristics of the e-cig device and liquid, as well as user behavior [9]. Those e-cig device/liquid combinations that are most likely to lead to smoking cessation may well be those that approximate the nicotine delivery profile of a tobacco cigarette (eg [10]).
