Reduced carcinogens found in e-cigarette users

Reduced carcinogens found in e-cigarette users

News Long-term users of electronic cigarettes (e-cigarettes) are exposed to far lower levels of tobacco-specific carcinogens and toxins than are users...

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Long-term users of electronic cigarettes (e-cigarettes) are exposed to far lower levels of tobacco-specific carcinogens and toxins than are users of combustible cigarettes, according to a cross-sectional study. Lion Shahab (University College London, London, UK) and colleagues assessed five groups of nicotine users: users of combustible cigarettes only, former smokers who switched to exclusively using e-cigarettes, former smokers who switched to exclusively using nicotine replacement therapy (NRT), individuals who used both e-cigarettes and combustible cigarettes, and individuals who used both NRT and combustible cigarettes. The total study population was 181, mean age was 37·8 (SD 11·8) years, and participants had all used their specific products for at least 6 months before the study. The researchers assessed urine and saliva samples

for biomarkers of nicotine, tobaccospecific N-nitrosamines (TSNAs), and volatile organic compounds (VOCs). After controlling for confounders, nicotine intake was similar for all five groups. But the e-cigarettesonly and NRT-only groups had significantly lower concentrations of TSNAs and VOCs than the other three groups (p<0·001). For example, concentration of the metabolite 4-(methylnitrosamino)-1-(3-pyridyl)1-butanol, which is linked to lung cancer, was 97·5% lower in the e-cigarette-only group than in exclusive users of combustible cigarettes. “Across the range of toxic and carcinogenic biomarkers that we looked at, we found reductions for e-cigarette users that were between 56·5% and 97·5%”, explained Shahab. Individuals who continued to smoke alongside using e-cigarettes or NRT had similar levels of TSNAs

and VOCs as individuals who only used combustible cigarettes. Shahab attributed this to dual users only reducing their average consumption of combustible cigarettes by two per day. “Many smokers use e-cigarettes or NRT as a way of tolerating brief abstinence, but dual use can still work as an interim stage between full smoking and stopping”, added John Britton (University of Nottingham, Nottingham, UK). “We know from NRT that if smokers find the product is effective when they cannot smoke, they are more likely to quit smoking entirely.” Shahab said it is important to examine the immediate harm caused by combustible cigarettes and their alternatives. “We looked at biomarkers that are an index of future disease risk but we also need to look at lung function and cardiovascular function.”

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Reduced carginogens found in e-cigarette users

Lancet Oncol 2017 Published Online February 16, 2017 http://dx.doi.org/10.1016/ S1470-2045(17)30118-3 For the study by Shahab and colleagues see Ann Intern Med 2017; published online Feb 7. DOI:10.7326/M16-1107

Talha Khan Burki

www.thelancet.com/oncology Published online February 16, 2017 http://dx.doi.org/10.1016/S1470-2045(17)30118-3

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