Talk:Health effects of electronic cigarettes

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Text and/or other creative content from Safety of electronic cigarettes was copied or moved into Nicotine. The former page's history now serves to provide attribution for that content in the latter page, and it must not be deleted as long as the latter page exists.

Text and/or other creative content from Safety of electronic cigarettes was copied or moved into Nicotine poisoning. The former page's history now serves to provide attribution for that content in the latter page, and it must not be deleted as long as the latter page exists.

Text and/or other creative content from Safety of electronic cigarettes was copied or moved into 2019–20 vaping lung illness outbreak. The former page's history now serves to provide attribution for that content in the latter page, and it must not be deleted as long as the latter page exists.

Archives

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This article was the subject of a Wiki Education Foundation-supported course assignment, between 1 June 2024 and 17 August 2024. Further details are available on the course page. Student editor(s): Rrmisra, JMonka, Dmirandajuarez, LNariyoshi (article contribs). Peer reviewers: FionaMai, Selowe, A.MahmoudiWIKI, Jarynmiguel.

— Assignment last updated by Health Economics and Policy (talk) 19:38, 26 July 2024 (UTC)[reply]

· A.MahmoudiWIKI (talk) 21:55, 29 July 2024 (UTC)[reply]

1. Do the group's edits substantially improve the article as described in the Wikipedia peer review "Guiding framework"? [explain]

Per the Wikipedia peer review guiding framework, the group's edits substantially improve the Wikipedia article "Health effects of electronic cigarettes". The following changes have been noted:

1. Lead Section:
   1. The previous lead was brief and lacked detail about the major sections of the article.
   2. The revised lead has been significantly expanded, providing a more comprehensive overview of the article's contents.
2. Content:
   1. New, relevant, and up-to-date information has been added, addressing recent studies and findings.
   2. Some specific additions include:
      1. Expanded section on cardiovascular effects, citing a 2023 study linking e-cigarette use to increased blood pressure and arterial stiffness.
      2. New subsection on demographic impacts, particularly focusing on youth and pregnant women.
      3. Expanded section on respiratory health, citing a 2024 study showing a correlation between e-cigarette use and chronic bronchitis symptoms in long-term users.
   3. These additions ensure the article remains current and addresses Wikipedia's equity gaps by highlighting effects on historically underrepresented populations (i.e., women and children)
3. Tone and Balance:
   1. The edits maintain a neutral tone throughout, presenting information with minimal bias.
   2. Balanced representation of different viewpoints, including perspectives from both proponents and critics of e-cigarettes. For instance, the potential benefits of e-cigarettes as smoking cessation tools are discussed alongside health risks.
4. Sources and References:
   1. New content is backed by reliable, recent secondary sources from peer-reviewed journals.
   2. Citations accurately reflect the information presented and cover a wide spectrum of available literature.
   3. Notable new sources include a 2023 article from the Journal of the American Heart Association and a 2024 review in The Lancet Respiratory Medicine.
5. Organization:
   1. The article's structure has been enhanced with clear, concise, and easy-to-read content.
   2. New content is well-organized into logical sections such as cardiovascular effects, respiratory health, and demographic impacts.
   3. Minor grammatical errors were corrected and sentence structure improved for clarity.
6. Images and Media:
   1. While no new images were added, existing visuals are well-captioned and adhere to Wikipedia's copyright regulations.
   2. Image captions were updated to be more descriptive, enhancing readers' understanding.
7. Overall Impressions:
   1. The edits have significantly improved the article's comprehensiveness, balance, and readability.
   2. The content is now more complete, with thorough sourcing and a well-structured layout.
   3. The strengths of the added content include its relevance, neutrality, and up-to-date research findings.

2. Has the group achieved its overall goals for improvement? [explain]

The group has largely achieved its overall goals for improving the Wikipedia article "Health effects of electronic cigarettes," with several specific accomplishments aligning with their stated objectives.

1. Introduction of Electronic Cigarettes:
   1. Achieved: The lead now includes a more comprehensive overview of electronic cigarettes, including sections on alternatives to smoking and their effects on increasing nicotine products and smoking cessation. These additions provide a thorough background and context for the rest of the article.
2. Add to Other Effects:
   1. Partially Achieved: The group successfully added content on the impact of e-cigarettes on the gastrointestinal (GI) system, dermatological manifestations, renal, and hepatic effects. These additions enhance the "Other Effects" section by broadening the scope of health impacts covered. However, more detailed information and specific studies could further strengthen these sections.
3. Update Repetitive Paragraphs & Out-of-date Research:
   1. Achieved: The group revised several sections to remove repetitive content and update out-of-date research. The "Adverse Effects" section, including battery-related malfunctions, was updated to reflect more current findings and provide clearer information. These revisions improve the clarity and accuracy of the article.
4. Adverse Effects and Related Sections:
   1. Achieved: The sections on adverse effects, reported deaths, direct exposure, and respiratory effects (EVALI) have been updated. The revisions include recent research and detailed findings on these topics, providing a more comprehensive and up-to-date overview. The gallery section remains unchanged, which might be an area for future improvement.
5. Regulation, Toxicology, Public Perceptions:
   1. Partially Achieved: The "Regulation" section has seen some updates, but it could benefit from more detailed information on specific regulations and their impacts across different regions. The sections on toxicology and public perceptions have been tentatively addressed but could be further expanded with more detailed and current content.
6. Current References and Updated Pictures:
   1. Partially Achieved: The group has added more current references throughout the article, citing recent studies and reliable sources. This enhances the credibility and relevance of the information presented. However, there were no significant updates to pictures, which could be an area for further enhancement.

The group has successfully achieved most of its goals for improving the article. Some areas, such as more detailed regulatory information and expanded sections on toxicology and public perceptions, could be further developed to fully meet all their objectives.

3. Does the article meet Wikipedia guidelines?

A. Does the draft submission reflect a neutral point of view? [explain]

The draft submission of the Wikipedia article "Health effects of electronic cigarettes" largely reflects a neutral point of view, aligning well with Wikipedia's standards for neutrality. The revisions include balanced coverage of both the potential benefits and risks associated with e-cigarettes. For instance, the article presents data on the effectiveness of e-cigarettes as smoking cessation tools alongside evidence of their adverse health effects, such as cardiovascular and respiratory issues. This balanced approach ensures that the article does not disproportionately favor one perspective over another.

The new content is supported by a range of reliable sources, including recent peer-reviewed studies and authoritative reviews, which helps to maintain neutrality by representing a broad spectrum of expert opinions. Additionally, the article avoids sensational language and unsubstantiated claims, focusing instead on well-supported scientific findings and documented evidence. The sections on regulatory aspects and public perceptions provide a diverse range of viewpoints, reflecting the complexity of the topic without promoting any particular agenda. A.MahmoudiWIKI (talk) 21:55, 29 July 2024 (UTC)[reply]

· FionaMai (talk) 22:21, 29 July 2024 (UTC)[reply]

1. Yes, the group’s edits substantially improve the article. The introductory paragraph summarizes the topics in the article and gives a brief description of what electronic cigarettes are. The content added are up-to-date and written from a neutral standpoint. It explores both the advantages and disadvantages of electronic cigarettes throughout the years. Overall, the article provides valuable information and covers multiple perspectives.

2. The group achieved its overall goals for improvement. I also enjoyed the addition of images and charts throughout the article. The title is short and simple, and the introductory lead is direct and easy to read. The quotations are cited to their original source, and there are links to other Wikipedia articles for definitions, making the content more accessible to a wider audience.

3b. The claims in the article are verifiable with cited sources freely available, such as information from the CDC, World Health Organization, and articles from PubMed. FionaMai (talk) 22:27, 29 July 2024 (UTC)[reply]

· Jaryn copies and answers Question 1, Question 2, and Question 3c Jarynmiguel (talk) 06:37, 30 July 2024 (UTC) --Jarynmiguel (talk) 18:12, 30 July 2024 (UTC)[reply]

1. Do the group’s edits substantially improve the article as described in the Wikipedia peer review “Guiding framework”? The information added and the edits submitted do substantially improve the article as the background information is built upon, and the topic at hand is thoroughly addressed. However, while the information added does add value to their page overall, I will say that because the page title is specifically "HEALTH EFFECTS of electronic cigarettes", I would expect to see more dense emphasis on the health effects rather than the debate of what they are used for/smoking cessation/regulations/their malfunctions. I would have expected to see specific headings for the different health effects (instead of just an "other" section), than informational paragraphs describing the pathophysiology behind those health effects/treatment/rates/etc. The information is great, just maybe the organization is off and should have the health effects as the main headings or headings at least. Throughout, a non-bias standpoint was kept!

2. Has the group achieved its overall goals for improvement? The introduction gives a thorough yet concise overview on both the pros and cons of e-cigarettes. The introduction first provides background information on what e-cigarettes are as well as the debates behind them, then later moves into the varying health effects along with their own descriptions. Overall, the introduction gives a great description of what's to be expanded on in the later parts of the wikipedia page. The "other effects" section I think should be expanded upon (I believe it is not yet complete?) to better reflect the other organs/body systems effected, especially since the article is titled with "health effects". I believe the users are still working on adding more information for the hepatic, renal, and nervous systems. Signs of repetition or outdated information has been eliminated. The public perceptions, regulations, and toxicology subjects are definitely touched upon in depth! This information provides great background detail. Overall, goals were achieved, or seem to be in the process of being achieved!

3c. Does the article meet Wikipedia guidelines? Are the edits formatted consistent with Wikipedia’s manual of style? Yes, the edits are consistent with Wikipedia's manual of style. Headings are clear, and information is well-organized throughout. Only critique would be possibly having more clear headings for the different health effects. For example, they touch on dermatological effects, but it did not have its own section/subheading to click through on the left, so it was a bit easy to miss if one were trying to skim through for information on a specific health effect. The "other effects" section I felt could also have their own "clickable" sections on the left and be more of a highlight of the article. Jarynmiguel (talk) 06:37, 30 July 2024 (UTC) --Jarynmiguel (talk) 18:12, 30 July 2024 (UTC)[reply]

· Sebastian copies and answers Question 1, Question 2, and Question 3d. --Selowe (talk) 06:40, 30 July 2024 (UTC)[reply]

Sebastian Lowe's Peer Review Questions: 1, 2, and 3D 7/29/2024

Q1: The group’s edits did in fact substantially improve the article. Prior to the edits, a lot of the information was either left as unclear or not well referenced. The group had a clear framework and idea for where and how they wanted to improve the article, and they found reliable sources to do so. Furthermore, using their background knowledge and thinking more like medical professionals, they provided lots of information that read similar to that of a drug. Some examples include pregnancy/lactation impact, adverse events/reactions, toxicology, regulation, and more. Overall, I feel like the content they added did apply to the topic, and it improved the article overall.

Q2: I believe that the group has achieved its overall goals for improvement. They set out to discuss and provide more information on e-cigarettes from a medical standpoint. Using their experiences and knowledge as a pharmacist, they delved deeper into topics such as adverse reactions or events, they discussed how it impacts multiple organ systems, and they mentioned why individuals would even consider e-cigarettes as a smoking cessation option along with the benefits they pose.

Q3D: The edits do reflect language that supports diversity, equity, and inclusion as they not only discuss the effects of e-cigarettes on multiple ethnic groups using data from several reliable articles, but also how they impact other special populations such as those who are pregnant or lactating. They also discuss how the general public views e-cigarettes and the core issue which is the lack of awareness of the harm that these devices pose on the masses. What I really liked was how they also briefly discussed ways to tackle this issue such as advertisements to make the harm of e-cigarettes more known to the general public.

Overall: Going through the peer review checklist, there is a lot of content in the article and for good reason considering the topic, but I really appreciated how all of you organized the content so nicely, and it all was relevant to the article topic. In terms of bias, this topic is a really hard situation to remain neutral about, but I think you all did a good job weighing out the pros and cons such as in your smoking cessation section of your article. I loved the articles and images you all provided and the references used to support the information that you added to this topic. The articles and citations provided were up to date, they worked, and the sources did support the claims in the article. If there was one thing I might consider adding to the article, it would be a bit more information on what is an e-cigarette, what sort of variations it has out on the market, and its mechanism on how it works and what makes it harmful to carry or breathe in. — Preceding unsigned comment added by Selowe (talk • contribs) 06:28, 30 July 2024 (UTC)[reply]

Proposed Editing Plan

• Add Introduction of Electronic Cigarettes: History, Composition

Added excerpt from E-cigarettes

• Add to Other Effects: Impact on GI, dermatological manifestations (integumentary system), renal, hepatic
• Cut out repetitive paragraphs (revise Battery Adverse Effects, delete Suction, delete Adolescents, delete Methodological issue)

- Much less repetitive now

• Add more current references
• Change pictures
• Update current guidelines/sources (Regulations, EVALI)

- Added update on net impact

Rrmisra (talk) 19:14, 30 July 2024 (UTC)[reply]

See comments. Added updates and massively reduced text to ~10k as of 2/5/2025 Lfstevens (talk) 08:16, 5 February 2025 (UTC)[reply]

This article is too long to read and navigate comfortably. When the tag was added, its readable prose size was 20,100 words. Consider splitting content into sub-article or condensing it. The article size impacts usability in multiple ways: Reader issues, such as attention span, readability, organization, information saturation, etc. (when articles are large). Total article size should be kept reasonably low, particularly for readers using slow internet connections or mobile devices or who have slow computer loading. Some large articles exist for topics that require depth and detail, but typically articles of such size are split into two or more smaller articles.

Word count	What to do
this article 20,100 words	Almost certainly should be divided or trimmed
> 15,000 words	Almost certainly should be divided or trimmed.
> 9,000 words	Probably should be divided or trimmed.

— Isaidnoway (talk) 06:51, 19 January 2025 (UTC)—[reply]

Am trimming as hard as I can. So much is repetitive or outdated. Stay tuned. Lfstevens (talk) 01:09, 21 January 2025 (UTC)[reply]

@Lfstevens I hope you might have time to do more as this important article deserves translation to more languages Chidgk1 (talk) 07:40, 7 June 2025 (UTC)[reply]

So many articles; so little time. I've moved on to other topics. This one could probably be summarized as "Youth smoking now at record lows". Lfstevens (talk) 15:56, 7 June 2025 (UTC)[reply]

I am not an expert but to shorten this article I am going to remove all the info except that based on medically reliable sources published in 2020 or later. Because far more people vape nowadays so I guess more recent studies ought to be better. If you disagree feel free to rollback and explain why here Chidgk1 (talk) 13:58, 29 June 2025 (UTC)[reply]

I drastically shortened this to remove everything before the 2020s. Previously it said:

A 2017 review noted that the public found vaping to be safer than smoking.^[1]

A 2014 review concluded that few users are concerned about potential adverse health effects.^[2] A 2016 German survey reported that 21% consider vaping to be less harmful than smoking, 46% just as harmful, 16% thought they were more harmful, while 17% gave no answer.^[3]: 189 As of 2018^[update], under 50% of adults in the UK believe vaping is less harmful than smoking.^[3]: 20

A 2014 worldwide survey reported that 88% of respondents perceived vaping to be less harmful than smoking and 11% believed that vaping was absolutely harmless.^[4]

% of adult smokers who believed that vaping is as risky or more risky than smoking (2017)^[3]: 188

Country	Date	%
Republic of Korea	2016	66%
US	2016	37%
Netherlands	2015	32%
Canada	2016	30%
UK	2016	24%
Australia	2016	22%
Uruguay	2014	19%
Malaysia	2013	70%
Zambia	2014	57%
Thailand	2012	54%
Mexico	2014 to 2015	38%
Bangladesh	2014 to 2015	37%
Brazil	2012 to 2013	22%
China	2013 to 2015	15%

The largest age group contributing to the use and purchase of e-cigarettes are young adults, which include an age range from teens to 30's. A questionnaire examining college students demonstrated that current users believe that e-cigarettes are more convenient and taste and smell better than traditional tobacco products. Another notable result was the trend among current electronic cigarette users to have reported no previous use of tobacco. This would be contraindicative of what the original claims of e-cigarettes manufacturers when they were introduced to the market. While a majority of electronic cigarette users state the understanding of possible harm to their health, there is also the belief that they are safer than other forms of tobacco.^[5]

A 2015 PHE report noted a nation-wide US survey among adults that reported 11% thought vaping during pregnancy was less harmful than smoking, 51% thought it was as harmful, 12% thought it was more harmful, while 26% were unsure.^[3]: 190 A 2017 review concluded that the majority of survey respondents perceived vaping can carry health risks to mother and child, and that vaping was less harmful than smoking.^[6]

Over the 2015-2017 period, multiple surveys reported that youth believe vaping to be a safe substitute for smoking.^{[7][8][9][10][11]} A 2016 study reported that flavored vapes reduced the perception of tobacco use danger among youth.^[12] Another 2016 study reported that tobacco flavor increased harm perception while fruit and sweet flavors decreased harm perception among UK adolescents.^[12] Similarly, a 2016 study in the US reported that, for US adolescents, fruit-flavored e-cigarettes were perceived to be less harmful than tobacco flavored ones.^[12] E-cigarettes were the most commonly used nicotine delivery system youth as of the 2023 National Youth Tobacco Survey. E-cigarette use in high school students was reported to be decreasing despite increasing in middle school; about 2.8 million American youth use any tobacco product.^[13][14]

Data from two states in the Pregnancy Risk Assessment System (PRAMS) show that in 2015—roughly the mid-point of the study period—10.8% of the sample used e-cigarettes in the three months prior to the pregnancy while 7.0%, 5.8%, and 1.4% used these products at the time of the pregnancy, in the first trimester, and at birth respectively.^[15] According to National Health Interview Survey (NHIS) data from 2014 to 2017, 38.9% of pregnant smokers used e-cigarettes compared to only 13.5% of non-pregnant, reproductive age women smokers.^[16] A health economic study found that passing an e-cigarette minimum legal sale age law in the United States increased teenage prenatal smoking by 0.6 percentage points and had no effect on birth outcomes.^[17]

According to the CDC, E-cigarettes are not safe during pregnancy. "Although the aerosol of e-cigarettes generally has fewer harmful substances than cigarette smoke, e-cigarettes and other products containing nicotine are not safe to use during pregnancy. Nicotine is a health danger for pregnant women and developing babies and can damage a developing baby's brain and lungs. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby."^[18] Chidgk1 (talk) 14:44, 29 June 2025 (UTC)[reply]

Sources

^ Fracol M, Dorfman R, Janes L, Kulkarni S, Bethke K, Hansen N, Kim J (November 2017). "The Surgical Impact of E-Cigarettes: A Case Report and Review of the Current Literature". Archives of Plastic Surgery. 44 (6): 477–481. doi:10.5999/aps.2017.00087. PMC 5801784. PMID 29069879. ^ Cite error: The named reference Pepper201322 was invoked but never defined (see the help page). ^ a b c d Cite error: The named reference mcn182 was invoked but never defined (see the help page). ^ Tomashefski A (September 2016). "The perceived effects of electronic cigarettes on health by adult users: A state of the science systematic literature review". Journal of the American Association of Nurse Practitioners. 28 (9): 510–515. doi:10.1002/2327-6924.12358. PMID 26997487. S2CID 42900184. ^ Kelsh, Shelby; Ottney, Anne; Young, Mark; Kelly, Michelle; Larson, Rodney; Sohn, Minji (2023-03-07). "Young Adults' Electronic Cigarette Use and Perceptions of Risk". Tobacco Use Insights. 16: 1179173X231161313. doi:10.1177/1179173X231161313. ISSN 1179-173X. PMC 9996725. PMID 36911177. ^ McCubbin A, Fallin-Bennett A, Barnett J, Ashford K (February 2017). "Perceptions and use of electronic cigarettes in pregnancy". Health Education Research. 32 (1): 22–32. doi:10.1093/her/cyw059. PMC 5914445. PMID 28158490. ^ Cite error: The named reference Modesto-LoweAlvarado201722 was invoked but never defined (see the help page). ^ Schneider S, Diehl K (May 2016). "Vaping as a Catalyst for Smoking? An Initial Model on the Initiation of Electronic Cigarette Use and the Transition to Tobacco Smoking Among Adolescents". Nicotine & Tobacco Research. 18 (5): 647–653. doi:10.1093/ntr/ntv193. PMID 26386472. ^ Cite error: The named reference ClappJaspers201722 was invoked but never defined (see the help page). ^ Cite error: The named reference GreenhillDawkins201622 was invoked but never defined (see the help page). ^ McCausland K, Maycock B, Leaver T, Jancey J (February 2019). "The Messages Presented in Electronic Cigarette-Related Social Media Promotions and Discussion: Scoping Review". Journal of Medical Internet Research. 21 (2): e11953. doi:10.2196/11953. PMC 6379814. PMID 30720440. This article incorporates text by Kahlia McCausland, Bruce Maycock, Tama Leaver, and Jonine Jancey available under the CC BY 4.0 license. ^ a b c Cite error: The named reference Cormet-BoyakaZare201822 was invoked but never defined (see the help page). ^ Products, Center for Tobacco (2024-06-26). "Results from the Annual National Youth Tobacco Survey". FDA.[dead link] ^ Aly, Ameera Syafiqah; Mamikutty, Rokiah; Marhazlinda, Jamaludin (2022-10-31). "Association between Harmful and Addictive Perceptions of E-Cigarettes and E-Cigarette Use among Adolescents and Youth—A Systematic Review and Meta-Analysis". Children. 9 (11): 1678. doi:10.3390/children9111678. ISSN 2227-9067. PMC 9689130. PMID 36360406. ^ Kapaya, Martha (2019). "Use of Electronic Vapor Products Before, During, and After Pregnancy Among Women with a Recent Live Birth — Oklahoma and Texas, 2015". MMWR. Morbidity and Mortality Weekly Report. 68 (8): 189–194. doi:10.15585/mmwr.mm6808a1. PMC 6394383. PMID 30817748. ^ Liu, Buyun; Xu, Guifeng; Rong, Shuang; Santillan, Donna A.; Santillan, Mark K.; Snetselaar, Linda G.; Bao, Wei (2019). "National Estimates of e-Cigarette Use Among Pregnant and Nonpregnant Women of Reproductive Age in the United States, 2014-2017". JAMA Pediatrics. 173 (6): 600–602. doi:10.1001/jamapediatrics.2019.0658. ISSN 2168-6211. PMC 6547070. PMID 31034001. ^ Pesko, Michael F.; Currie, Janet M. (1 July 2019). "E-cigarette minimum legal sale age laws and traditional cigarette use among rural pregnant teenagers". Journal of Health Economics. 66: 71–90. doi:10.1016/j.jhealeco.2019.05.003. ISSN 0167-6296. PMC 7051858. PMID 31121389. ^ "E-Cigarettes and Pregnancy". Centers for Disease Control. March 2019.

I moved this here as the research is from previous decade so i guess out of date:

This section contains close paraphrasing of an external source, http://journal.frontiersin.org/article/10.3389/fonc.2015.00196/full (Copyvios report). Relevant discussion may be found on the talk page. Please help Wikipedia by rewriting this section in your own words. (May 2025) (Learn how and when to remove this message)

Concerns about carcinogenicity arise from both nicotine^[1] and from other vapor chemicals.^[2]

Evidence from in vitro and animal research does not indicate carcinogenicity in vivo.^[1] A 2014 Surgeon General report stated that the only relevant randomized trial "does not indicate a strong role for nicotine in promoting carcinogenesis in humans". It concluded that data is insufficient "to conclude that nicotine causes or contributes to cancer in humans, but there is evidence showing possible oral, esophageal, or pancreatic cancer risks".^{[3] : 116} However, a 2014 study suggested that vaping may be a risk factor for lung cancer.^[4] Nicotine in the form of nicotine replacement products is reported to be less of a cancer risk than smoking,^[5]: 115 and they vaping had not been shown to be associated with cancer.^[1]

As of 2015 it was not possible to conclude that nicotine itself is a complete carcinogen. In mice studies with NNK as an initiator, nicotine was reported to act as a promoter after injection or dermal absorption, but not after oral administration. In drinking water experiments, considerable first-pass metabolism of nicotine occurred before nicotine entered systemic circulation. As a result, serum concentration is much lower after ingestion than after intraperitoneal injection administration.^[6]

However, nicotine has been reported to promote metastasis by causing cell cycle progression, epithelial-to-mesenchymal transition, migration, invasion, angiogenesis, and avoidance of apoptosis.^[7] Nicotine promotes the growth of blood vessels, which can supply tumors and speed tumor growth.^[8] As of 2015, long-term vaping had not been assessed for malignancy in individuals with a susceptibility for tumor growth.^[9] The effects of nicotine on the sympathoadrenal system could stimulate growth in cancers already present.^[10]

Multiple in vitro experiments reported that nicotine in concentrations as low as 1 μM decreased the anti-proliferative and pro-apoptotic effects exerted by chemotherapeutics on multiple malignant cell lines. These effects were partially reverted by exposure to α-bungarotoxin (α-BTX), a α7-nAChR inhibitor. During radiotherapy (RT), nicotine administration was reported to increase survival of H460 and A549 lung cancer cells. This effect was likewise reduced by addition of α-BTX prior to nicotine addition and radiation. On this basis, it may be expected that use of nicotine products during cancer treatment reduces the effects due to reactions following interaction of nicotine with α7-nAChR.^[6]

Evidence from in vitro studies on cell cultures, rodents and humans inclusive of epidemiological studies indicate that nicotine may contribute in cancer development by stimulating important processes. Nicotine acts primarily by activation of nicotine acetylcholine receptors (NAR) and nicotine binds to these receptors with a higher affinity than acetylcholine. Furthermore, the tobacco-specific nitrosamines (TSNAs) NNN (N′-nitrosonornicotine) and the potent lung carcinogen NNK (4-(metylnitrosamino)-1-(3-pyridyl)-1-butanon) may be formed from nicotine after oral administration.^[6] E-cigarettes deliver NNK. Some evidence indicates that the NNK dose-response curve for cancer is highly nonlinear, with substantial risk at low doses.^[8]

A 2015 study reported that urine from vapers had low levels of NNAL (4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), which may suggest that endogenous formation of TSNA after nicotine inhalation is negligible. That data indicates that TSNA may be formed internally after absorption of nicotine through the oral mucous membranes and through the skin, while formation after lung absorption may be negligible. Thus, the toxicokinetics of nicotine may depend on the administration route.^[6]

The interaction of nicotine with NARs activates signaling pathways that trigger multiple reactions, such as increased cell proliferation and cell survival. Although NARs are the primary receptors, nicotine binding to β-ARs and EGFRs may also be important. Nicotine induces epithelial–mesenchymal transition, which is one of the vital steps for the acquisition of malignant phenotype. This transition allows the cell to acquire migratory properties, which may facilitate cancer metastases.^[6]

In May 2014, Cancer Research UK stated that very preliminary unpublished results "suggest that e-cigarettes promote tumour growth in human cells."^[11]

Nicotine enhanced tumor growth and progression after injection of malignant cells in mice. Enhancements were reported both after exposure by intraperitoneal injection, oral, and skin administration. Moreover, cotinine did also enhance tumor growth. Nicotine may inhibit antitumor immune response. It has been reported that exposure to nicotine adversely affects dendritic cells, a cell type that has an important role in anticancer immunosurveillance. Moreover, in studies on xenograft in mice, nicotine was reported to reduce the effects of radiotherapy and chemoradiotherapy.^[6]

No long-term research considers the cancer risk related to the relatively small level of exposure to the identified carcinogens in e-cigarette vapor.^[12][13] Their long-term use is anticipated to raise the risk of developing lung cancer.^[14]: 3 A 2015 study reported carcinogenicity was mainly evident in the lungs, mouth, and throat, which may be associated with nitrosamines, propylene glycol, and some flavoring additives.^[15] A 2019 review associated vaping with a possible risk of head and neck cancers.^[16]

Since e-liquids are made from tobacco they may contain impurities such cotinine, anabasine, anatabine, myosmine and beta-nicotyrine.^[17] The health implications of suchimpurities are not known.^[18] A 2016 review concluded, "impurities and nicotine degradation products such as nicotine-cis-N-oxide, nicotine-trans-N-oxide, myosmine, anabasine, and anatabine, which are very carcinogenic, can be reported in e-cigarette refill liquids. The molecules can lead to mutations in genes such as Ras (vital function in signal transduction of cell proliferation), p53 and retinoblastoma (with roles as tumour suppressors) as these molecules can form adducts with cellular DNA."^[19] The majority of e-cigarettes evaluated included carcinogenic TSNAs; heavy metals such as cadmium, nickel, and lead; and the carcinogen toluene.^[20] However, in comparison to traditional cigarette smoke, the toxic substance levels identified in e-cigarette vapor were 9- to 450-fold less.^[20]

Nicotine promotes endothelial cell migration, proliferation, survival, tube formation, and nitric oxide (NO) production in vitro, mimicking the effect of other angiogenic growth factors. In 2001, it was reported that nicotine was a potent angiogenic agent at tissue and plasma concentrations similar to those induced by light to moderate smoking. Angiogenic effects on tumor cells were found in breast, colon, and lung cancers. Similar results were demonstrated in in vivo mouse models of lung cancer, where nicotine significantly increased tumor size and numbers in the lung, and enhanced metastasis. At high enough concentration levels, nicotine becomes cytotoxic.^[6] Chidgk1 (talk) 14:46, 29 June 2025 (UTC)[reply]

Sources

^ a b c Jerry JM, Collins GB, Streem D (August 2015). "E-cigarettes: Safe to recommend to patients?". Cleveland Clinic Journal of Medicine. 82 (8): 521–526. doi:10.3949/ccjm.82a.14054. PMID 26270431. ^ Cite error: The named reference Cheng201422 was invoked but never defined (see the help page). ^ National Center for Chronic Disease Prevention Health Promotion (US) Office on Smoking Health (2014). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Surgeon General of the United States. pp. 1–943. PMID 24455788. ^ Cite error: The named reference NansseuBigna201622 was invoked but never defined (see the help page). ^ Cite error: The named reference mcn152 was invoked but never defined (see the help page). ^ a b c d e f g h Sanner T, Grimsrud TK (2015). "Nicotine: Carcinogenicity and Effects on Response to Cancer Treatment - A Review". Frontiers in Oncology. 5: 196. doi:10.3389/fonc.2015.00196. PMC 4553893. PMID 26380225. This article incorporates text available under the CC BY 4.0 license. ^ Schaal C, Chellappan SP (January 2014). "Nicotine-mediated cell proliferation and tumor progression in smoking-related cancers". Molecular Cancer Research. 12 (1): 14–23. doi:10.1158/1541-7786.MCR-13-0541. PMC 3915512. PMID 24398389. ^ a b Cite error: The named reference GlantzBareham201822 was invoked but never defined (see the help page). ^ Cite error: The named reference Collaco201522 was invoked but never defined (see the help page). ^ Mravec B, Tibensky M, Horvathova L, Babal P (February 2020). "E-Cigarettes and Cancer Risk". Cancer Prevention Research. 13 (2): 137–144. doi:10.1158/1940-6207.CAPR-19-0346. PMID 31619443. ^ Cite error: The named reference CancerResearchUK201422 was invoked but never defined (see the help page). ^ Cite error: The named reference Drummond201422 was invoked but never defined (see the help page). ^ Cite error: The named reference Orellana-Barrios201522 was invoked but never defined (see the help page). ^ Cite error: The named reference who162 was invoked but never defined (see the help page). ^ Cite error: The named reference QasimKarim201722 was invoked but never defined (see the help page). ^ Flach S, Maniam P, Manickavasagam J (September 2019). "E-cigarettes and head and neck cancers: A systematic review of the current literature". Clinical Otolaryngology. 44 (5): 749–756. doi:10.1111/coa.13384. PMID 31148389. S2CID 171094189. ^ Cite error: The named reference Hajek201422 was invoked but never defined (see the help page). ^ Cite error: The named reference SGUSReport201622 was invoked but never defined (see the help page). ^ Cite error: The named reference SinghLuquet201622 was invoked but never defined (see the help page). ^ a b Cite error: The named reference Rom201422 was invoked but never defined (see the help page).

Have asked at Wikipedia:Help desk#Fixing cites after text move? if possible to automate. If no easy way will do gradually over maybe a week Chidgk1 (talk) 11:55, 9 July 2025 (UTC)[reply]

Hello all,

I am drastically cutting stuff but as I am neither a vaper nor an expert I am not really sure about various stuff such as:

What is still valid when studies are ten years old? Far more people vape nowadays so recent studies should be measuring more people over a longer time I guess.

Which stuff is important enough for lead?

If any of you could edit a bit that would be great. Chidgk1 (talk) 07:32, 12 July 2025 (UTC)[reply]

I think the present structure is much too complicated. How about something like:

Harms

• Minor
• Lungs
  • Asthma
  • COPD
• Brain
• Rare or uncertain
  • Burns
  • Poisoning
  • Heart

Benefits of quitting smoking for vaping

• Sickness avoided
• Lives saved

Chidgk1 (talk) 10:04, 12 July 2025 (UTC)[reply]