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Electronic cigarettes: harm reduction or another addiction?; the dental perspective Richard Holliday Catherine Horridge Margaret Corson Dental Update 2024 41:8, 707-709.
Authors
RichardHolliday
BDS(Hons), MFDS RCS(Ed)
Academic Clinical Fellow/Specialty Registrar in Restorative Dentistry
The use of electronic cigarettes (e-cigarettes) has grown rapidly over recent years with an estimated 2.1 million people ‘vaping’ in the UK. E-cigarettes are battery-powered devices which simulate smoking. A heated element vaporizes chemicals, usually nicotine plus diluents like propylene glycol and glycerine as well as flavourings, which are then inhaled.
Only limited research exists on the safety and efficacy of e-cigarettes and opinions are divided in the health profession as to whether they should be endorsed or not. Similarly, at a regulatory level and among the general public, an intense debate is taking place as to how they should be considered.
In this paper we will review the available research with regards to e-cigarette contents, safety and health effects. As the mouth will take the initial insult from the vapour, we consider the potential effects on oral health as well as discussing the current regulatory and political position, so that we can be in a more informed position to advise our patients.
Clinical Relevance: As dental health professionals it is already our duty of care to educate patients about the impact of smoking on their oral health. So if patients look to alternatives in the form of e-cigarettes, it is important that we are informed about this new technology and its potential effects on oral health to be able to advise in discussions on the subject.
Article
The use of electronic cigarettes (e-cigarettes) has seen a ‘meteoric rise’1 over recent years with an estimated 2.1 million people in the UK using e-cigarettes.2 A ‘vaping’ culture is blossoming with e-cigarette shops and cafes, sometimes referred to as vaporiums, springing up across the UK. Worldwide sales of e-cigarettes have been estimated at $1.5 billion a year with economic projections predicting sales of e-cigarettes surpassing traditional tobacco products by 2023.3
An intense debate is taking place in the UK with regards to the appropriate level of regulation for e-cigarettes, with recent debates in the House of Commons and Lords, as well as headline features in the media. E-cigarettes are currently unlicensed but will be regulated under the EU Tobacco Products Directive from May 2016.2
The first record of e-cigarettes was in 1965 when a US patent was filed by Herbert Gilbert (US Patent Office # 3200819).4 The recent explosion in e-cigarette popularity is often linked to Hon Lik, a Chinese pharmacist and heavy smoker. He filed a US patent in 2005 for an ‘electronic atomization’ cigarette that contains nicotine without tar’,5 apparently invented after his father, a heavy smoker, died of lung cancer. Hon then developed his business ‘Ruyan’ meaning ‘like smoke’ which recently (2012) sold for $75 million to the Imperial Tobacco Group Plc (Ruyan is now called Dragonite International Ltd).6 Commentators7 have likened the tobacco industry's growing interest in e-cigarettes as an attempt to avoid the ‘Kodak moment’ when the world's leading maker of camera film realized that the world had gone digital and it was too late to catch up.
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