The risk of lung injury from electronic cigarettes

Abstract

Topic Overview: E-cigarette, vaping associated lung injury (EVALI) is a recent outbreak in pulmonary health. The purpose of this literature review is to examine evidence regarding the risk of potential lung injury and the risk associated with occurrence of respiratory diseases induced by e-cigarette usage. Research Question: Do electronic cigarettes increase the risk of lung injury? PICO Elements: The population (P) studies was people who vape. The intervention (I) under review was vaping. The comparison (C) utilised adults who do not vape e-cigarettes. The outcome (O) was the risk of lung injury. Methods: A systematic search was carried out from multiple databases with the use of relevant keywords. Inclusion criteria for selecting studies included being published in English, in the past ten years and having examined the effects of e-cigarettes on lung health. Three randomised clinical trials, two prospective-cohort studies were selected and appraised using the CASP tool and one cross-sectional study was appraised using the AXIS tool. Results: Five out of six key-studies found that e-cigarette usage significantly induced oxidative stress and impaired lung function. This shows that e-cigarette are indeed likely to induce lung injury. Certain methodological limitations were found in all key-studies, pointing to the need for further research. Implications and Recommendations: Further research on the matter including larger sample sizes and improved methods is ideal to provide more evidence regarding e-cigarette usage repercussions, as they should not be regarded as a ‘healthy’ alternative to smoking. Awareness and health promotion should be considered in the future, diligent training about risk assessment and symptoms should be given to all healthcare professions, and laws regarding e-cigarette regulations should be re-evaluated.