Electronic cigarette and other electronic nicotine release systems: review of evidence on a controversial topic

Introduction: e-cigarettes are systems that produce and release aerosol that contains nicotine and other substances. They have been controversial in the scientific community that works on tobacco control ever since they were created. There is evidence suggesting they are an alternative therapy for tobacco cessation and other studies prove they are harmful to health, and they end up being the door that welcomes young people to the world of nicotine addiction. Objective: to collect evidence on e-cigarette in connection with: components, risks to the health, tobacco cessation, impact on the population and normative and regulatory aspects. Method: Review of the literature. Bibliographic search on PubMed, MEDLINE, SCOPUS, Redalyc, Scielo, LiLACS, Dialnet, ScienceDirect, as well as in other documents of the World Health Organization, scientific societies, websites dedicated to consumers and the national and international laws. Results: 130 documents were reviewed, and the 63 most relevant ones served as the grounds for the study. There is scientific evidence on the toxic and carcinogenic content of liquids and aerosols of e-cigarettes, as well as on their negative effect on cardiovascular and respiratory health. We present controversial studies on its effectiveness to give up smoking, evidence on how e-cigarettes have a negative influence on the initiation of consumption by the young and on ex-smokers relapse. The study also analyses the national and international norms regulating e-cigarettes. Conclusions: health professionals must not recommend the use of e-cigarettes, since they are not safe and expose consumers and the general population to its direct and indirect harmful effects.