COMPARATIVE EFFECTS OF ALTERNATE TOBACCO PRODUCT (ELECTRONIC CIGARETTE) AND TRADITIONAL TOBACCO SMOKING ON VARIOUS ORGAN/SYSTEMS: A GUIDE TO REGULATORS AND HEALTH POLICY MAKERS.

Traditional Tobacco smoking (TTS) is globally known as the single largest avoidable risk factor for a broad range of diseases. Over a century ago, there has been a wide spread of tobacco cigarettes, originating particularly from the Americas; and most recently alternative tobacco products, such as e-cigarettes aerosol (ECA) and smokeless tobacco. This is due to the perceived safety of the latter. There are several indications that frequent e-cigarette use causes possible direct and indirect health threats, requiring urgent regulatory provisions particularly in resource constrain setting. Data for this review were gotten through a rigorous search of scientific literatures on PubMed, Elsevier, Google scholar and Scopus. The deleterious health effects of ECA have been linked largely to the e-juice or e-liquid which majorly contains nicotine, flavorings, propylene glycol and other unregulated additives. In the respiratory system, TTS and ECA cause increase in pulmonary macrophage count and higher cell influx. However, TTS caused a higher lipid peroxidation, while ECA caused a negative shift in the histology of the lungs, featuring an increase in volume density of the alveolar space. Studies involving the cardiovascular system explored the constituents such as nicotine, linked to atherosclerosis; cardiac tissue remodeling and cardiotoxic thermal metabolites of propylene glycol. On cardiac tissue remodeling, ECA caused significant increase in angiogenesis in mouse heart tissues, coupled with increase collagen production but not tissue fibrosis. This suggests that acute exposure to ECA did not adversely affect contractile functions or fibrosis. However, this was contrary with TTS, which showed inhibition of angiogenesis and induction of cardiac fibrosis. The increasing use of ECA amongst young adults showed more tendency for neurological defects when compared with TTS, this is mainly due to combinatory neurotoxic effects of nicotine, flavorings, formaldehyde, etc., causing a negative effect on cognition and attention span.

Putting these together, Uncontrolled spreading of these unregulated and addictive products is creating inconsistent quality assurance in resource constrain countries resulting in public health risk. There is therefore an urgent need for the regulation of these products and further research carried out on long-term safety of e-cigarettes, while national health regulators and policy makers should provide informed policies on the use of e-cigarettes and other alternative tobacco products.