Ozge BEYAZCICEK, Ersin BEYAZCICEK, Recep OZMERDIVENLI, Serif DEMIR

E-sigaralar: Yeni Bir Fenomen

Elektronik sigaralar, geliştirildiğinden beri, tüm dünyada her geçen gün artan bir pazara sahiptir. Günümüzde e-sigara, tütün kullanımı insidansını azaltabilecek yeni bir “tütün” endüstrisini temsil etmektedir. Elektronik nikotin verme sistemi olarak da bilinen elektronik sigaralar minimal bir araçla aerosol haline getirilmiş nikotini vermek üzere tasarlanan cihazlardır. Elektronik sigaraların asıl amacı kullanıcıya sigara içiyor hissini tütün kullanmadan vermektir. Esigara üreticileri elektronik sigaraları, sigarayı azaltmanın ya da tamamıyla bırakmanın bir yolu olarak pazarlamakla birlikte pek çok kullanıcı, özellikle gençler, e-sigarayı tütün sigarasından daha güvenli olduklarını düşündükleri için tercih etmektedirler. Birçok e-sigara markası marketlerde satılmakta ve bunlara her gün yeni bir tanesi eklenmektedir. Ek olarak, e-sigaralar için birçok farklı tatlandırıcı madde içeren ve birbirinden farklı aromalara sahip çeşitli e-likitler vardır. Bu e-likitlerin ana içerikleri; nikotin, propilen glikol ve bitkisel gliserindir. Çeşitli e-likit içerikleri nedeniyle, esigaranın inhalasyondan sonra insan sağlığı üzerindeki etkisi hala belirsizdir. Bu derlemede, e-sigaranın tarihi, çalışma mekanizması, gelişimi ve pazarlaması, bölümleri ve özellikleri, içerdiği maddeler, nikotin ve nikotinin farmakokinetiği, ülkelerin getirdiği düzenlemeler hakkında genel bilgiler ele alınmıştır.

E-cigarettes: A Novel Phenomenon

Electronic cigarettes (e-cig), since it developed, have very big market all over the world, and which increases day byday. Nowadays e-cigarette represents a new “tobacco” industry that could reduce the incidence of tobacco smoking.Electronic cigarettes are electronic delivery system are devices designed to deliver aerosolized nicotine with at least onevehicle. The main purpose of electronic cigarettes is to give the user the feeling of smoking without using tobacco. Ecigarette suppliers are marketed e-cigs as a way to reduce or completely quit smoking, and many users, especiallyyoung, prefer e-cigarettes because they thought it was safer than tobacco cigarettes in general. Many e-cigarette brandsare currently sold in the markets and a new one is added every day. In addition to this there are various e-liquids withdistinctive aromas which contain many different types of sweetening agents for e-cigarettes. Main ingredients of thesee-liquids are nicotine, propylene glycol and vegetable glycerin. Due to various e-liquid ingredients, e-cigarette's effecton human health after inhalation is still undetermined. In this review is focused on general information about the ecigarette history, its working mechanism, development and marketing, parts and feature of it, ingredients, nicotine andnicotine's pharmacokinetics, regulation of the countries.

PDF

___

1. Beyazcicek O. The effects of new generation ecigarette components on ENaC, CFTR, CaCC channels, and airway surface liquid height [PhD dissertation]. Duzce: Duzce University; 2019.
2. Gilbert HA. Smokeless non-tobacco cigarette. Google Patents; 1965.
3. Brown J, West R, Beard E, Michie S, Shahab L, McNeill A. Prevalence and characteristics of ecigarette users in Great Britain: findings from a general population survey of smokers. Addict Behav. 2014; 39(6): 1120-5.
4. Brown J, Beard E, Kotz D, Michie S, West R. Realworld effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study. Addiction. 2014; 109(9): 1531-40.
5. Zhu SH, Zhuang YL, Wong S, Cummins SE, Tedeschi GJ. E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys. BMJ. 2017; 358: j3262.
6. Pasquereau A, Guignard R, Andler R, Nguyen-Thanh V. Electronic cigarettes, quit attempts and smoking cessation: a 6-month follow-up. Addiction. 2017; 112(9): 1620-8.
7. Russell M. Low-tar medium-nicotine cigarettes: a new approach to safer smoking. Br Med J. 1976; 1(6023): 1430-3.
8. Hartmann-Boyce J, McRobbie H, Bullen C, Begh R, Stead LF, Hajek P. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2016; 9(9): CD010216.
9. Kalkhoran S, Glantz SA. E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. Lancet Respir Med. 2016; 4(2): 116-28.
10.Brown CJ, Cheng JM. Electronic cigarettes: product characterisation and design considerations. Tob Control. 2014; 23 (Suppl 2): ii4-10.
11. El-Hellani A, Salman R, El-Hage R, Talih S, Malek N, Baalbaki R, et al. Nicotine and carbonyl emissions from popular electronic cigarette products: correlation to liquid composition and design characteristics. Nicotine Tob Res. 2018; 20(2): 215-23.
12. Schroeder MJ, Hoffman AC. Electronic cigarettes and nicotine clinical pharmacology. Tob Control. 2014; 23(Suppl 2): ii30-5.
13. Zhu SH, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, et al. Four hundred and sixty brands of ecigarettes and counting: implications for product regulation. Tob Control. 2014; 23(Suppl 3): iii3-9.
14.Barrington-Trimis JL, Samet JM, McConnell R. Flavorings in electronic cigarettes: an unrecognized respiratory health hazard? JAMA. 2014; 312(23): 2493-4.
15.Cooper M, Harrell MB, Perez A, Delk J, Perry CL. Flavorings and perceived harm and addictiveness of e-cigarettes among youth. Tob Regul Sci. 2016; 2(3): 278-89.
16. Leigh NJ, Lawton RI, Hershberger PA, Goniewicz ML. Flavourings significantly affect inhalation toxicity of aerosol generated from electronic nicotine delivery systems (ENDS). Tob Control. 2016; 25(Suppl 2): ii81-ii7.
17. Tierney PA, Karpinski CD, Brown JE, Luo W, Pankow JF. Flavour chemicals in electronic cigarette fluids. Tob Control. 2016; 25(e1): e10-5.
18.Clapp PW, Jaspers I. Electronic cigarettes: their constituents and potential links to asthma. Curr Allergy Asthma Rep. 2017; 17(11): 79.
19.Bowen S-J, Hull J. The basic science of cystic fibrosis. Paediatrics and Child Health. 2015; 25(4): 159-64.
20. Etter J-F, Due TV, Perneger TV. Saliva cotinine levels in smokers and nonsmokers. American Journal of Epidemiology. 2000; 151(3): 251-8.
21. Knorst MM, Benedetto IG, Hoffmeister MC, Gazzana MB. The electronic cigarette: the new cigarette of the 21st century? J Bras Pneumol. 2014; 40(5): 564-72.
22. Taylor M, Carr T, Oke O, Jaunky T, Breheny D, Lowe F, et al. E-cigarette aerosols induce lower oxidative stress in vitro when compared to tobacco smoke. Toxicol Mech Methods. 2016; 26(6): 465-76.
23. Fearon IM, Eldridge A, Gale N, Shepperd CJ, McEwan M, Camacho OM, et al. E-cigarette Nicotine delivery: Data and learnings from pharmacokinetic studies. Am J Health Behav. 2017; 41(1): 16-32.
24. D'Ruiz CD, Graff DW, Yan XS. Nicotine delivery, tolerability and reduction of smoking urge in smokers following short-term use of one brand of electronic cigarettes. BMC Public Health. 2015; 15: 991.
25. Hajek P, Przulj D, Phillips A, Anderson R, McRobbie H. Nicotine delivery to users from cigarettes and from different types of e-cigarettes. Psychopharmacology (Berl). 2017; 234(5): 773-9.
26. Dawkins LE, Kimber CF, Doig M, Feyerabend C, Corcoran O. Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects. Psychopharmacology (Berl). 2016; 233(15-16): 2933- 41.
27. Zhang Y, Sumner W, Chen DR. In vitro particle size distributions in electronic and conventional cigarette aerosols suggest comparable deposition patterns. Nicotine Tob Res. 2013; 15(2): 501-8.
28.Benowitz NL, Hukkanen J, Jacob P. Nicotine chemistry, metabolism, kinetics and biomarkers. Nicotine Psychopharmacology. Berlin: Springer; 2009. p. 29-60.
29. Stepanov I, Fujioka N. Bringing attention to ecigarette pH as an important element for research and regulation. Tob Control. 2015; 24(4): 413-4.
30. Tomar SL, Henningfield JE. Review of the evidence that pH is a determinant of nicotine dosage from oral use of smokeless tobacco. Tobacco Control. 1997; 6(3): 219-25.
31. Farsalinos KE, Gillman G. Carbonyl emissions in ecigarette aerosol: a systematic review and methodological considerations. Front Physiol. 2017; 8: 1119.
32. Sosnowski TR, Odziomek M. Particle size dynamics: toward a better understanding of electronic cigarette aerosol interactions with the respiratory system. Front Physiol. 2018; 9: 853.
33. Sosnowski TR, Kramek-Romanowska K. Predicted deposition of e-Cigarette aerosol in the human lungs. J Aerosol Med Pulm Drug Deliv. 2016; 29(3): 299- 309.
34. Manigrasso M, Buonanno G, Fuoco FC, Stabile L, Avino P. Aerosol deposition doses in the human respiratory tree of electronic cigarette smokers. Environ Pollut. 2015; 196: 257-267.
35. Scungio M, Stabile L, Buonanno G. Measurements of electronic cigarette-generated particles for the evaluation of lung cancer risk of active and passive users. Journal of Aerosol Science. 2018; 115: 1-11.
36. Ehtezazi T, Horsfield MA, Barry PW, O'callaghan C. Dynamic change of the upper airway during inhalation via aerosol delivery devices. Journal of Aerosol Medicine. 2004; 17(4): 325-34.
37.Cho JH, Shin E, Moon SS. Electronic-cigarette smoking experience among adolescents. J Adolesc Health. 2011; 49(5): 542-6.
38. Sutfin EL, McCoy TP, Morrell HE, Hoeppner BB, Wolfson M. Electronic cigarette use by college students. Drug Alcohol Depend. 2013; 131(3): 214- 21.
39.Besaratinia A, Tommasi S. An opportune and unique research to evaluate the public health impact of electronic cigarettes. Cancer Causes Control. 2017; 28(10): 1167-71.