Counseling patients with asthma and allergy about electronic cigarettes: an evidence-based approach

Objective To provide an evidence-based review of common safety concerns and emerging potential benefits deriving from the regular use of electronic cigarettes (ECs) and thus improve counseling between physicians and their patients with asthma and allergy using or intending to use ECs. Data Sources Peer-reviewed articles from the National Center for Biotechnology Information's PubMed about ECs, risk reduction, and harm reversal were appraised. Study Selection Keywords used in the search were smoking cessation, electronic cigarette, counseling, asthma, allergy, nicotine, tobacco harm reduction, and harm reversal. Results Vapor toxicology is far less problematic compared with combustible cigarettes, with exclusive EC users having substantial lower risk of exposure to tobacco smoke toxicants and carcinogens compared with cigarette smokers. Moreover, there is emerging evidence that switching to regular EC use could produce significant respiratory health gains. Conclusion Inaccurate and inconsistent information about EC safety and efficacy, tobacco harm reduction, and nicotine toxicity is being offered to smokers and EC users. In particular, most health care professionals cannot communicate a clear and consistent message to their patients with respiratory problems and allergy who use or intend to use ECs. Therefore, it is important for the medical community to take an active role in considering all the pathways available to a smoking patient and recommend those that provide the greatest probability of eliminating exposure to tobacco smoke, including ECs.