电子烟的危害是香烟的7倍是真的吗?

电子烟的危害是香烟的7倍是真的吗?先不管这篇文章是否为电子烟打call,但我认为能将事实摆清楚很重要,而不是直接copy+paste“电子烟比香烟毒7倍”这样的无脑信息,这样电子烟才能更好地向前发展。不管国标的限制与否,以及相关部委的态度及措施,我们电子烟民要对自己使用的东西有清醒的认识和自主的判断,才不容易被各方带偏。

电子烟的危害是香烟的7倍是真的吗?

2015年,英国公共卫生部(Public Health England,PHE)已经公开宣布电子烟比传统香烟至少减害95%,不得不说是一剂电子烟烟民的强心针。然而,尽管在国内自媒体“电子烟比香烟毒7倍”的论调大行其道,“减害95%”已经成为电子烟的护身法宝,但大多数电子烟民并不了解为什么会更安全,为什么是95%,而不是94%、96%,凡叔带你追根溯源地来捋一捋。
 

这个故事始于2014年,当时英国电子烟刚刚兴起,因此PHE委托了一项研究,目的是研究电子烟对健康的影响。一年之后,由英国诺丁汉大学烟草与酒精研究中心的John Britton和Ilze Bogdanovica撰写的2015年度报告被提交给PHE。在仔细审查报告后,PHE官宣:“目前市场上使用电子烟产品的危害可能非常低,当然远低于吸烟,被动接触电子烟蒸气的健康风险很可能是极低“。
 

 

该报告首先指出“电子香烟含有有毒物质,包括少量甲醛和乙醛”等物质,但“ 这些物质的含量远远低于传统卷烟”。

然后继续解释与吸烟相比,从吸烟中获得的危害减少,并描述了使用电子烟优于尼古丁替代疗法(NRT)的一些优点。“电子烟以模仿吸烟的形式提供尼古丁传递,具有社会可接受的非医学形象,使用户能够保留其吸烟者的身份特征,但没有冒烟的风险”。

"因此,与NRT不同,特别是如果可以改善尼古丁的输送方式以更接近地模仿卷烟,这些产品具有潜在的吸引力,可以挑战烟草作为尼古丁使用者首选产品的地位”,报告作者补充说。“选择转用电子烟作为替代品和更安全的尼古丁来源,作为个人生活方式选择而不是医疗服务,对于目前难以接触现有方法的吸烟者具有巨大的潜力。”

随后,PHE发布了自己的报告:“这些结论与国际专家团队的评估相吻合,评估了吸烟风险低于5%的风险,另一个国际团队对相关文献进行了全面审查,得出的结论是电子烟烟液可以含有烟草烟雾中存在的一些有毒物质,但含量要低得多。电子烟使用的长期健康影响尚不清楚,但与卷烟相比,电子烟可能会少得多,如果有的话,对使用者或旁观者有害。”

为了更好地理解“至少减害95%”陈述的起源,我们需要看一下由独立科学药物委员会(Independent Scientific Committee on Drugs,ISCD)召集的国际专家小组进行的另一项研究。后者的研究人员“开发了一个多标准决策分析模型,该模型描述了与使用含尼古丁产品相关的不同类型伤害的相对重要性”。

他们分析了12种产品,确定了14个危害标准,其中7个对使用者构成伤害标准,另外7个对周围群众有伤害可能性。研究者使用100定义为特定标准下最有害产品对每个标准的所有产品进行平均伤害评定,并将得分零定义为无害。

结果如下:
 

如上所述,ENDS(电子烟类)得分低于5分,这意味着此类产品仅为吸烟风险的5%。换句话说,“电子烟比香烟至少95%更安全”。

在审查了相关的科学文献之后,PHE得出结论,与吸烟相关的危险相比,与吸烟有关的危险可能“ 非常低” 。

为了确保调查结果准确,PHE还研究了蒸气中的化合物,特别是甲醛和丙烯醛。

关于这些有害物质的第一项研究是2014年日本时报首次提到的,根据该研究,“在各种电子香烟的测试过程中,其中一种负责甲醛的排放比烟草卷烟高10倍”。

然而,PHE已经解释说,这些有毒物质排放只发生在电子烟液过热时。并且,上述日本研究从未在任何学术期刊发表过。

根据2017年美国加州公共卫生部(CDPH)的实验证明,当加热到250度以上才会逐渐大量产生甲醛、乙醛等有害物质。
 

几个月后,在2015年1月,一项类似的研究被公布,根据该研究,“当电子烟以最大功率使用并持续3到4秒时,气溶胶中发现的甲醛比率比烟草高5到15倍”。

然而,在回应这一点时,PHE已经正式解释过:“这些结果是通过在吸烟机上进行测试而获得的,并且没有人会在这样的动力下进行如此长时间的抽吸”。此外,当电子烟用户感觉干渴时,他们本能地吐出蒸气,因为难以忍受的味道,吸烟机器检测不到的味道。因此,尽管在电子液体过热的情况下这些有毒物质的存在是不可否认的,但没有一种物质会被反复吸入。

雅典奥纳西斯心脏外科中心和希腊帕特雷大学的著名反烟专家Konstantinos Farsalinos博士和他的研究员进行了一项研究证实了这些陈述。

Farsalinos博士的报告提到,参与该研究的每个测试者都没有能够在与吸烟机相同的条件下进行vaping。由于烟雾的影响,所有人都被迫吐出蒸汽。此外,他说,在正常使用情况下,气溶胶中存在的有毒化合物水平“ 不存在或可忽略不计”。

同样,关于丙烯醛,其他科学家已经证明,“电子烟民尿液中丙烯醛和巴豆醛的含量比烟草吸烟者低得多”。

注意:只有在恶劣和不切实际的条件下使用时,蒸发器产生的甲醛含量高于吸烟量。在正常使用中,电子烟产生的蒸汽含有“不存在或可忽略不计”的有毒化合物。

2015年的另一项研究将电子烟与肺部健康问题联系在了一起。研究人员通过将试验白鼠锁定在一个盒子中并将它们暴露在电子烟的气溶胶中,研究小组得出结论,vaping会导致“炎症和肺部感染 ,甚至癌症 “。

PHE再一次指出这项研究存在一些问题。

1. 电子烟只应被视为降低吸烟风险的工具。因此,任何旨在突出由vaping引起的问题的研究,都必须将它们与吸烟引起的问题进行比较,而这项研究并没有这样做。

2. 暴露于电子烟蒸气的小鼠组比对照组“更加紧张”,并且已知压力会影响“细菌和病毒反应”。因此,这项研究的结果再次被认为是不可靠的。

3. 此外,鉴于老鼠的代谢特性限制,他们也更容易“引发重复性尼古丁中毒”。英国卫生部解释说,受体体重加速降低,免疫力减少和寿命变短“更可能是由长期压力和高浓度尼古丁中毒引起的,而非暴露于自由基”,特别是根据研究中对自由基含量,电子烟的气溶胶所含“比烟草卷烟低1000倍”。

注:自由基是不稳定的和高反应性的分子。简单地说,体内的氧气被分成单个原子,伴随着不匹配的电子。问题是电子成对地工作,因此那些被隔离的(称为自由基)将寻找与其形成一对的其他电子,这个过程会破坏细胞,DNA和蛋白质的组成。自由基在香烟烟雾中大量存在,并且已知会引起各种癌症,心血管疾病和皮肤老化。

同年,另一项研究揭示了类似的结果。然而,正如PHE指出的那样,“再一次,没有与吸烟进行比较”。

电子烟的危害是香烟的7倍是真的吗?目前使用电子烟时目前报告的多数症状是口腔局部刺激和口腔干燥。关于呼吸道,有研究显示患有哮喘的烟民使用电子烟后病情有所改善。另一项研究发现使用电子烟1年后对人体没有显著影响。

参考资料:

[1] Britton, J. and Bogdanovica, I., Electronic cigarettes: A report commissioned by Public Health England. London: Public Health England, 2014

[2] McNeill, A., Brose, L.S., Calder, R., Hitchman, S.C., Hajek, P., and McRobbie, H., E-cigarettes: an evidence update – A report commissioned by Public Health England, 2015

[3] Nutt, D. J., et al., Estimating the harms of nicotine-containing products using the MCDA approach.European addiction research, 2014

[4] Hajek, P., et al., Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction, 2014

[5] Jensen, R. P., et al., Hidden Formaldehyde in E-Cigarette Aerosols. New England Journal of Medicine, 2015

[6] Farsalinos, C., E-cigarette aerosols generates high levels of formaldehyde only in ‘dry puff’ conditions. Addiction, (in press)

[7] Hecht, S.S., et al., Evaluation of toxicant and carcinogen metabolites in the urine of e-cigarette users versus cigarette smokers. Nicotine & Tobacco Research, 2014

[8] Sussan, T. E., et al., Exposure to Electronic Cigarettes Impairs Pulmonary Anti-Bacterial and Anti-Viral Defenses in a Mouse Model. PLoS One, 2015

[9] Lerner, C.A., et al., Vapors produced by electronic cigarettes and e-juices with flavorings induce toxicity, oxidative stress, and inflammatory response in lung epithelial cells and in mouse lung.PLoS One, 2015

[10] Hajek, P., et al., Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction, 2014

[11] Polosa, R., et al., Effect of smoking abstinence and reduction in asthmatic smokers switching to electronic cigarettes: evidence for harm reversal. Int J Environ Res Public Health, 2014

[12] McRobbie, H., et al., Electronic cigarettes for smoking cessation and reduction.Cochrane Database Syst Rev, 2014

[13] Alistair Servet,How is vaping 95% safer than smoking, 2019

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