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Farsalinos and Polosa: two active researchers in the field of e-cigarette and related topics

Dr Konstantinos Farsalinos is one of the most prolific researchers in the domain of the electronic cigarette (EC) and he is keeping on publishing from his office at the Onassis Cardiac Surgery Center, in Kallithea, Greece. Such work greatly contributes to customer’s information and policy in the European Union.

Pioneering in the study on the cardiovascular effects of the e-cigarette, Dr Farsalinos has contributed to the improvement of experimental protocols to be applied in the studies on this product and is also very active on the political scene by attending several meetings at the European Commission to present his scientific perspectives.

After he has recently announced the results of his investigation into the behaviour of vapers, he comes back to scene with a condensate of worldwide studies that he has analyzed with the help of another well-known researcher, Riccardo Polosa.

In this peer-reviewed publication, Farsalinos and Polosa address a pertinent question: is the electronic cigarette without danger? For that, they are screening 114 independent studies on the EC.

With this scientific paper [1] available in full upon (free) subscription, one dives into over one hundred clinical and chemical studies of which 97 relate directly to the electronic cigarette.

We appreciate the authors’ statement regarding their independency with respect to any funding agency. In this study, it clearly appears that this work has received no sponsoring, has not been ordered by any company or organization, and its publication results from a peer-review process.

All Big Issues addressed

In the twenty ages of this document, the main topics are: a discussion about nicotine and its effects and toxicity, presentation of chemical studies, cytotoxicity studies, clinical studies and case studies, research surveys, studies on passive vaping, and other matters such as the use of the e-cigarette by specific subpopulations (i.e. patients with respiratory disorders or psychiatric illnesses), accidental exposure to nicotine, electrical accidents, fires, and also some consideration over the use of the e-cigarette by young people and non-smokers. The authors have also pointed out a summary of methodological errors and typical cases of result misinterpretation.

Crystal clear conclusions on the risk reduction

Here is in substance the message carried over this publication:

The vaping is a less harmful alternative to smoking tobacco cigarettes. Toxic substances in vapours are in substantially lower concentration as in tobacco smoke and may reach comparable levels as in pharmaceutical nicotine products. But no by-product of combustion nor fine particles are present in vapors.

Misinterpretation or mispresentation of scientific studies has often lead to an exacerbated harmfulness of vaping. Notwithstanding obvious risks associated to their use, e-cigarettes’ dangerousness doesn’t compare with the pandemic lethal impact of tobacco. The methodological approach supported in this paper should focus on any risk associated to vaping to the risk of continuing or relapsing back to smoking.

The authors recommend the use of the e-cigarette as a substitute of the conventional one, versus the low efficacy of approved medications for smoking cessation.

They point out several caveats associated to the evaluation of the risk in the context of the growing popularity of atomisers and the need for regulations, especially to restraint the access of such products to the youth while making it more accessible for the (former) smokers than conventional cigarettes. A real dilemma and a battle in perspective.

[1] Farsalinos, K. E., & Polosa, R. (2014). Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review.Therapeutic advances in drug safety, 5(2), 67-86.