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Harm Reduction and bias: a review confirms that ecigs are less harmful, but high-quality studies are much needed

"It is surprising to note that there are very few studies that can be considered truly informative of the risk-benefit ratio of new technologies with reduced risk in terms of their impact on health. We are proud to say that CoEHAR research ranks among the best in the current scientific landscape"

A pioneering review evaluates the link between the use of ecig and the implications on health. The review examines 755 case studies, conducted in the last five years, which have reported damage to health caused by electronic cigarettes.

The European Commission recently issued a report which emphasized the damage caused by the use of electronic nicotine-releasing devices. At the same time, it requested for ecigs the same stringent rules valid for all tobacco products in the market. However, it is unclear on what basis the decision by Commission came from. Indeed, it seems that the sources used by government bodies in Brussels came from poor-quality studies.

A pioneering review evaluates the causal link between the use of ecig and the implications on health and examines 755 studies, conducted in the last 5 years, which have reported health damage caused by electronic cigarettes.

According to the research, only 37 are eligible for precise criteria of scientific quality.

By comparing the selected studies and critically evaluating their contents, it was possible to say that electronics are safer than conventional cigarettes.

When it comes to disseminating accurate scientific data about the potential harm of electronic cigarettes, we should proceed based on studies that can be defined scientifically relevant” – explained prof. Riccardo Polosa, founder of CoEHAR and head of a pool of international researchers.

Proper optimization of the study, the use of clinically relevant clinical-functional indicators, and the correct assessment of the correlation are essential criteria for reaching scientifically valid results” – added Cother Hajat of the University of the United Arab Emirates.

A scoping review of studies on the health impact of electronic nicotine delivery systems” is a review that assessed the argumentative strength, quality and structure of studies that associate the use of electronic nicotine-releasing devices with a particular negative outcome in terms of health. Thus, certifying the relationship between use and possible pathological degenerations.

To assess the impact of ecigs on health, it is necessary to compare the benefits of quitting smoking with the potential harm or benefits of switching to electronics.

Using a rating scale to determine the quality of the studies, it was found that of the 37 studies evaluated, as many as 54% received a low score.

The studies that assessed a potential positive outcome in terms of health deriving from these devices were of higher quality, unlike the low overall quality of those focused solely on possible harmful effects.

What is alarming is that the qualitatively inadequate studies were decisive for the evaluation expressed by the European Commission on the use of ecigs: one of these, for example, underlined the correlation between the use of electronic devices and the possibility of incurring a myocardial infarction.

A subsequent analysis of the study showed that the data used were before the first use of an e-cigarette by at least a decade.

Due to such research, the common perception of ecigs has worsened, highlighting the need to disseminate reliable information on the risks and benefits of these products.

The review also shows no evidence of any links between the use of electronic devices to cardiovascular diseases: on the contrary, there are benefits for patients suffering from hypertension.

A similar pattern was identified for patients with lung diseases, such as COPD.  Switching from conventional cigarettes to e-cigarettes has resulted in an improvement in disease exacerbations, without evidence of long-term pulmonary deterioration or an increased risk of developing asthmatic forms.

Results underlined by different studies conducted by the CoEHAR, the Center of Excellence for the Acceleration of Harm Reduction of the University of Catania, whose founder, Riccardo Polosa, author of the study, commented on the results as follows: “It is surprising to note that there are very few studies that can be considered truly informative of the risk-benefit ratio of new technologies with reduced risk in terms of their impact on health. We are proud to say that CoEHAR research ranks among the best in the current scientific landscape. Therefore, it is alarming to note that many health authorities rely on poor quality research to insist on perpetuating the disinformation campaign against electronic products”.

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