Health Health wants to ban smoking in cars and put an end to electronic cigarettes
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Smoking Experts criticize the ill-advised decision of the FDA to give the green light to the electronic device
The use of
electronic cigarettes
is presented as an option to traditional tobacco formulas.
A choice
called 'less harmful' than tobacco and that 'would serve to quit smoking'
.
And from the point of view of Medicine, "there is nothing further from reality", as underlined by the Spanish Society of Pneumology and Thoracic Surgery (Separ).
Carlos Rábade, spokesman for the Separ Smoking Area, insists that "
electronic cigarettes and vaping do not represent a healthy alternative to tobacco. They have not shown efficacy when it comes to quitting smoking, nor have they eliminated the harm to smokers
."
In addition to the pneumological effects attributed to these products, a new study points to direct damage to the oral cavity, in the mouth.
A work published in
mBio
points out how
the regular use of 'e-cigars' modifies the bacterial flora of the mouth
and promotes the development of gum disease or
periodontitis
.
"To our knowledge,
this is the first longitudinal study of oral health and e-cigarette use
. We are now beginning to understand
how e-cigarettes and the chemicals they contain are changing the oral microbiome
and upsetting the balance of bacteria." said Deepak Saxena, who led the investigation with Xin Li;
both are professors of molecular pathobiology at New York University (NYU) School of Dentistry.
From Health, the Report on electronic cigarettes has recently been published: current situation, available evidence and regulation where it is mentioned that
"these products are advertised as harmless, however they pose a risk to health
, associated with both use and exposure to aerosol they emit.
In
Spain
, according to data from the ESTUDES 2018-2019 survey,
practically half of students aged 14 to 18 have used electronic cigarettes on some occasion
(48.4%), being more frequent among boys than girls, regardless of age.
Nearly a quarter (21%)
of people who have tried e-cigarettes are
between the ages of 25 and 39.
By comparison,
only 6% of those over 55
have tried these products.
Although there are still very few long-term studies and clinical trials on the effects of vaping on oral health, Óscar Castro Reino, president of the General Council of Dentists, explains that "
the data available so far point to a possible effect on the increased risk of oral cancer and a clear effect on periodontal diseases
. It is likely that new studies will provide more data on other possible oral pathologies associated with vaping."
These works point to the toxicity of chemicals contained in aerosols, such as propylene glycol and glycerin.
"
We had already seen how irritation developed in the mucous membranes of the eyes and nose
, and now we certify that there is a destruction of the microbiome of the oral cavity," says Rábade.
To be more exact, Castro Reina explains this process in detail: "
The microbiome is the set of bacteria and other microorganisms that inhabit the mouth
. In healthy conditions, there is a balance in such a way that protective microorganisms predominate against pathogens. But under certain circumstances, such as uncontrolled diabetes or smoking,
what is called dysbiosis occurs, this is an alteration of that balance, in favor of pathogens
".
The president of the Spanish dentists comments that "
the association of smoked tobacco with periodontal diseases was already known. The scientific evidence is high
".
The novelty is in determining the organic deterioration of the new forms of smoking.
"Regarding vaping, although it is true that there are fewer studies, all experts agree that it is highly likely that it also gives rise to this microbial dysbiosis and, therefore, favors or worsens periodontal disease.
Some studies have shown a increased risk of developing periodontal pockets in vaping users
."
Destruction of the 'good' bacteria in the mouth
It must be borne in mind that the continued use of these products, electronic cigarettes and vapers, add one more point of risk to the development of periodontitis,
gum disease that undermines the bone of the teeth until it completely damages the gum.
Therefore, experts warn of cumulative damage over time and early exposure to these substances, "the sooner this addiction begins, the greater the health risks," insists the president of dentists.
"Certain bacteria such as
Selenomonas, Leptotrichia or Saccharibacteria, are known to be highly present in the microbiome of smokers and are thought to be present in vapers as well
. Fusobacterum and Bacteroides have also been found in the microbiome of vapers This dysbiosis or alteration of the microbiome alters the host's immune response, aggravating the evolution of periodontal pathology", explains Castro Reino.
In the work by researchers at the NYU School of Dentistry, the
oral health of 84 adults from three groups: cigarette smokers, e-cigarette users, and people who have never smoked were measured
.
Gum disease was assessed through two dental exams six months apart, during which plaque samples were taken to test for bacteria present.
A key indicator of gum disease is
clinical attachment loss as measured by the gum ligament and tissue that pulls away from the surface of a tooth
, causing the gum to recede and form pockets.
These
'pockets' are breeding grounds for bacteria
and can cause further damage.
In a study of the same participants published in
Frontiers in Oral Health,
the research team found that clinical attachment loss was significantly worse only in e-cigarette smokers, not nonsmokers or cigarette smokers, after six months.
Altered immune response of users
In addition to the impact on the bacterial environment, the research also specifies how the immune response in this area is affected.
Specifically, vaping is associated with different levels of cytokines, proteins that help regulate the immune system.
"
Certain cytokines [such as IL-1 and IL-6] are related to an imbalance in oral bacteria and can worsen gum disease
by making people prone to inflammation and infection," says Rábade.
For this reason, in the aforementioned Health report they point out that "in summary,
the statement that the risk of consuming electronic cigarettes is reduced by 95% compared to traditional cigarettes, is unsustainable with current evidence
. And the idea of its use as a 'risk reduction strategy' is due more to a commercial strategy of the industry for the sale of these products, than to a public health policy of a population nature".
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