Dovrebbe l'Italia bandire le sigarette elettroniche usa e getta?
In the midst of the ongoing debate surrounding the use of disposable e-cigarettes in Italy, the concerns raised by pediatricians and health organizations are gaining momentum. These concerns stem from the increasing evidence pointing towards the potential risks these devices pose, especially to younger individuals. The Global Tobacco Youth Survey (GYTS) data from 2022 revealed that nearly 20% of Italians between the ages of 13 and 15 have been using disposable e-cigarettes, a significant rise from the 8.4% in 2014 and 17.5% in 2018. Despite being prohibited for sale to minors, almost 34% of them have tried these devices at least once. Similar trends are observed in other European countries, with a study indicating that the prevalence of e-cigarettes in Italy between 2014 and 2019 was notably higher than the average.
Initially marketed as a safe and effective cessation aid, concerns have grown over their popularity among youth. In December of the previous year, the World Health Organization (WHO) issued a statement asserting the lack of clear evidence supporting e-cigarettes as an effective smoking cessation tool, while highlighting the mounting and convincing evidence of them serving as a gateway to cigarette smoking. This gateway effect appears to be particularly prominent among young people, who are the primary target of aggressive marketing campaigns and are enticed by the wide array of e-liquid flavors available.
Silvano Gallus, leading the lifestyle research laboratory at the Mario Negri Institute in Milan, spearheaded one of the few prospective studies in Europe on the gateway hypothesis. E-cigarettes began gaining traction in Europe in the early 2010s. To explore the potential causal relationship between e-cigarette use and the initiation of cigarette smoking, Gallus and colleagues surveyed approximately 3,200 Italian adults twice, first in March 2020 and again seven months later. They found that the percentage of respondents who started smoking during those seven months was 2% among those who had never used e-cigarettes, and 20% among e-cigarette users. Similar results were observed in the United States among adolescents and young adults. Gallus predicts that "e-cigarettes create nicotine addiction, and a substantial portion of teenagers using them today will be smoking traditional cigarettes in ten years."
Even the United Kingdom, whose public health agency once strongly endorsed e-cigarettes as a smoking cessation method, asserting that they are 95% less harmful than tobacco, recently banned the sale of disposable e-cigarettes, citing concerns for youth health.
The Italian Society of Pediatrics, alongside other pediatric scientific societies and patient organizations, recently sent a letter to the Minister of Health urging for stricter regulations on flavors and marketing campaigns. In addition to the risk of initiating smoking, the letter underscores the growing evidence on the acute effects of e-cigarettes on the respiratory system, such as chronic cough, wheezing, and asthma. Maria Elisa Di Cicco, a pediatric pulmonologist at the university hospital in Pisa and one of the letter's authors, emphasizes that parents often perceive vaping as completely safe and use e-cigarettes at home, increasing passive exposure for their children. Di Cicco further notes that secondhand exposure has been proven to lead to respiratory symptoms.
Emanuela Testai, a toxicologist at the Italian National Institute of Health and the chair of the EU Scientific Committee on Health, Environment, and Emerging Risks (SCHEER), points out the challenge in thoroughly evaluating the toxicity of chemicals inhaled from e-cigarettes due to the growing number of different liquids and devices on the market. Regarding flavors, she notes that most have been approved as food additives, signifying their safety for ingestion, but their toxicity when inhaled remains unknown.
As the discussion unfolds, the Italian Ministry of Health has yet to respond to queries regarding any plans to review the current regulations on e-cigarettes.
This critical examination of disposable e-cigarettes in Italy reflects a broader global concern over the potential health risks associated with these devices, particularly among young users. The push for stricter regulations and public health initiatives underscores the need for proactive measures to safeguard the well-being of individuals, especially the youth, in the face of evolving tobacco and nicotine consumption trends.
Source: https://www.nature.com/articles/d43978-024-00047-w
Initially marketed as a safe and effective cessation aid, concerns have grown over their popularity among youth. In December of the previous year, the World Health Organization (WHO) issued a statement asserting the lack of clear evidence supporting e-cigarettes as an effective smoking cessation tool, while highlighting the mounting and convincing evidence of them serving as a gateway to cigarette smoking. This gateway effect appears to be particularly prominent among young people, who are the primary target of aggressive marketing campaigns and are enticed by the wide array of e-liquid flavors available.
Silvano Gallus, leading the lifestyle research laboratory at the Mario Negri Institute in Milan, spearheaded one of the few prospective studies in Europe on the gateway hypothesis. E-cigarettes began gaining traction in Europe in the early 2010s. To explore the potential causal relationship between e-cigarette use and the initiation of cigarette smoking, Gallus and colleagues surveyed approximately 3,200 Italian adults twice, first in March 2020 and again seven months later. They found that the percentage of respondents who started smoking during those seven months was 2% among those who had never used e-cigarettes, and 20% among e-cigarette users. Similar results were observed in the United States among adolescents and young adults. Gallus predicts that "e-cigarettes create nicotine addiction, and a substantial portion of teenagers using them today will be smoking traditional cigarettes in ten years."
Even the United Kingdom, whose public health agency once strongly endorsed e-cigarettes as a smoking cessation method, asserting that they are 95% less harmful than tobacco, recently banned the sale of disposable e-cigarettes, citing concerns for youth health.
The Italian Society of Pediatrics, alongside other pediatric scientific societies and patient organizations, recently sent a letter to the Minister of Health urging for stricter regulations on flavors and marketing campaigns. In addition to the risk of initiating smoking, the letter underscores the growing evidence on the acute effects of e-cigarettes on the respiratory system, such as chronic cough, wheezing, and asthma. Maria Elisa Di Cicco, a pediatric pulmonologist at the university hospital in Pisa and one of the letter's authors, emphasizes that parents often perceive vaping as completely safe and use e-cigarettes at home, increasing passive exposure for their children. Di Cicco further notes that secondhand exposure has been proven to lead to respiratory symptoms.
Emanuela Testai, a toxicologist at the Italian National Institute of Health and the chair of the EU Scientific Committee on Health, Environment, and Emerging Risks (SCHEER), points out the challenge in thoroughly evaluating the toxicity of chemicals inhaled from e-cigarettes due to the growing number of different liquids and devices on the market. Regarding flavors, she notes that most have been approved as food additives, signifying their safety for ingestion, but their toxicity when inhaled remains unknown.
As the discussion unfolds, the Italian Ministry of Health has yet to respond to queries regarding any plans to review the current regulations on e-cigarettes.
This critical examination of disposable e-cigarettes in Italy reflects a broader global concern over the potential health risks associated with these devices, particularly among young users. The push for stricter regulations and public health initiatives underscores the need for proactive measures to safeguard the well-being of individuals, especially the youth, in the face of evolving tobacco and nicotine consumption trends.
Source: https://www.nature.com/articles/d43978-024-00047-w
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