Empfehlungen zum Umgang mit der elektronischen Zigarette (E-Zigarette)

Sollen Raucher:innen die E-Zigarette zur Tabakentwöhnung nutzen?

Raucher:innen soll die E-Zigarette nicht zur Tabakentwöhnung empfohlen werden. Im Gegensatz zu Nikotinersatztherapie (NET) oder Medikamenten zur Unterstützung der Tabakentwöhnung werden E-Zigaretten von der Mehrheit der ausstiegswilligen Raucher:innen dauerhaft genutzt. Das anhaltende Inhalieren des E-Zigaretten-Aerosols beinhaltet Gesundheitsrisiken, deren Ausmaß bisher nicht abschätzbar ist. Raucher:innen, die auf E-Zigaretten umsteigen, haben ein erhöhtes Rückfallrisiko.

Publication History

Article published online:
15 June 2022

• Literatur

• 1 Hering T. E-Zigaretten – toxikologisches Fiasko oder besser als kein Rauchstopp?. Internist 2020; 61: 634-643 DOI: 10.1007/s00108-020-00794-0.
• 2 Pfeifer M. E-Zigaretten – gesundheitlich riskant und für den Rauchstopp nicht empfohlen!. Internist 2020; 61: 1106-1108
• 3 Hering T. Ist es gerechtfertigt, den Beratungssuchenden Vorteile der E-Zigarette vorzuenthalten?. Internist 2020; 61: 1109-1110
• 4 McNeill A, Brose LS, Calder R. et al. Vaping in England: an evidence update including mental health and pregnancy, March 2020: a report commissioned by Public Health England. London: Public Health England;
• 5 WHO report on the global tobacco epidemic 2021: addressing new and emerging products. https://www.who.int/publications/i/item/9789240032095 (Stand: 01.04.2022)
• 6 Pankow W, Andreas S, Rupp A. et al. Tabakentwöhnung mit E-Zigarette? Eine Ad-Hoc-Stellungnahme der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin e. V. (DGP). Pneumologie 2021; 75: 31-32 DOI: 10.1055/a-1323-6045.
• 7 Stellungnahme des Aktionsbündnisses Nichtrauchen e.V. zu E-Zigaretten. 2021 https://www.abnr.de/media/abnr-stellungnahme_e-zigaretten_20210519.pdf (Stand: 01.04.2022)
• 8 Pisinger C, Dagli E, Filippidis FT. ERS Tobacco Control Committee, on behalf of the ERS. et al. ERS and tobacco harm reduction. Eur Respir J 2019; 54: 1902009 Erratum in: Eur Respir J. 2020 Jan 30; 55(1): PMID: 31801824. Übersetzung durch die DGP mit Genehmigung der ERS: ERS Positionspapier zur Tabak-Harm-Reduction. Stellungnahme, vorbereitet durch das ERS Tobacco-Control-Committee. DOI: 10.1183/13993003.02009-2019. https://pneumologie.de/fileadmin/user_upload/Publikationen/ERS_Position_Paper_on_Tobacco_Harm_Reduction_DE.pdf
• 9 Bals R, Boyd J, Esposito S. et al. Electronic cigarettes: a task force report from the European Respiratory Society. Eur Respir J 2019; 53: 1801151 DOI: 10.1183/13993003.01151-2018.
• 10 Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften S3-Leitlinie „Rauchen und Tabakabhängigkeit: Screening, Diagnostik und Behandlung“. AWMF-Register Nr. 076-006. 2020 (Gültig bis 31.12.2025). https://www.awmf.org/uploads/tx_szleitlinien/076-006l_S3_Rauchen-_Tabakabhaengigkeit-Screening-Diagnostik-Behandlung_2021-03.pdf (Stand: 01.04.2022)
• 11 Nationale VersorgungsLeitlinie (NVL) COPD 2021. https://www.leitlinien.de/themen/copd (Stand: 01.04.2022)
• 12 Dewhirst T. Co-optation of harm reduction by Big Tobacco. Tob Control 2020; DOI: 10.1136/tobaccocontrol-2020-056059.
• 13 Peeters S, Gilmore AB. Understanding the emergence of the tobacco industry’s use of the term tobacco harm reduction in order to inform public health policy. Tob Control 2015; 24: 182-189 DOI: 10.1136/tobaccocontrol-2013-05150.
• 14 Hackshaw A, Morris JK, Boniface S. et al. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ 2018; 360: j5855 Erratum in: BMJ. 2018 Apr 11; 361: k1611. Erratum in: BMJ. 2018 Nov 28; 363: k5035. PMID: 29367388; PMCID: PMC5781309. DOI: 10.1136/bmj.j5855.
• 15 Hua M, Omaiye EE, Luo W. et al. Identification of Cytotoxic Flavor Chemicals in Top-Selling Electronic Cigarette Refill Fluids. Sci Rep 2019; 9: 2782 DOI: 10.1038/s41598-019-38978-w.
• 16 Escobar YH, Nipp G, Cui T. et al. In vitro toxicity and chemical characterization of aerosol derived from electronic cigarette humectants using a newly developed exposure system. Chem Res Toxicol 2020; 33: 1677-1688 DOI: 10.1021/acs.chemrestox.9b00490. [Epub 2020 Apr 13]
• 17 Traboulsi H, Cherian M, Abou Rjeili M. et al. Inhalation Toxicology of Vaping Products and Implications for Pulmonary Health. Int J Mol Sci 2020; 21: 3495 DOI: 10.3390/ijms21103495.
• 18 Wiebel FJ, Gohlke H, Loddenkemper R. E-Zigaretten: Eine unterschätzte Gefahr für Lunge und Herz-Kreislauf. Vergleich des Schadenspotentials von E-Zigaretten und Tabakzigaretten. Zwischenbilanz zum Weltnichtrauchertag 2019. http://www.aerztlicher-arbeitskreis.de/files/gesundheitsgefahren_durch_e-zigaretten.pdf (Stand: 01.04.2022)
• 19 Flacco ME, Fiore M, Acuti Martellucci C. et al. Tobacco vs. electronic cigarettes: absence of harm reduction after six years of follow-up. Eur Rev Med Pharmacol Sci 24: 3923-3934 DOI: 10.26355/eurrev_202004_20859.
• 20 Gotts JE, Jordt SE, McConnell R. et al. What are the respiratory effects of e-cigarettes?. BMJ 2019; 366: l5275 Erratum in: BMJ. 2019 Oct 15; 367: l5980. PMID: 31570493; PMCID: PMC7850161. DOI: 10.1136/bmj.l5275.
• 21 Wills TA, Soneji SS, Choi K. et al. E-cigarette use and respiratory disorder: An integrative review of converging evidence from epidemiological and laboratory studies. Eur Respir J 2020; 1901815 DOI: 10.1183/13993003.01815-2019.
• 22 Bozier J, Rutting S, Xenaki D. et al. Heightened response to e-cigarettes in COPD. ERJ Open Res 2019; 5: 00192-2018 DOI: 10.1183/23120541.00192-2018.
• 23 Hikichi M, Mizumura K, Maruoka S. et al. Pathogenesis of chronic obstructive pulmonary disease (COPD) induced by cigarette smoke. J Thorac Dis 2019; 11 (Suppl. 17) S2129-S2140 DOI: 10.21037/jtd.2019.10.43.
• 24 Kennedy CD, van Schalkwyk MCI, McKee M. et al. The cardiovascular effects of electronic cigarettes: A systematic review of experimental studies. Prev Med 2019; 127: 105770
• 25 Kavousi M, Pisinger C, Barthelemy JC. Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC). Eur J Prev Cardiol 2020; 2047487320941993 DOI: 10.1177/2047487320941993.
• 26 Buchanan ND, Grimmer JA, Tanwar V. et al. Cardiovascular risk of electronic cigarettes: a review of preclinical and clinical studies. Cardiovasc Res 2020; 116: 40-50
• 27 Tarran R, Barr RG, Benowitz NL. et al. E-cigarettes and cardiopulmonary health. Function (Oxf) 2021; 2: zqab004 DOI: 10.1093/function/zqab004.
• 28 Bianco E, Skipalskyi A, Goma F. et al. E-Cigarettes: A New Threat to Cardiovascular Health – A World Heart Federation Policy Brief. Glob Heart 2021; 16: 72 DOI: 10.5334/gh.1076.
• 29 Metzen D, MʼPembele R, Zako S. et al. Platelet reactivity is higher in e-cigarette vaping as compared to traditional smoking. Intern J Cardiol 2021; 43: 146-148 DOI: 10.1016/j.ijcard.2021.09.005.
• 30 Bracken-Clarke D, Kapoor D, Baird AM. et al. Vaping and lung cancer – A review of current data and recommendations. Lung Cancer 2021; 153: 11-20 DOI: 10.1016/j.lungcan.2020.12.030. [Epub 2021 Jan 2]
• 31 Lee HW, Park SH, Weng MW. et al. E-cigarette smoke damages DNA and reduces repair activity in mouse lung, heart, and bladder as well as in human lung and bladder cells. Proc Natl Acad Sci U S A 2018; 115: E1560-E1569 DOI: 10.1073/pnas.1718185115. [Epub 2018 Jan 29]
• 32 Tang MS, Wu XR, Lee HW. et al. Electronic-cigarette smoke induces lung adenocarcinoma and bladder urothelial hyperplasia in mice. Proc Natl Acad Sci U S A 2019; 116: 21727-21731
• 33 Kotz D, Batra A, Kastaun S. Smoking cessation attempts and common strategies employed. Dtsch Arztebl Int 2020; 117: 7-13 DOI: 10.3238/arztebl.2020.000.
• 34 Kim T, Kang J. Association between dual use of e-cigarette and cigarette and chronic obstructive pulmonary disease: an analysis of a nationwide representative sample from 2013 to 2018. BMC Pulm Med 2021; 21: 231 DOI: 10.1186/s12890-021-01590-8.
• 35 Kim CY, Paek YJ, Seo HG. et al. Dual use of electronic and conventional cigarettes is associated with higher cardiovascular risk factors in Korean men. Sci Rep 2020; 10: 5612 DOI: 10.1038/s41598-020-62545-3.
• 36 Wang JB, Olgin JE, Nah G. et al. Cigarette and e-cigarette dual use and risk of cardiopulmonary symptoms in the Health eHeart Study. PLoS One 2018; 13: e0198681 DOI: 10.1371/journal.pone.0198681.
• 37 Reddy KP, Schwamm E, Kalkhoran S. et al. Respiratory symptom incidence among people using electronic cigarettes, combustible tobacco, or both. Am J Respir Crit Care Med 2021; 204: 231-234 DOI: 10.1164/rccm.202012-4441LE.
• 38 Jeong SM, Jeon KH, Shin DW. et al. Smoking cessation, but not reduction, reduces cardiovascular disease incidence. Eur Heart J 2021; 42: 4141-4153 DOI: 10.1093/eurheartj/ehab578.
• 39 Pisinger C, Godtfredsen N, Bender AM. A conflict of interest is strongly associated with tobacco industry-favourable results, indicating no harm of e-cigarettes. Prev Med 2019; 119: 124-131 DOI: 10.1016/j.ypmed.2018.12.011. [Epub 2018 Dec 18]
• 40 Villanti AC, Feirman SP, Niaura RS. et al. How do we determine the impact of e-cigarettes on cigarette smoking cessation or reduction? Review and recommendations for answering the research question with scientific rigor. Addiction 2018; 113: 391-404 DOI: 10.1111/add.14020. [Epub 2017 Oct 3]
• 41 Hartmann-Boyce J, McRobbie H, Lindson N. et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev 2020; 10: CD010216 Update in: Cochrane Database Syst Rev 2021 Apr 29; 4: CD010216. PMID: 33052602; PMCID: PMC8094228. DOI: 10.1002/14651858.CD010216.pub4.
• 42 Pound CM, Zhang JZ, Sampson M. et al. Smoking cessation in individuals who use vaping as compared with traditional nicotine replacement therapies: a systematic review and meta-analysis. BMJ Open 2021; 11: e044222 DOI: 10.1136/bmjopen-2020-044222.
• 43 Hedman L, Galanti MR, Ryk L. et al. Electronic cigarette use and smoking cessation in cohort studies and randomized trials: A systematic review and meta-analysis. Tob Prev Cessat 2021; 7: 62 DOI: 10.18332/tpc/142320.
• 44 Hajek P, Phillips-Waller A, Przulj D. et al. A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy. N Engl J Med 2019; 380: 629-637 DOI: 10.1056/NEJMoa1808779. [Epub 2019 Jan 30]
• 45 Barufaldi LA, Guerra RL, de Albuquerque RCR. et al. Risk of smoking relapse with the use of electronic cigarettes: A systematic review with meta-analysis of longitudinal studies. Tob Prev Cessat 2021; 29: 29 DOI: 10.18332/tpc/132964.
• 46 Pierce JP, Chen R, Kealey S. et al. Incidence of Cigarette Smoking Relapse Among Individuals Who Switched to e-Cigarettes or Other Tobacco Products. JAMA Netw Open 2021; 4: e2128810 DOI: 10.1001/jamanetworkopen.2021.28810.
• 47 Thomas KH, Dalili MN, López-López JA. et al. Comparative clinical effectiveness and safety of tobacco cessation pharmacotherapies and electronic cigarettes: a systematic review and network meta-analysis of randomized controlled trials. Addiction 2021; DOI: 10.1111/add.15675.
• 48 Oloyede EO, Ola O, Kolade VO. et al. Looking Back and Going Forward: Roles of Varenicline and Electronic Cigarettes in Smoking Cessation. Cureus 2021; 13: e16824 DOI: 10.7759/cureus.16824.