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Diseases

Electronic Nicotine Delivery Systems Pose Significant Health Risks, Warns WHO Study

Strategic Insights

— 2 min read

Research published in the BMJ Open journal has highlighted the alarming health impacts of electronic nicotine delivery systems (ENDS), particularly among young adults and adolescents. The study, conducted by the World Health Organization Regional Office Southeast Asia, found that ENDS use is associated with increased risks of cardiovascular and respiratory diseases, mental health issues, and substance abuse.

Key Takeaways:

  • The study included a comprehensive analysis of 69 systematic reviews, synthesizing data from multiple databases to evaluate the health impacts of ENDS.
  • ENDS use was found to increase heart rate, blood pressure, and cardiovascular risk factors, including endothelial dysfunction and increased platelet activity.
  • Respiratory risk factors associated with ENDS use include reduced lung function, asthma, and chronic obstructive pulmonary disease.
  • Mental health concerns, such as depression and suicidality, were prevalent among adolescent ENDS users.
  • Evidence of carcinogens was found in the urinary examinations of ENDS users in some studies.
  • The adverse events reported in seven randomized controlled trials were similar between ENDS and nicotine replacement therapy (NRT).
  • Comprehensive regulatory measures and public health strategies are necessary to curb the use of ENDS, particularly among young people.

Researchers conducted a systematic literature search across multiple databases, focusing on e-cigarettes, ENDS, and e-liquids, while excluding non-nicotine e-cigarette and nicotine replacement therapies (NRTs). A total of 5055 records were included, with 69 systematic reviews being included in the final analysis. The study used the AMSTAR-2 tool to assess the methodological quality of the systematic reviews and prioritized the highest-rated reviews.

Statistics:

  • 69 systematic reviews were included in the final analysis.
  • ENDS use was associated with an increased heart rate (mean difference (MD) 1.41, 95% CI 0.81 to 2.01, I=91%).
  • ENDS use was associated with increased blood pressure (MD for systolic blood pressure=0.51 mm Hg, 95% CI 0.26 to 0.75, I=89%; MD for diastolic blood pressure=0.59 mm Hg, 95% CI 0.35 to 0.83, I=82%).
  • The incidence of asthma in ENDS users was increased, with an odds ratio (OR) of 1.30 (95% CI 1.1 to 1.55; I=43%).
  • The number of participants in seven randomized controlled trials was 2611.

Sources:

  • Health impacts of electronic nicotine delivery systems: an umbrella review of systematic reviews. BMJ Open, 2025;15(10).
  • World Health Organization Regional Office Southeast Asia. New Delhi, India.
  • Jagdish Kaur, World Health Organization Regional Office Southeast Asia, New Delhi, India.
  • Sonu Goel, Muhammed Shabil, Rishabh Kumar Rana, Arvind Vashishta Rinkoo, Anil Chauhan, and Shibaji Gupta.

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