Davis, Lauren CSapey, ElizabethThickett, David RScott, Aaron2024-10-252024-10-252022-01-12Davis LC, Sapey E, Thickett DR, Scott A. Predicting the pulmonary effects of long-term e-cigarette use: are the clouds clearing? Eur Respir Rev. 2022 Jan 12;31(163):210121. doi: 10.1183/16000617.0121-2021.0905-91801600-061710.1183/16000617.0121-202135022257http://hdl.handle.net/20.500.14200/6261Commercially available since 2007, e-cigarettes are a popular electronic delivery device of ever-growing complexity. Given their increasing use by ex-smokers, smokers and never-smokers, it is important to evaluate evidence of their potential pulmonary effects and predict effects of long-term use, since there has been insufficient time to study a chronic user cohort. It is crucial to evaluate indicators of harm seen in cigarette use, and those potentially unique to e-cigarette exposure. Evaluation must also account for the vast variation in e-cigarette devices (now including at least five generations of devices) and exposure methods used in vivo and in vitroThus far, short-term use cohort studies, combined with in vivo and in vitro models, have been used to probe for the effects of e-cigarette exposure. The effects and mechanisms identified, including dysregulated inflammation and decreased pathogen resistance, show concerning overlaps with the established effects of cigarette smoke exposure. Additionally, research has identified a signature of dysregulated lipid processing, which is unique to e-cigarette exposure.This review will evaluate the evidence of pulmonary effects of, and driving mechanisms behind, e-cigarette exposure, which have been highlighted in emerging literature, and highlight the gaps in current knowledge. Such a summary allows understanding of the ongoing debate into e-cigarette regulation, as well as prediction and potential mitigation of future problems surrounding e-cigarette use.enCopyright ©The authors 2022.Respiratory medicinePublic health. Health statistics. Occupational health. Health educationArticle