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This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
Millions of Americans use e-cigarettes. Despite their popularity, little is known about their health effects. Some suggest that e-cigarettes likely confer lower risk compared to combustible tobacco cigarettes, because they do not expose users to toxicants produced through combustion. Proponents of e-cigarette use also tout the potential benefits of e-cigarettes as devices that could help combustible tobacco cigarette smokers to quit and thereby reduce tobacco-related health risks. Others are concerned about the exposure to potentially toxic substances contained in e-cigarette emissions, especially in individuals who have never used tobacco products such as youth and young adults. Given their relatively recent introduction, there has been little time for a scientific body of evidence to develop on the health effects of e-cigarettes. Public Health Consequences of E-Cigarettes reviews and critically assesses the state of the emerging evidence about e-cigarettes and health. This report makes recommendations for the improvement of this research and highlights gaps that are a priority for future research.
Biologic markersâ€"indicators of biological exposure or changeâ€"offer the promise of early detection of disease caused by environmental exposure. Researchers have used these markers to discover indications of pulmonary damage from low-level ozone, a finding with serious implications for health professionals and environmental regulators. Biologic Markers in Pulmonary Toxicology is a comprehensive study of this use of biologic markers. Focusing on the respiratory tract as an entryway for airborne pollutants, this volume reviews new ways of measuring markers, the need for markers to indicate dose or exposure levels, noninvasive respiratory function tests for use with healthy humans to detect sensitivity to inhaled pollutants, approaches to evaluating markers down to the cellular and biochemical levels, and more.