title: Counseling patients with asthma and allergy about electronic cigarettes: an evidence-based approach.
abstract: OBJECTIVE
  To provide an evidence-based review of common safety concerns and emerging potential benefits deriving from the regular use of electronic cigarettes (ECs) and thus improve counseling between physicians and their patients with asthma and allergy using or intending to use ECs.
  
  
  METHODS
  Peer-reviewed articles from the National Center for Biotechnology Information's PubMed about ECs, risk reduction, and harm reversal were appraised.
  
  
  METHODS
  Keywords used in the search were smoking cessation, electronic cigarette, counseling, asthma, allergy, nicotine, tobacco harm reduction, and harm reversal.
  
  
  RESULTS
  Vapor toxicology is far less problematic compared with combustible cigarettes, with exclusive EC users having substantial lower risk of exposure to tobacco smoke toxicants and carcinogens compared with cigarette smokers. Moreover, there is emerging evidence that switching to regular EC use could produce significant respiratory health gains.
  
  
  CONCLUSIONS
  Inaccurate and inconsistent information about EC safety and efficacy, tobacco harm reduction, and nicotine toxicity is being offered to smokers and EC users. In particular, most health care professionals cannot communicate a clear and consistent message to their patients with respiratory problems and allergy who use or intend to use ECs. Therefore, it is important for the medical community to take an active role in considering all the pathways available to a smoking patient and recommend those that provide the greatest probability of eliminating exposure to tobacco smoke, including ECs.
authors.affiliation: Centro per la Prevenzione e Cura del Tabagismo, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Catania, Italy; Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania, Italy; UOC di Medicina Interna e d'Urgenza, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Catania, Italy. Electronic address: polosa@unict.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Polosa
authors.affiliation: Centro per la Prevenzione e Cura del Tabagismo, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Catania, Italy; Dipartimento di Medicina Clinica e Sperimentale, Università di Catania, Catania, Italy; UOC di Medicina Interna e d'Urgenza, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Catania, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Campagna
authors.affiliation: Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, New York; The Veterans Administration Healthcare System of Western New York, Buffalo, New York.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Sands
mesh_terms: D003376:Counseling; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects; D019317:Evidence-Based Medicine; D006801:Humans; D006967:Hypersensitivity; D010817:Physician-Patient Relations; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation