Unfriendly Fire: How the Tobacco Industry is Destroying the Future of Our Children
Review papers
Andrew Bush
Imperial College Centre for Paediatrics and Child Health, UK
Thomas Ferkol
Washington University School of Medicine, St. Louis,Missouri, USA
Algirdas Valiulis
Vilnius University Medical Faculty Institute of Health Sciences, Lithuania
Artur Mazur
Medical College of Rzeszow University, Poland
Ivane Chkhaidze
Tbilisi State Medical University, Georgia
Tamaz Maglakelidze
Ivane Javakhishvili Tbilisi State University, Georgia
Sergey Sargsyan
Arabkir Medical Centre, Armenia
Gevorg Boyajyan
Arabkir Medical Centre, Armenia
Olga Cirstea
University of Medicine and Pharmacy “Nicolae Testemitanu”, Republic of Moldova
Svitlana Doan
Kyiv Medical University, Ukraine
Oleksandr Katilov
National Pirogov Memorial Medical University, Ukraine
Valeriy Pokhylko
Ukrainian Medical Stomatological Academy, Ukraine
Leonid Dubey
Lviv National Medical University by Danylo Galytsky, Ukraine
Edita Poluziorovienė
Vilnius University, Lithuania
Nina Prokopčiuk
Vilnius University, Lithuania
Vaida Taminskienė
Vilnius University, Lithuania
Arūnas Valiulis
Vilnius University, Lithuania
Published 2021-02-08


Acute lung injury
alveolar haemorrhage
eosinophilic pneumonia
lipoid pneumonia
innate immune system

How to Cite

Bush A., Ferkol T., Valiulis A., Mazur A., Chkhaidze I., Maglakelidze T., Sargsyan S., Boyajyan G., Cirstea O., Doan S., Katilov O., Pokhylko V., Dubey L., Poluziorovienė E., Prokopčiuk N., Taminskienė V. and Valiulis A. (2021) “Unfriendly Fire: How the Tobacco Industry is Destroying the Future of Our Children”, Acta medica Lituanica, 28(1), pp. 6-18. doi: 10.15388/Amed.2020.28.1.6.


Tobacco has long been known to be one of the greatest causes of morbidity and mortality in the adults, but the effects on the foetus and young children, which are lifelong, have been less well appreciated. Developing from this are electronic nicotine delivery systems or vapes, promulgated as being less harmful than tobacco. Nicotine itself is toxic to the foetus, with permanent effects on lung structure and function. Most vapes contain nicotine, but they also contain many other compounds which are inhaled and for which there are no toxicity studies. They also contain known toxic substances, whose use is banned by European Union legislation. Accelerating numbers of young people are vaping, and this does not reflect an exchange of vapes for cigarettes. The acute toxicity of e-cigarettes is greater than that of tobacco, and includes acute lung injury, pulmonary haemorrhage and eosinophilic and lipoid pneumonia. Given the worse acute toxicity, it should be impossible to be complacent about medium and long term effects of vaping. Laboratory studies have demonstrated changes in lung proteomics and the innate immune system with vaping, some but not all of which overlap with tobacco. It would be wrong to consider vapes as a weaker form of tobacco, they have their own toxicity. Children and young people are being targeted by the vaping industry (which is largely the same as the tobacco industry), including on-line, and unless an efficient legislative program is put in place, a whole new generation of nicotine addicts will result.

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