{"id":20678,"date":"2024-06-14T08:19:42","date_gmt":"2024-06-14T08:19:42","guid":{"rendered":"https:\/\/www.tuat.org\/?p=20678"},"modified":"2024-10-07T09:55:55","modified_gmt":"2024-10-07T09:55:55","slug":"electronic-cigarettes-and-evalie","status":"publish","type":"post","link":"https:\/\/www.tuat.org\/en\/electronic-cigarettes-and-evalie\/","title":{"rendered":"Electronic Cigarettes: An Innocent Alternative or a Public Health Hidden"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"20678\" class=\"elementor elementor-20678\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-35d5f43d e-flex e-con-boxed e-con e-parent\" data-id=\"35d5f43d\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8e2dc9e elementor-widget elementor-widget-text-editor\" data-id=\"8e2dc9e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tBug\u00fcn elektronik sigaralardan, elektronik sigaralar\u0131n bir Halk Sa\u011fl\u0131\u011f\u0131 problemi olabilece\u011finden ve elektronik sigaraya ba\u011fl\u0131 geli\u015fen literat\u00fcre yeni girmi\u015f a\u00e7\u0131l\u0131m\u0131 \u201cE-cigarette and Vaping use Associated Lung Injury\u201d olan bizim k\u0131saca EVAL\u0130 olarak bildi\u011fimiz tablodan bahsetmek istiyorum. Elektronik sigara ba\u015flang\u0131\u00e7ta \u201ct\u00fct\u00fcn mamullerine duyulan ba\u011f\u0131ml\u0131l\u0131ktan kurtulmak veya zararlar\u0131n\u0131 azaltmak i\u00e7in kullan\u0131lan elektronik cihaz\u201d gibi masumane? bir ama\u00e7la pazara \u00e7\u0131km\u0131\u015ft\u0131r. Elektronik sigaran\u0131n seyrine bakacak olursak ilk modern E-sigara cihaz\u0131n\u0131 kendisi de bir nikotin ba\u011f\u0131ml\u0131s\u0131 olan \u00c7inli eczac\u0131 Hon Lik taraf\u0131ndan 2003\u2019de icat edildi\u011fi bilinmektedir. Cihaz\u0131n \u00e7al\u0131\u015fma prensibi, kartu\u015ftaki nikotin i\u00e7eren likitin bir atomizer arac\u0131l\u0131\u011f\u0131yla \u0131s\u0131t\u0131larak buharla\u015ft\u0131r\u0131lmas\u0131 esas\u0131na dayanmaktad\u0131r. 2006 y\u0131l\u0131nda Avrupa\u2019ya giri\u015f yapan E-sigara, T\u00fcrkiye\u2019de de 2008 itibariyle kullan\u0131lmaya ba\u015flanm\u0131\u015f olup genel olarak elektronik sigara kullan\u0131m\u0131 olarak adland\u0131r\u0131lan elektronik nikotin \u00fcr\u00fcnlerinin kullan\u0131m\u0131, 2013&#8217;ten bu yana gen\u00e7ler ve gen\u00e7 yeti\u015fkinler aras\u0131nda \u00f6nemli \u00f6l\u00e7\u00fcde artm\u0131\u015ft\u0131r. Hem 2016 Amerika Birle\u015fik Devletleri Genel Cerrah\u0131&#8217;n\u0131n Gen\u00e7ler ve Gen\u00e7 Yeti\u015fkinler Aras\u0131nda E-Sigara Kullan\u0131m\u0131 raporu hem de g\u00fcncellenmi\u015f 2018 Genel Cerrah Tavsiye Karar\u0131 bu artm\u0131\u015f kullan\u0131m\u0131 vurgulamaktad\u0131r. Halk Sa\u011fl\u0131\u011f\u0131 uzmanlar\u0131na e-sigara ve ilgili \u00fcr\u00fcnlerin kullan\u0131m\u0131n\u0131 taramalar\u0131 ve kullan\u0131m ile riskleri ele almalar\u0131 \u00e7a\u011fr\u0131s\u0131nda bulunulmaktad\u0131r. Peki Sa\u011fl\u0131k Kurumlar\u0131n\u0131 elektronik sigara hakk\u0131nda bu kadar endi\u015feye sokan sebep(ler) nedir? Elektronik sigara kendisinin pazara sunulma amac\u0131 kadar geleneksel sigara kullan\u0131m\u0131n\u0131 azalt\u0131c\u0131 etkiye sahip midir? Elektronik sigara ba\u011f\u0131ml\u0131l\u0131\u011f\u0131 ile olan m\u00fccadele geleneksel sigara ile olan m\u00fccadeleye g\u00f6re zorla\u015ft\u0131r\u0131c\u0131 etkenlere sahip midir? Gen\u00e7 ve \u00e7ocuklar i\u00e7in \u00e7ekicili\u011fi hakk\u0131nda neler d\u00fc\u015f\u00fcn\u00fclmektedir? Elektronik sigaran\u0131n Hep birlikte bu sorular\u0131 d\u00fc\u015f\u00fcn\u00fcp bizlerle payla\u015f\u0131lan verileri tartal\u0131m isterim.\nElektronik sigara ile birlikte \u201csmoking\u201d kavram\u0131na ek olarak \u201cvaping\u201d kavram\u0131 g\u00fcndemimize girmi\u015ftir. &#8220;Vaping&#8221;, nikotin, kanabinoidler (\u00f6rne\u011fin, tetrahidrokannabinol, kannabidiol), tatland\u0131r\u0131c\u0131 ve katk\u0131 maddeleri (\u00f6rne\u011fin, gliserol, propilen glikol) gibi \u00e7e\u015fitli maddeler i\u00e7eren bir s\u0131v\u0131 veya mumun \u0131s\u0131t\u0131lmas\u0131yla olu\u015fturulan bir aerosol\u00fcn solunmas\u0131 i\u015flemidir. Bu aerosol\u00fc \u00fcretmek i\u00e7in pille \u00e7al\u0131\u015fan elektronik sigaralar (e-sigara olarak da adland\u0131r\u0131l\u0131r), elektronik sigara kalemleri veya elektronik sigara modlar\u0131 dahil olmak \u00fczere \u00e7e\u015fitli cihazlar mevcuttur. Bu tatland\u0131r\u0131c\u0131 ve aromatik maddeler baz\u0131 elektronik sigara kullan\u0131c\u0131lar\u0131 i\u00e7in normal sigaradansa elbisede ciltte koku kalmas\u0131 gibi k\u00f6t\u00fc sonlan\u0131mlar\u0131 azaltarak daha cazip k\u0131lmaktad\u0131r. Ancak i\u00e7erilen bu katk\u0131 maddelerinin en az sigara kadar zararl\u0131 olabilece\u011fi bilinmektedir. \u00d6rnek verecek olursak: Propilen glikol veya gliserol\u00fcn \u0131s\u0131t\u0131ld\u0131\u011f\u0131nda ve aerosol haline getirildi\u011finde genel g\u00fcvenli\u011fi veya kanserojen etkileri hakk\u0131nda \u00e7ok az \u015fey bilinmektedir. Y\u00fcksek s\u0131cakl\u0131klarda propilen glikol ayr\u0131\u015f\u0131r ve olas\u0131 bir insan kanserojeni olan propilen oksit olu\u015fturabilir. Gliserol, akrolein toksini \u00fcretir, ancak \u00fcretilen seviyeler geleneksel sigaralardan daha d\u00fc\u015f\u00fckt\u00fcr. Hem propilen glikol hem de gliserol, e-sigarada kullan\u0131lan pilin voltaj\u0131na ba\u011fl\u0131 d\u00fczeylerde kanserojen formaldehit ve asetaldehit olu\u015fturmak \u00fczere ayr\u0131\u015f\u0131r. Hatta ki E-sigara aerosol\u00fcndeki par\u00e7ac\u0131klar\u0131n herhangi bir toksisiteye sahip olup olmad\u0131\u011f\u0131 bilinmemektedir.\nGelelim sigara b\u0131rakt\u0131r\u0131c\u0131 etkileri olup olmad\u0131\u011f\u0131na. Yap\u0131lan \u00e7al\u0131\u015fmalar E-sigaralar\u0131n kullan\u0131c\u0131lar i\u00e7in sigaray\u0131 b\u0131rakmaya y\u00f6nelik di\u011fer ila\u00e7lardan daha \u00e7ekici olabilece\u011fini g\u00f6r\u00fcn\u00fc\u015flerinin ve tatlar\u0131n\u0131n geleneksel sigaralara daha \u00e7ok benzeyip kullan\u0131c\u0131n\u0131n elden a\u011fza sigara i\u00e7me rit\u00fcelini s\u00fcrd\u00fcrmesine izin verdi\u011fini bildirmektedir. Bu da ba\u011f\u0131ml\u0131l\u0131k davran\u0131\u015f\u0131n\u0131n sonlan\u0131m\u0131n\u0131 zorla\u015ft\u0131rmaktad\u0131r. K\u00fc\u00e7\u00fck \u00e7al\u0131\u015fmalarda, e-sigara kullan\u0131c\u0131lar\u0131 geleneksel sigara isteklerinin ve nikotin yoksunluk semptomlar\u0131n\u0131n azald\u0131\u011f\u0131n\u0131 bildirmi\u015ftir. Bununla birlikte, e-sigaralar\u0131n, insanlar\u0131 bilinen g\u00fcvenlik ve etkinlik kayd\u0131na sahip sigaray\u0131 b\u0131rakma ila\u00e7lar\u0131n\u0131 kullanmaktan cayd\u0131rabilece\u011fine dair teorik bir endi\u015fe vard\u0131r. Gen\u00e7 ve \u00e7ocuklarda renkli d\u0131\u015f g\u00f6rsellerle sunumu, tatland\u0131r\u0131c\u0131l\u0131 olmas\u0131 \u00e7ekicili\u011fini artt\u0131rmaktad\u0131r. Buna ra\u011fmen E-sigara cihazlar\u0131n\u0131n yan\u0131klara, patlay\u0131c\u0131 yaralanmalara ve kimyasal yaralanmalara neden oldu\u011fu rapor edilmi\u015f olup \u00e7e\u015fitli incelemelerde, cihaz\u0131n saklan\u0131rken (\u00f6rn. cepte) veya kullan\u0131m s\u0131ras\u0131nda ar\u0131zalanmas\u0131 nedeniyle elektronik nikotin da\u011f\u0131t\u0131m sistemlerinden (ENDS) kaynaklanan yan\u0131klar i\u00e7in acil servis ziyaretleri tespit edilmi\u015f ve bu durum uyluk, kas\u0131k, y\u00fcz ve\/veya elde yan\u0131klara neden oldu\u011fu raporlanm\u0131\u015ft\u0131r. Ayr\u0131ca e-sigara s\u0131v\u0131s\u0131na a\u011f\u0131z yoluyla, parenteral yoldan veya cilt temas\u0131 yoluyla maruz kalmak da \u00f6zellikle k\u00fc\u00e7\u00fck \u00e7ocuklara zarar verebilir. Bu t\u00fcr bir maruz kalma genellikle bulant\u0131, kusma, uyu\u015fukluk ve ta\u015fikardiye neden olabilir ve hatta n\u00f6betler, anoksik beyin hasar\u0131, laktik asidoz ve \u00f6l\u00fcmle sonu\u00e7lanabilir. \u0130kincil olarak aerosol maruziyeti yani yan duman maruziyeti hakk\u0131nda bilgimiz yoktur. Amerikan Toraks Derne\u011fi, sigaray\u0131 b\u0131rakmak i\u00e7in e-sigara yerine kan\u0131tlanm\u0131\u015f farmakoterapinin (yani vareniklin) kullan\u0131lmas\u0131n\u0131 \u00f6nermektedir.\nElektronik sigaralarla g\u00fcndemimize giren \u00f6l\u00fcmc\u00fcl olabilecek EVAL\u0130\u2019den bahsedelim. \u0130lk olarak 2019&#8217;da tan\u0131mlanan e-sigara veya elektronik sigara, \u00fcr\u00fcn kullan\u0131m\u0131yla ili\u015fkili akci\u011fer hasar\u0131 (EVALI; orijinal olarak elektronik sigara ile ili\u015fkili akci\u011fer hasar\u0131 olarak adland\u0131r\u0131ld\u0131), ciddi ve ya\u015fam\u0131 tehdit edebilen akut veya subakut bir solunum hastal\u0131\u011f\u0131d\u0131r EVALI&#8217;nin patogenezi bilinmemektedir. EVALI, akut fibrin\u00f6z pn\u00f6moni, diff\u00fcz alveoler hasar veya organize pn\u00f6moni gibi patolojik bulgularla seyreden, genellikle bron\u015fiyosentrik ve bron\u015fiyolitin e\u015flik etti\u011fi bir akut akci\u011fer hasar\u0131 formu gibi g\u00f6r\u00fcnmektedir. Semptomlar\u0131 aras\u0131nda ate\u015f, \u00fc\u015f\u00fcme, titreme, nefes darl\u0131\u011f\u0131, \u00f6ks\u00fcr\u00fck, g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131, pl\u00f6retik g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 ve hemoptizi, gastrointestinal semptomlar da g\u00f6r\u00fclmektedir: mide bulant\u0131s\u0131, kusma, ishal, ve kar\u0131n a\u011fr\u0131s\u0131n\u0131 i\u00e7ermektedir. Hastalarda solunum yetmezli\u011fine ilerleme yayg\u0131nd\u0131r. Prognoz de\u011fi\u015fkendir; bir\u00e7ok vaka tamamen d\u00fczelirken, az say\u0131da vaka \u00f6l\u00fcmle sonu\u00e7lan\u0131r. Hastal\u0131\u011f\u0131n ilerlemesi ve \u00f6l\u00fcm i\u00e7in risk fakt\u00f6rleri hen\u00fcz bilinmemektedir. Gayri resmi veya yasa d\u0131\u015f\u0131 kaynaklardan elde edilen ve E vitamini asetat\u0131 ile kontamine olmu\u015f yeniden doldurulmu\u015f e-sigara kartu\u015flar\u0131n\u0131n EVALI vakalar\u0131yla en g\u00fc\u00e7l\u00fc \u015fekilde ili\u015fkili oldu\u011fu g\u00f6r\u00fclmektedir ve etkilenen hastalardan elde edilen bronkoalveoler lavaj s\u0131v\u0131s\u0131 \u00f6rneklerinde E vitamini asetat\u0131 tespit edilmi\u015ftir. \u00c7al\u0131\u015fmalar devam etmekle birlikte tablo bizlere elektornik sigaran\u0131n sebep olabilece\u011fi sa\u011fl\u0131k sorunlar\u0131n\u0131n en az geleneksel sigaralar kadar \u00f6nemli olabilece\u011fini g\u00f6stermektedir. Geleneksel sigara ba\u011f\u0131ml\u0131l\u0131\u011f\u0131 ile elektronik sigara ba\u011f\u0131ml\u0131l\u0131\u011f\u0131n\u0131n iki farkl\u0131 Halk Sa\u011fl\u0131\u011f\u0131 problemi olarak g\u00f6r\u00fclmesi belki de en uygunu olabilir.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\n    <div class=\"xs_social_share_widget xs_share_url after_content \t\tmain_content  wslu-style-1 wslu-share-box-shaped wslu-fill-colored wslu-none wslu-share-horizontal wslu-theme-font-no wslu-main_content\">\n\n\t\t\n        <ul>\n\t\t\t        <\/ul>\n    <\/div> \n","protected":false},"excerpt":{"rendered":"<p>Today, I want to talk about e-cigarettes, the potential public health problems they pose, and the condition we know as EVALI, which stands for &#8220;E-cigarette and Vaping use Associated Lung Injury.&#8221; E-cigarettes were initially introduced to the market with the seemingly benign purpose of helping people quit or reduce harm from tobacco products. The first [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":21369,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[115],"tags":[],"class_list":["post-20678","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/posts\/20678","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/comments?post=20678"}],"version-history":[{"count":0,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/posts\/20678\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/media\/21369"}],"wp:attachment":[{"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/media?parent=20678"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/categories?post=20678"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.tuat.org\/en\/wp-json\/wp\/v2\/tags?post=20678"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}