{"id":1397,"date":"2020-07-31T11:06:27","date_gmt":"2020-07-31T09:06:27","guid":{"rendered":"https:\/\/www.comll.cat\/els-sistemes-electronics-dadministracio-de-nicotina\/"},"modified":"2022-03-29T19:35:31","modified_gmt":"2022-03-29T17:35:31","slug":"els-sistemes-electronics-dadministracio-de-nicotina","status":"publish","type":"post","link":"https:\/\/www.comll.cat\/es\/els-sistemes-electronics-dadministracio-de-nicotina\/","title":{"rendered":"Els sistemes electr\u00f2nics d\u2019administraci\u00f3 de nicotina"},"content":{"rendered":"

\"nicotina\"<\/strong><\/p>\n

Dr. Francesc Abella Pons<\/strong><\/p>\n

Psic\u00f2leg Cl\u00ednic<\/span><\/p>\n

Unitat de Tabaquisme<\/span><\/p>\n

Hospital Universitari de Santa Maria<\/span><\/p>\n

 <\/p>\n

Ja ning\u00fa dubta de les importants conseq\u00fc\u00e8ncies del consum de tabac. Des de la publicaci\u00f3 dels primers resultats de l\u2019associaci\u00f3 del fum del tabac amb el c\u00e0ncer (Richard Doll i Bradford\u00a0<\/span>Hill<\/span>, 1954) fins a l\u2019actualitat son milers els estudis i publicacions que consideren fumar com origen i causa de la m\u00e9s important epid\u00e8mia (evitable) de l\u2019actualitat.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Diverses han estat les tend\u00e8ncies, modes i estrat\u00e8gies que la persona fumadora ha disposat per a fer \u00fas i ab\u00fas del seu consum (primer) i de la seva addicci\u00f3 (despr\u00e9s).<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

El consum de tabac te tend\u00e8ncia a la baixa (malgrat un lleuger repunt en les darreres dades, tant a nivell d\u2019Espanya com de Catalunya). Algunes situacions aix\u00ed ho demostren: important disminuci\u00f3 del consum especialment en els pa\u00efsos desenvolupats, augment de les demandes milion\u00e0ries a la ind\u00fastria del tabac per danys i perjudicis en salut i intents\u00a0<\/span>d\u2019aquesta ind\u00fastria<\/span>\u00a0en buscar noves estrat\u00e8gies per reduir les p\u00e8rdues econ\u00f2miques que<\/span>\u00a0va<\/span>\u00a0tenint.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u00c9s en aquest context on hem de situar aquest fenomen de tanta actualitat i, a la vegada, tant desconeixement. Malgrat aquesta aparent novetat, consta ja un primer registre d\u2019una cigarreta electr\u00f2nica l\u2019any 1963 a EE.UU, tot i que aquests aparells no han comen\u00e7at a comercialitzar-se de manera significativa fins\u00a0<\/span>no fa massa<\/span>.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

B\u00e0sicament es disposen de tres tipus de sistemes electr\u00f2nics que promociona i facilita la ind\u00fastria del tabac com alternativa al consum convencional de tabac.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Les\u00a0<\/span><\/b>Cigarretes electr\u00f2niques.<\/span><\/b>\u00a0<\/span><\/p>\n

S\u2019hi troben<\/span>\u00a0diverses subst\u00e0ncies qu\u00edmiques. L<\/span>es que cont\u00e9 la pr\u00f2pia cigarreta (propilenglicol, glicerina, nicotina \u2013en dosis de 0 a 36 mg\/ml-, saboritzants, menta, fruita, canyella, etc. i altres additius). Tamb\u00e9 subst\u00e0ncies que es produeixen per\u00a0<\/span>calentament<\/span>\u00a0del l\u00edquid vehiculades pel vapor (formaldehid, acetaldehid, acrole\u00efnes i metalls \u2013n\u00edquel, crom i plom-.). El seu funcionament \u00e9s el seg\u00fcent: la bateria controla el\u00a0<\/span>calentador<\/span>\u00a0i el llum led. Un sensor detecta quan la persona fa una pipada. El\u00a0<\/span>calentador<\/span>\u00a0vaporitza la nicotina o subst\u00e0ncia<\/span>\u00a0(que va inserida en un cartutx dissolta amb propilenglicol).<\/span>\u00a0<\/span><\/p>\n

En alguns casos s\u2019han descrit accidents per explosi\u00f3 de l\u2019aparell.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

El s<\/span><\/b>istema JUUL.<\/span><\/b>\u00a0<\/span><\/p>\n

Es tracta d\u2019un vaporitzador que utilitza un sistema de regulaci\u00f3 de temperatura per\u00a0<\/span>calentar<\/span>\u00a0el l\u00edquid a base de nicotina. S\u2019anomena tamb\u00e9 \u201c<\/span>l\u2019iPhone<\/span>\u00a0dels vaporadors\u201d, es carrega en qualsevol port USB. La c\u00e0rrega dura aproximadament una hora i proporciona entre 150 i 200 pipades en aquest temps. Es disposen c\u00e0psules de rec\u00e0rrega amb diversos sabors: mango, tabac de Virginia, etc.<\/span>\u00a0<\/span><\/p>\n

El dispositiu calenta el l\u00edquid aromatitzat amb extracte de nicotina per tal de generar un vapor que \u00e9s inhalat per la persona. Els fabricants afirmen haver inventat una \u201ccigarreta intel\u00b7ligent\u201d, per la seva capacitat de regular la intensitat de la nicotina en cada emissi\u00f3. Dins el mercat americ\u00e0 aquest sistema ja ocupa\u00a0<\/span>el 50% de les cigarretes electr\u00f2niques, arribant a ser una aut\u00e8ntica epid\u00e8mia entre els seus adolescents<\/span>1<\/span>.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

El s<\/span><\/b>istema IQOS.<\/span><\/b>\u00a0<\/span><\/p>\n

\u00c9s el sistema m\u00e9s semblant a l\u2019acte de fumar tabac. En aquest cas, per\u00f2, aquest no es cre<\/span>ma (800\u00baC), es calenta (350\u00baC). A\u00a0<\/span>l\u2019acalentar<\/span>\u00a0el tabac es volatilitza la nicotina i les altres subst\u00e0ncies, amb la qual cosa es facilita la seva inhalaci\u00f3. L\u2019aparell consta de tres elements: el dispositiu cil\u00edndric buit d\u2019acetat on s\u2019insereix la cigarreta, un carregador rectangular per al dispositiu i la cigarreta.<\/span>\u00a0<\/span><\/p>\n

Les cigarretes estan compostes de tabac processat en pols impregnat de pro<\/span>pilenglicol i glicerina, inserit<\/span>\u00a0entre dos filtres i coberts per una l\u00e0mina d\u2019alumini. Es tracta de l\u2019aparell m\u00e9s semblant a la cigarreta. L\u2019aerosol generat cont\u00e9 nicotina i altres subst\u00e0ncies t\u00f2xiques. \u00c9s aquest el motiu que es considera l\u2019IQOS un producte\u00a0<\/span>addictiu<\/span>\u00a0amb efectes nocius per a la salut.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Aquest sistema \u00e9s comercialitzat en exclusiva per Philip Morris que proposa una \u201cnova forma de fumar i l\u2019abandonament de la cigarreta tradicional per combusti\u00f3\u201d. Impressiona potser sentir dir aix\u00f2,\u00a0<\/span>per\u00f2 aquesta important companyia<\/span>\u00a0ha pres una dr\u00e0stica decisi\u00f3 comercial que l\u2019est\u00e0 portant no nom\u00e9s a abandonar paulatinament el consum tradicional de tabac sin\u00f3 que tamb\u00e9 a mostrar el risc i perill que fins ara comporta fumar. Aquesta nova estrat\u00e8gia utilitza un esl\u00f2gan prou significatiu d\u2019aix\u00f2: \u201cI\u00a0<\/span>Quit<\/span>\u00a0<\/span>Ordinary<\/span>\u00a0<\/span>Smoking<\/span>!\u201d. Per al seu llan\u00e7ament s\u2019ha creat, fins i tot<\/span>,<\/span>\u00a0una fundaci\u00f3 amb la falsa aparen\u00e7a d\u2019organitzaci\u00f3 per a la defensa del medi ambient: Foundation for a\u00a0<\/span>Smoke<\/span>\/<\/span>Free<\/span>\u00a0<\/span>Wordl<\/span>. Iniciativa aquesta sobre la que diversos estaments sanitaris\u00a0<\/span>ja\u00a0<\/span>han posat en av\u00eds<\/span>2<\/span>.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Vist aix\u00f2, es pot pensar en all\u00f2 de la reducci\u00f3 de danys. Si efectivament les conseq\u00fc\u00e8ncies del fum del tabac son tant nefastes com sabem qui sap si les conseq\u00fc\u00e8ncies d\u2019aquests aparells electr\u00f2nics en son menors. D\u2019entrada apareixen alguns dubtes. Un de primer: la soluci\u00f3 al consum de tabac ha de venir, precisament, de la mateixa ind\u00fastria tabaquera?. Encara manca informaci\u00f3 sobre els seus efectes a mig i llarg termini, per\u00f2 s\u00ed podem avan\u00e7ar les conclusions d\u2019alguns estudis que ja s\u2019han publicat.<\/span>\u00a0Aix\u00ed, els fumadors de cigarretes electr\u00f2niques sense experi\u00e8ncia en aquests aparells poden, des del seu primer \u00fas, obtenir perfils d\u2019administraci\u00f3 de nicotina similars a les cigarretes convencionals<\/span>3<\/span>. L\u2019exposici\u00f3 a aerosols pot estar associada amb el deteriorament de la funci\u00f3 respirat\u00f2ria i els nivells de nicotina s\u00e8rica son similars als dels fumadors de cigarretes tradicionals<\/span>4<\/span>. Les afectacions de la nicotina son independents de l\u2019aparell o sistema de ingesta que s\u2019utilitzi<\/span>5<\/span>.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

En definitiva \u00e9s aquest un actual tema de debat<\/span>. Possiblement en alguns col\u00b7lectius molt espec\u00edfics o en determinades situacions de consum l\u2019\u00fas d\u2019aquests sistemes electr\u00f2nics d\u2019administraci\u00f3 de nicotina podrien tenir un \u00fas terap\u00e8utic a mig pas de l\u2019abstin\u00e8ncia si es donessin algunes condicions, b\u00e0sicament el control de prop de personal especialitzat en el tema.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

El m\u00f3n del tabac \u00e9s ple de contradiccions (perjudica la salut per\u00f2 hi convivim i fins fa poc l\u2019hem promocionat, fumar mata, segons indiquen alguns paquets i es <\/span>segueix venent a un preu ben assequible). No sigui que la promoci\u00f3, el debat i l\u2019\u00fas d\u2019aquestes m\u00e0quines de fumar siguin tamb\u00e9 una actual contradicci\u00f3 que distreu la nostra atenci\u00f3.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Refer\u00e8ncies.<\/span><\/b>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

1 Barrington-<\/span>Trimis<\/span>\u00a0JL, Leventhal AM. Adolescents' Use of Pod Mod E-Cigarettes - Urgent Concerns. N\u00a0<\/span>Engl<\/span>\u00a0J Med. 2018 Sep 20;379(12):1099-1102.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

2 Koh HK, Geller AC. The Philip Morris International\u2013Funded Foundation for a Smoke-Free World. JAMA. 2018 Jul 10;320(2):131-132.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

3 Lopez AA,\u00a0<\/span>Hiler<\/span>\u00a0MM, Soule EK,\u00a0<\/span>Ramoa<\/span>\u00a0CP,\u00a0<\/span>Karaoghlanian<\/span>\u00a0NV,\u00a0<\/span>Lipato<\/span>\u00a0T, Breland AB,\u00a0<\/span>Shihadeh<\/span>\u00a0AL,\u00a0<\/span>Eissenberg<\/span>\u00a0T. Effects of Electronic Cigarette Liquid Nicotine Concentration on Plasma Nicotine and Puff Topography in Tobacco Cigarette Smokers: A Preliminary Report. Nicotine\u00a0<\/span>Tob<\/span>\u00a0Res. 2016;18(5):720-3.\u00a0<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

4 Callahan-Lyon P. Electronic cigarettes: human health effects.\u00a0<\/span>Tob<\/span>\u00a0Control. 2014;23\u00a0<\/span>Suppl<\/span>\u00a0<\/span>2:ii<\/span>36-40.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

5 Verhaegen A, Van\u00a0<\/span>Gaal<\/span>\u00a0L. Etiology and Pathophysiology\/Obesity Comorbidity. Do E- cigarettes induce weight changes and increase cardiometabolic risk? A signal for the future. Obesity Reviews 2017; 18: 1136-1146.<\/span>\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Dr. Francesc Abella Pons Psic\u00f2leg Cl\u00ednic Unitat de Tabaquisme Hospital Universitari de Santa Maria   Ja ning\u00fa dubta de les...<\/p>\n","protected":false},"author":1,"featured_media":1398,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[28],"tags":[],"class_list":["post-1397","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-opinion"],"acf":[],"yoast_head":"\nEls sistemes electr\u00f2nics d\u2019administraci\u00f3 de nicotina - Col\u00b7legi Oficial de Metges de Lleida<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.comll.cat\/es\/els-sistemes-electronics-dadministracio-de-nicotina\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Els sistemes electr\u00f2nics d\u2019administraci\u00f3 de nicotina - 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