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Ethical considerations of e-cigarette use for tobacco harm reduction

Fetal and neonatal exposure to nicotine leads to augmented hepatic and circulating triglycerides in adult male offspring due to increased expression of fatty acid synthase

[7] Nicotine is a parasympathomimetic stimulant [8] that binds to and activates nicotinic acetylcholine receptors in the brain, [9] which subsequently causes the release of dopamine and other neurotransmitters, such as norepinephrine, acetylcholine, serotonin, gamma-aminobutyric acid, glutamate and endorphins

This interaction is particularly concerning given that many smokers also consume alcohol regularly, creating a 'double hit' to hepatic function