They look like gadgets, have no distinct smell and contain no tar. Their manufacturers consistently claim they are healthier than regular tobacco cigarettes, and electronic cigarettes are gaining popularity with millions of users worldwide. But are they as harmless as marketers want us to believe?
The reports of actual damage caused to electronic cigarette users are piling rapidly over the recent months. The American Centers for Disease Control and Prevention (CDC) is currently investigating the deaths of nearly 50 people, whose deaths were found to be directly related to smoking electronic cigarette, AKA “vaping”. Furthermore, the CDC identified a new lung disease, called “E-cigarette or Vaping Product Use-Associated Lung Injury” - or EVALI. This disease has affected over 2,200 electronic cigarette users across 49 states in the US and is also under investigation.
The disease arose suddenly among otherwise healthy people, without shared backgrounds other than the fact that all of them were smoking electronic cigarettes. The symptoms include shortness of breath, coughing, fatigue, vomiting and diarrhoea. So far, the CDC has linked EVALI to Vitamin E Acetate (a synthetic form of vitamin E). However, the CDC is still investigating and other substances may be connected to the illness.
Another investigation led by the FDA, examines the connection between electronic cigarettes and 127 cases of seizures and neurological symptoms reported by e-cigarette users. In addition, since 2018 the FDA has been funding extensive research, in order to examine the short and long-term effects of electronic cigarettes.
What are Electronic Cigarettes?
An electronic cigarette, e-cigarette in short, is a device that heats liquid to 100-250 degrees Celsius, to produce inhalable gas. The liquid, commonly referred to as e-liquid, usually contains a combination of ingredients such as propylene glycol, glycerine, nicotine and flavour additives – that emulate the smoking experience of tobacco cigarettes. Some electronic cigarettes use nicotine-free liquids that don’t contain certain ingredients found in tobacco cigarettes, which are known to be harmful (such as diammonium phosphate or ammonium hydroxide).
Electronic cigarettes were invented in 2003 in China by Hon Lik, a 52-year-old pharmacist and smoker. They began to be distributed internationally in 2004, and their popularity has been on the rise ever since.
When examining the reasons to start using electronic cigarettes, several factors stand out; the cost is lower, compared to tobacco cigarettes; they have almost no smell; public smoking is not prohibited; and the still common belief that smoking electronic cigarette is of lower risk and is generally better for your health in comparison with the alternative.
Is vaping an easy way to quit smoking?
Many manufacturers market electronic cigarettes as an effective way to quit smoking: first you switch to electronic, and from there it’s easier to stop all together. But is that really the case?
Research examining how turning to smoking electronic cigarettes helps in quitting tobacco cigarette shows mixed results. Most research has concluded that electronic cigarettes do not assist to quit; some articles claim they are only mildly effective, and others deemed them not only ineffective but actually showed they can increase the use of tobacco cigarettes overtime.
An American research from 2017 has examined people who started smoking electronic cigarettes without having any previous tobacco smoking history. The findings revealed that the chances of such users to turn to smoking tobacco cigarettes rose to almost 4 times higher, compared to people who never smoked (30% and 7.9% respectively).
Teen vaping is an epidemic
Data reveals a significant increase in electronic cigarette smoking among teenagers: from 11.7% in 2017 to 20.8% in 2018.
in 2008, the FDA had announced that electronic cigarettes that contain nicotine must bear a warning, much like ordinary tobacco cigarettes. However, in July 2019 the administration has made regulations even stricter and mandated that all electronic cigarette devices must register through the FDA as tobacco products and are subject to the administration’s approval before going to market. This would also mean electronic cigarettes cannot be sold to minors, just like regular tobacco cigarettes.
The FDA directly went against electronic cigarette brands, accusing them of focusing on teenagers as a main target audience, using aggressive marketing techniques, selling e-liquid flavours that are considered attractive to this demographic, and other similar methods. The FDA accused the brands of maliciously attempting to grow a new generation of consumers. While in the US electronic cigarette companies are required to propose a plan to minimise teenager’s use only, far extreme measures have been taken in other parts of the world. In Singapore, Brunei and Hong Kong, the use of electronic cigarettes has been banned completely and is prohibited by law.
What now?
One myth about electronic cigarettes is that smoking them poses no threats to passive smokers, as no smoke and tar are exhaled - commonly known carcinogens. However, a systematic review from 2016 revealed that second-hand vaping could lead to inhalation of ultrafine nicotine particles. Other particles that could be inhaled include heavy metals, proven to lead to an increase in heart and lung disease. In cases of prolonged exposure to volatile substances that are inhaled passively, one could develop cancer in the respiratory system, as well as suffer metal poisoning.
It is therefore recommended to avoid being in the presence of electronic cigarettes. It is also advised to request smokers to refrain from smoking next to you – just like you would if they were smoking ordinary cigarettes.
Data on electronic cigarettes is still preliminary, and further research is needed in order to provide the full picture of the dangers they entail. However, it is advised to approach marketing messages from manufacturers with caution. The overall dangers of electronic cigarettes to smokers and their surroundings are only beginning to unravel.