The Dangers of E-cigarettes

Health

What are e-cigarettes?

Electronic cigarettes, or e-cigarettes, include e-pens, e-pipes, e-hookah, and e-cigars and are known collectively as ENDS – electronic nicotine delivery systems.  Vaping is another term used to describe the use of e-cigarettes.  According to the FDA, e-cigarettes are devices that allow users to inhale an aerosol containing nicotine or other substance.  Unlike traditional cigarettes, e-cigarettes are generally battery-operated and use a heating element to heat e-liquid from a refillable cartridge, releasing a chemical-filled aerosol.1

The National Academies of Science, Engineering and Medicine concluded that there is substantial evidence that if a youth or young adult uses an e-cigarette, they are at an increased risk of using traditional cigarettes.  Research shows that 20% of all youths use e-cigarettes, which is a 135% increase in only two years.  This is no surprise when the FDA allows the marketing of candy-flavored products that appeal to kids.  The Surgeon General reports e-cigarette use among youths is a significant public health concern, and steps must be taken by parents, educators and especially policymakers to discourage use of e-cigarettes.1

What is in e-cigarette aerosol?

E-cigarette aerosol that users breathe from the device and exhale can contain potentially harmful substances, including:2

  • Nicotine
  • Ultra fine particles that can be inhaled deep into the lungs
  • Flavoring such as diacetyl, a chemical linked to a serious lung disease
  • Volatile organic compounds
  • Cancer-causing chemicals
  • Heavy metals such as nickel, tin, and lead

The strength of an e-cigarette is determined by the amount of nicotine in the e-liquid and is expressed in milligrams per milliliter or as a percentage.4  It is difficult for consumers to know what e-cigarette products contain.  For example, some e-cigarettes marketed as containing zero percent nicotine have been found to contain nicotine.2  A pod containing 5% nicotine salt may have as much as 30 to 50 milligrams of nicotine, which is equivalent to the amount of nicotine delivered in one to three packs of cigarettes.4

What are the health effects of using e-cigarettes?

Nicotine is the primary substance in both regular cigarettes and e-cigarettes, and it is a highly addictive and toxic chemical.  It causes cravings, and users suffer withdrawal symptoms if the craving is ignored.  It raises blood pressure and spikes adrenaline, which increases one’s heart rate and the likelihood of having a heart attack or stroke.1,3  In recent months, the Centers for Disease Control and Prevention (CDC) has reported more than 2,500 cases of lung injury tied to vaping, mostly involving products that contain tetrahydrocannabinol (THC).4  Vaping has been around for less than a decade in the US, therefore, the mid-to-long-term health consequences are not yet known.  Emerging data suggests links to chronic lung disease and asthma, and associations between dual use of e-cigarettes and smoking with cardiovascular disease.  The inhalation of harmful chemicals can cause irreversible lung damage and lung diseases.1,3  If you vape, watch for symptoms like coughing, shortness of breath, and chest pain.4  E-cigarette users expose themselves to all kinds of chemicals that are not yet fully understood and are probably not safe for one’s health.1,3

A study conducted at the University of North Carolina showed that even in small doses, inhaling the two primary ingredients found in e-cigarettes – propylene glycol and vegetable glycerin – is likely to expose users to a high level of toxins, and that the more ingredients a user is inhaling, the greater the toxicity.1  It is known that nicotine can harm adolescent and young adult brain development, which continues into the early to mid-20’s.  It is also a health danger for pregnant adults and the developing fetus.  E-cigarettes also contain cancer-causing chemicals.  Defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious bodily injuries.  Additionally, children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their eyes or skin.2

Will e-cigarettes help me quit smoking?

E-cigarettes aren’t approved by the FDA as a quit aid.  Studies to test whether e-cigarettes can help people stop using tobacco have had inconsistent results.  Limited research suggests that using only e-cigarettes containing nicotine to quit smoking can be effective short-term compared with using medicinal nicotine replacements, such as nicotine patches or Chantix.  There is an inadequate amount of evidence comparing the safety and effectiveness of using e-cigarettes to quit smoking or to establish evidence-based treatments.  E-cigarettes might be appropriate only in those unwilling to try evidence-based smoking cessation therapies or who haven’t had success with such therapies.4  If an individual is using e-cigarettes to quit smoking, they should remember that their goal is to completely quit using all tobacco products.  Dual use of e-cigarettes containing nicotine and traditional cigarettes is strongly discouraged.  There are several FDA-approved medications that have been shown to be safe and effective to aid in quitting.  A combination of medication and counseling has been shown to work best.   Due to unresolved safety concerns and because the research on e-cigarettes as a stop-smoking aid is inconclusive, it is not recommended to use e-cigarettes as a way to quit smoking.4  

Getting help to quit

If you want to stop smoking or need assistance with e-cigarette cessation, call 1-800-QUIT-NOW (800-784-8669) to connect to your state’s quit line.  You can also contact your primary healthcare provider to set-up an appointment to get assistance with quitting.  Remember the goal is to quit – not switch.

©2022HealthSpot  References: (1)American Lung Association (2020). E-cigarettes.  Retrieved on 09/16/2020 from https://www.lung.org/quit-smoking/e-cigarettes-vaping/lung-health;(2)CDC (2020). About electronic cigarettes: E-cigarettes.  Retrieved on 09/16/2020 from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html;(3)Johns Hopkins Medicine (2020). 5 vaping facts you need to know.  Retrieved on 09/16/2020 from https://www.hopkinsmedicine.org/health/wellness-and-prevention/5-truths-you-need-to-know-about-vaping;(4)Mayo Clinic (2020).  Electronic cigarettes: Not a safe way to light up.  Retrieved on 09/16/2020 from https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/in-depth/electronic-cigarettes/art-20204330.