The Rise in Electronic Cigarette Use Leads to More Cause for Concern

Electronic cigarettes are often marketed as healthy alternatives to smoking, but are they actually harmless? Studies have discovered otherwise. Learn more here.

The Rise in Electronic Cigarette Use

Photo by Joseph Morris on Flickr. 


While the trend of electronic cigarettes has been on the rise and the expansion of available flavors and nicotine strengths have done much to entice nicotine users, little research has been done on the long-term effects of electronic cigarettes.

E-cigarettes, invented in 2003 by a Chinese pharmacist Hon Lik, are electronic nicotine-delivery systems (ENDS) that consist of a cartridge containing nicotine and propylene glycol, an atomizer, and a battery. Upon inhaling, a pressure-sensitive circuit is activated, causing the atomizer to heat and vaporize the liquid as it is brought through the mouthpiece. The vapor consists of a fine mist that does not contain smoke or carbon monoxide and disperses more quickly than traditional cigarette smoke.

Not only do the nicotine cartridges come in a variety of flavors including cherry, vanilla, java, pina colada, and menthol, but they can also be purchased at gas stations, grocery stores, tobacco shops, and shopping malls. E-cigarettes do not cause bad breath or leave a lingering smell on hair and clothing as traditional cigarette smoking does.

Did you know that the estimated annual cost of traditional cigarettes for the one-pack-per-day smoker is $1,800? The estimated annual cost for e-cigarettes is $874.

E-Cigarettes and Concerns

Younger Generations Enticed to Smoke

Approximately twenty-two percent of American adults smoke cigarettes. And one in five adult smokers have tried e-cigarettes. While the health effects remain uncertain, one of the main concerns is that e-cigarettes are enticing younger generations to try smoking which could potentially lead them to start smoking traditional cigarettes which are known to cause cancer and other health problems.

Hazards to Children

Another important concern is the hazard the liquid nicotine used in cartridges for e-cigarettes presents for small children. Because e-cigarettes are not required to be childproof and because they come in appealing candy and fruit flavors, children can get a hold of them, potentially resulting in a case of poisoning. The liquid nicotine can be ingested, inhaled, or absorbed through the skin or eyes.

According to the Centers for Disease Control and Prevention (CDC), more than half (approximately 51 percent) of the calls to poison centers due to e-cigarettes involved young children under age 5, and about 42 percent of the poison calls involved people age 20 or older.

Absence of Regulations

The U.S. Food and Drug Administration (FDA) does not currently regulate e-cigarettes; however, the FDA's Division of Pharmaceutical Analysis, part of the agency's Center for Drug Evaluation and Research, has announced findings that indicate that electronic cigarettes expose users to harmful chemical ingredients. In a small sample of cartridges from two leading brands of e-cigarette samples, one sample was found to contain diethylene glycol which is a toxic chemical used in antifreeze. Carcinogens, including nitrosamines, were found in several other cartridge samples. Other tobacco-specific impurities included anabasine, myosmine, and beta-nicotyrine, all of which are carcinogens.

Inaccurate Labeling

Another important concern about e-cigarettes is inaccurate labeling. Some e-cigarette cartridges labeled as containing no nicotine actually contained low levels of nicotine. Since they are not regulated by any governing agency, e-cigarette manufacturers do not have to be as particular about labeling as a regulation would require.

Health Effects of Nicotine

It's important to note the health effects of nicotine. Nicotine, a harmful and addictive substance found in all tobacco products, travels through the bloodstream and reaches the brain in seven to fifteen seconds. Once there, it boosts the "reward center", which releases chemicals that cause a pleasant, happy feeling. A hormone, called adrenaline, is released, causing an increased heart rate and blood pressure and making breathing rapid and shallow. With continued nicotine use, these effects can damage your heart, arteries, and lungs, increasing your risk of heart attack, stroke, and chronic lung disease.

Did you know it takes as long as four to six weeks for the brain to readjust to life without nicotine? It has to relearn how to make the chemicals to stimulate the pleasure centers on its own. When a person quits using nicotine, he may experience a craving for nicotine or feel irritable, anxious, or depressed. With time, however, the brain is able to heal and the withdrawal symptoms go away.

Toxic Chemical Exposure & Unpredictable Doses

Other concerns include exposure to toxic chemicals and the fact that consumers have no way of knowing whether e-cigarettes are safe for their intended use or about the types and concentrations of potentially harmful chemicals or the cartridge's nicotine dose.

Health Effects of Other Contents

Most importantly, doctors have raised concerns about e-cigarette vapor. The aerosol in the e-cigarette cartridges is not a harmless water vapor; it can contain heavy metals, ultrafine particulates that can be inhaled deep into the lungs, and cancer-causing agents like acrolein. They also contain propylene glycol or glycerin and flavorings. While the long-term health effects of inhaling these substances are widely unknown, the CDC states that inhaling the aerosol directly from the device or from secondhand aerosol that is exhaled by users is potentially harmful to health. In fact, the vapor is now thought to cause acute pulmonary issues.

As reported to CHEST Journal, the official publication of the American College of Chest Physicians, a 42-year-old woman was seen multiple times in the emergency department over the course of about seven months. Her symptoms included dyspnea, productive cough, and subjective fevers. During each visit, she received antibiotics, until she was finally admitted to the hospital. It turns out the patient had started using electronic cigarettes about seven months prior to her hospitalization which coincided with her history of symptoms. The diagnosis was determined to be exogenous lipoid pneumonia due to e-cigarette use.

According to the National Center for Biotechnology Information (NCBI), exogenous lipoid pneumonia is a rare form of pneumonia caused by inhalation or aspiration of a fatty substance.

The suspected source of this patient's diagnosis was recurrent exposure to glycerin-based oils found in the e-cigarette nicotine vapor. The patient was instructed to avoid the use of e-cigarettes, and, subsequently, her symptoms improved.

Dental Concerns: Traditional vs. Electronic

According to the CDC, smoking traditional cigarettes weakens your body's immune system, making it harder for it to fight off infections like gum disease. Smoking also makes it harder for your gums to heal once you have gum damage. So, if left untreated or unresolved, the gum disease can advance and even result in tooth loss. The bone and tissue that hold your teeth in place can weaken, resulting in loose teeth and the need for a tooth to be pulled.

A smoker has twice the risk for gum disease compared with a nonsmoker, and the longer the person smokes, the greater his risk for gum disease. It doesn't matter if you smoke cigarettes, pipes, or chew tobacco; if you use tobacco in any form, your risk for gum disease increases.

But what about dental concerns for e-cigarettes?

Unfortunately, little research has been done on the effects of e-cigarettes on our dental health, mainly because it is such a new product on the market. But a study conducted by Polosa et al in 2011 discovered that, after four weeks of use, six percent of patients reported mouth irritation; eight percent reported sore throat and dry mouth; and nine percent reported mouth ulcers. After eight weeks, eight percent reported coughing, and after twenty-four weeks, eight percent reported throat irritation and seven percent reported dry mouth.

The Takeaway

When considering the use of e-cigarettes or other vaping units, whether the use is for the purpose of tobacco cessation or simply to follow the "in-crowd", it's important to consider all of the health concerns we've talked about here. Since these devices are not currently regulated by the FDA, engaging in this activity puts users at the mercy of the manufacturing companies, trusting them to provide accurate information so users can make an informed decision.

Here are some important questions to ask before using e-cigarettes or vaping devices:

  • How accurate is the product labeling?

  • Do the e-liquids contain toxic chemicals? And what toxic chemicals are they?

  • What risks are involved with use?

  • In what country is the e-liquid manufactured?

  • Is the manufacturer, at minimum, certified by the American E-Liquid Manufacturing Standards Association (AEMSA)?

Staying away from e-cigarettes or vaping units is, of course, the best way to avoid any harmful effects. While they might seem trendy, little is known about their impact on our health. We often don't realize that what we do to our bodies today affects our health five or twenty years down the road.

The typical saying goes, "We're all going to die anyway so we might as well enjoy it." We hear a lot of people saying that, don't we? But it can be a long road of discomfort before our last moments. That's why organizations that promote tobacco cessation show people who are suffering from lung diseases like emphysema. They have to live out the rest of their lives hooked up to an oxygen supply in order to breathe.

But instead of saying, "it's not fun getting old," there is something we can do to promote health. We can treat our bodies right by giving them the vitamins and nutrients they need to keep us healthy, not just today, but twenty years from now.



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