21 Jul Vaping and E-cigs: Is It All Smoke and Mirrors?

Cigarette smoking remains a leading cause of sickness and mortality, responsible for over 400,000 deaths in the United States each year. The popularity of e-cigarettes has grown from this awareness, but these products that claim to be safer and a healthier alternative are just as dangerous as traditional cigarettes and pose their own set of new threats. There is a growing concern as younger and younger children are drawn to them and these products are exploding in popularity—they are being used by both adolescents and adults. Electronic nicotine delivery systems (ENDS) are now estimated to be a $1.5 billion market and shows no signs of slowing down. In 2015, more teens used e-cigarettes than regular cigarettes, and the ages of the users are shocking. A recent survey showed that 11% of seniors in high school have used traditional cigarettes, but 16% have used e-cigarettes. Amongst 8th graders aged 13–14years old, 10% had already admitted to trying an e-cigarette.

The worst health consequences associated with smoking (e.g., cancer and heart disease) are linked to inhalation of tar and other chemicals produced when the tobacco products are lit; the pleasurable, reinforcing, and addictive properties of smoking are produced mostly by the nicotine contained in tobacco.

The Truth behind E-cigs

Electronic cigarettes (also called e-cigarettes or ENDS) are battery-operated devices designed to deliver nicotine with flavorings and other chemicals to users in vapor instead of smoke. They can be manufactured to resemble traditional tobacco cigarettes, or even everyday items like pens or USB memory sticks; newer devices, such as those with fillable tanks, may look different. More than 250 different e-cigarette brands are currently on the market.

E-cigarettes are designed to simulate the act of tobacco smoking by producing an appealingly aerosol that looks and feels like tobacco. Because they deliver nicotine without burning tobacco, e-cigarettes appear as if they may be a safer, less toxic alternative to conventional cigarettes. Unfortunately, e-cigarettes still contain the highly addictive nicotine and other potentially harmful chemicals. Nicotine is a drug, and recent research suggests nicotine exposure may also prime the brain to become addicted to other substances. Also, testing of some e-cigarette products found the vapor to contain known carcinogens and toxic chemicals (such as formaldehyde and acetaldehyde), as well as potentially toxic metal nanoparticles from the vaporizing mechanism. The health consequences of repeated exposure to these chemicals are not yet clear.

Even Dangerous When They’re Turned Off

Another worry is the refillable cartridges used by some e-cigarettes. Users may expose themselves to potentially toxic levels of nicotine when refilling them. As the industry has been unregulated until just recently, there was no way of a consumer knowing how much nicotine was contained in refills. Studies have shown that often the levels of nicotine differ significantly than the label being sold, sometimes lower, but occasionally higher. E-cigarettes contain a liquid solution that is usually flavored and appealing to children such, peppermint, bubble gum, fruity, or chocolate.

The refill solutions can poison children and adults through ingestion or skin absorption. Young children across the country, including a toddler in Texas, have been killed by very small amounts of concentrated nicotine in the small, brightly colored refill bottles. Less than one highly-concentrated teaspoon of a refill can be fatal if ingested. Even adults can suffer from symptoms of nicotine poisoning, which include vomiting, sweating, dizziness, increased heart rate, lethargy, seizures, and difficulty breathing, and these cases are on the rise in ERs throughout the country.

Feeling the Effects

Poison centers in the US have seen an increase in these type of overdoses, as in 2015 3,073 exposures were reported, more than double seen just 2 years prior. Adult ENDS users should always keep e-cigarettes and liquid nicotine locked up and out of the reach of children and follow the specific disposal instructions on the label.

E-cigarettes are not approved for smoking cessation by the US Food and Drug Administration (FDA), and the long-term health effects to users and bystanders are still unknown. Because these devices mimic the gestures and actions of conventional cigarettes, they are normalizing these behaviors amongst youth.Talk to your teens about smoking, vaping, and all the behaviors they see around them. When you see smoke, there’s not always fire—it could be worse.

For more information on the web, visit drugabuse.gov or aap.org. If you have questions or would like to discuss any concerns you have regarding vaping or e-cigarettes, you can schedule an appointment with me, Dr. Kathryn Mandal, by calling 817-617-8600 or scheduling online at continuumtx.com.

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