They are everywhere. Literally everywhere. And I’ve seen people from all walks of life and different age groups use these products. E-cigarettes entered the market in 2003 in China and entered the United States and European markets in 2006.
They are battery-operated devices that heat a liquid containing nicotine, producing a vapor that can be inhaled.
In many areas, e-cigarettes entered the market as consumer products without government regulation.
It was initially produced by small companies, however, tobacco companies have bought some of these companies and are developing these products. They are easy to purchase as they are available both online and in traditional retail outlets.
Although they have been marketed as a safe alternative to smoking cigarettes, there is uncertainty about the long-term health effects of e-cigarettes and whether they will help with smoking cessation as advertised.
There are also public health concerns about these products. The effect of e-cigarettes on smoking prevalence and their potential use by children as a gateway to subsequently using combustible tobacco products is a concern.
So what exactly are these popular products?
E-cigarettes, a category of non combustible tobacco products, are a type of electronic nicotine delivery system consisting of a cartridge containing a liquid, a vaporization chamber with a heating element, and a battery.
It works by inhaling or by pressing a button, depending on the device characteristics. The aerosolized liquid in the cartridge creates a vapor that looks like, but is not tobacco smoke.
This process simulates the experience of smoking a conventional cigarette, but no combustion occurs.
The term "vaping" is used to distinguish the process from smoking a conventional cigarette. The term “dripping” is used to describe a technique in which a couple of drops of the liquid in the e-cigarette cartridge are “dripped” directly onto the heating element to create a cloud of vapor that can be inhaled.
This product was originally designed to resemble conventional cigarettes, this technology is rapidly evolving.
Newer versions feature rechargeable batteries as well as heating elements and refillable cartridges that can deliver higher concentrations of nicotine.
Across all brands, the main components of the liquid vaporized are nicotine, propylene glycol or glycerol, and flavorings. A variety of other compounds have also been identified, some with known cancer causing potential.
Who is using this product?
In the United States, the use of e-cigarettes has increased since 2010, corresponding to an increase in marketing for the products.
National surveys of United States middle and high school students reveal a sharp upward trend in e-cigarette use over the past decade.
The reported increase in e-cigarette use by high school students between 2011 and 2017 was greater than the increase in use of any other tobacco product.
In 2018, one in five high school students reported current use of e-cigarettes, a significant increase from previous years.
Fortunately, the rates of e-cigarette use appear to be increasing among current and former smokers but not among never smokers in the United States. So it is not recruiting non smokers to start using this product.
Is it really bad for you?
No observational data examining the long-term health effects (eg, risk of cancer) of e-cigarettes exist. There is growing appreciation that use of e-cigarettes among adults poses fewer risks than does smoking traditional cigarettes.
Potential adverse effects of e-cigarettes are related to exposure to nicotine as well as to other vapor components produced by the devices and risks of the actual device.
However, exposure to harmful toxins is lower among users who switch entirely to e-cigarettes than those who continue to use traditional tobacco cigarettes.
Data on the health consequences of chronic nicotine exposure alone in the absence of cigarette smoking is available from studies of chronic users of nicotine replacement products.
These data do not suggest that chronic nicotine exposure increases long-term cardiopulmonary or cancer risk.
What about the vapor exposure?
E-cigarettes do not expose the user to many of the constituents of cigarette smoke (eg, tars, oxidant gases, and carbon monoxide) that are responsible for many of the tobacco-attributable diseases.
There are concerns about the potential health consequences of secondhand exposure to e-cigarette vapor due to increases in environmental concentrations of nicotine and particulate matter
Most experts believe that inhaling e-cigarette vapor is likely to be less harmful than inhaling cigarette smoke.
The consequences of chronic inhalation of e-cigarette vapor are largely unknown, and levels of toxic and carcinogenic compounds may vary by e-cigarette liquid components and device used.
Little is known about the overall safety or the carcinogenic effects of propylene glycol or glycerol when heated and aerosolized. At high temperatures, propylene glycol decomposes and may form propylene oxide, a probable cancer causing agent.
The long-term cardiovascular risks of e-cigarette use are also unknown. However, they are thought to be lower than the risks of smoking.
There have been reports of these devices causing burns, explosive injuries, and chemical injuries.
So what is the big deal?
The potential impact on public health is uncertain but there are concerns including e-cigarettes' appeal to youth, their potential to reverse gains in social norms about the acceptability of cigarette smoking, and the risk of dependence.
Currently, federal law bans minors from purchasing e-cigarettes. Many states and localities also ban the use of e-cigarettes wherever smoking is banned.
According to the CDC, E-cigarettes can help wean adult smokers from combustible tobacco products. Although there is limited data, it is well established that E-cigarettes are not a safe product. Given this is still a relatively new product, we still have much to learn.
Ultimately, if you are a smoker it would probably be best for your overall health to quit, and if you are a never smoker, there is no need to start.