Doctors sound the alarm on e-cigarettes
E-CIGARETTES MAY ATTRACT A GENERATION OF NON-SMOKERS, FEAR DOCTORS
Legalising vaping could spawn a generation of nicotine addicts
Health care practitioners are worried that adolescents who were otherwise non-smokers might now get hooked on nicotine as the UAE plans to legalise ecigarettes.
Dr Sree Kumar Sreedhaharan, internal medicine specialist at Aster Clinic Karama, who is a staunch anti-smoking supporter feels the legalisation of e-cigarettes will unleash a whole generation of new nicotine addicts.
“Most e-cigarettes contain nicotine, the addictive drug in regular cigarettes,” he said. “Nicotine can harm the developing adolescent brain. The brain keeps developing until about the age of 25.
“Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood and impulse control,” he added. “Each time a new memory is created or a new skill is learnt, stronger connections — or synapses — are built between brain cells.
“Young people’s brains build synapses faster than adult brains. Because addiction is a form of learning, adolescents can get addicted more easily than adults. The nicotine in ecigarettes and other tobacco products can also prime the adolescent brain for addiction to other drugs.”
Many smokers trying to quit smoking alternate between ecigarettes and actual cigarettes, and it’s here that the younger more impressionable generation may get lured by the sudden trend.
“There is some evidence that young people who use e-cigarettes may be more likely to smoke cigarettes in the future,” said Dr Sreedharan.
“The bottom line is, the use of any tobacco product, including e-cigarettes, is unsafe for young people. The American Cancer Society and the Food and Drug Administration (FDA) warn that no youth should use nicotine products.
“Most e-cigarettes contain nicotine and some that claim to be nicotine-free have also been found to contain nicotine,” he said.
What are e-cigarettes?
Electronic Nicotine Delivery systems (ENDS), are nicotine delivery devices designed to look and feel like a traditional cigarette, a pen or a fashion accessory. They are often marketed as tobacco-free. The difference between conventional cigarettes and e-cigarettes is that instead of burning tobacco, the user is able to inhale nicotine and other flavourings without any combustion. When a user switches on the e-cigarette, and draws air through the device or an airflow sensor, a physical power button activates a battery that powers an atomiser to produce an aerosol containing nicotine and other flavourings. An aerosol in broad connotation here means a substance enclosed under pressure and released as a fine spray by means of a propellant gas. This entire process has been dubbed as vaping.
What are the harmful chemicals in e-cigarettes?
In a study conducted by Dr Tianrong Cheng reviewing ecigarettes at the FDA Centre for Tobacco Products, he stated: “Although deemed safer than cigarettes as these do not involve combustion as in conventional smoking, e-cigarettes contain a variety of toxic chemicals.” Chemicals in e cigarettes include nicotine, TobaccoSpecific Nitrosamines (TSNAs), aldehydes and metals, Volatile Organic Compounds (VOCs), flavours, solvent carriers, tobacco alkaloids in e-cigarette refill solutions and phenolic compounds, polycyclic aromatic hydrocarbons and drugs in e-cigarette refil, solutions, cartridges and aerosols.
How each chemical affects the vaper
Dr Sreedharan quoted several studies conducted on ecigarette smokers and the potential harm unleashed by its chemicals.
Nicotine
The nicotine content of ecigarettes and liquids varies and usually ranges from none (nicotine-free) up to 36 mg/ml, though it can be higher. Common nicotine concentrations of e-cigarette liquids are 6 mg/ml, 12 mg/ml, 18 mg/ml, or 24 mg/ ml. The level of nicotine measured by chemical analysis has been found to be inconsistent with manufacturers package labelling.
Cartridges labelled nicotinefree have nicotine. Nicotine exposure from e-cigarette use, as with cigarette smoking, increases heart rate and produces measurable levels of blood cotinine, a nicotine metabolite.
The amount of nicotine delivered and the level of nicotine in the blood varies depending on nicotine concentration in the e-cigarette liquid, other components in the e-cigarette liquid, user-experience, puffing intensity, device characteristics, and vaping technique.
Propylene glycol/glycerol
Propylene glycol or glycerol are humectants that are the main components of most ecigarette liquids; some products may use ethylene glycol. Vapour 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.
However, most e-cigarettes do contain a number of potentially toxic chemical substances. Most experts believe inhaling e-cigarette vapour is likely to be less harmful than inhaling cigarette smoke.
Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood and impulse control.” Dr Sree Kumar Sreedhaharan | Internal medicine specialist, Aster Clinic
Can e-cigarettes cause heart and cancer risk?
The long-term cardiovascular risks of e-cigarettes though unknown are thought to be substantially lower than the risks of smoking. Aerosol constituents that may influence this risk include nicotine, oxidising chemicals, particulate matter, and acrolein.
A small observational study found that e-cigarette use for at least one year was associated with factors that have been correlated with increased cardiovascular risk and increased oxidative stress.
No observational data examining the long-term health effects (eg, risk of cancer) of ecigarettes exist; however, there is awareness that use of e-cigarettes among adults poses fewer risks than does smoking traditional cigarettes.
Limited evidence on the effects of e-cigarette vapour on respiratory function suggests that changes in airway respiratory function are much smaller than those associated with conventional cigarettes, but there may be an association with cough and asthma symptoms among adolescents.