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Electronic cigarettes—let’s clear the air

  • Published
  • By Heather Braundmeier
  • 375th Aerospace Medicine Squadron

The rise of electronic cigarettes, marketed as a safe alternative to cigarettes, has sparked a growing debate: do electronic cigarettes, commonly referred to as e-cigarettes, offer a healthy alternative to smoking?

Could they be used as a quitting aid? Should minors be allowed to use e-cigs? The research is not yet conclusive, but the not-so-smoky haze surrounding e-cigarettes is beginning to clear.

An e-cigarette is a plastic, battery powered device that delivers nicotine by heating a nicotine-containing liquid to create a vapor that the user then inhales. They are not yet regulated by the Federal Drug Administration, and very little research exists on their long-term effects on health or use as a quitting aid.

The FDA’s Center for Drug Evaluation did recently conduct a pharmaceutical analysis on e-cigs of various flavors and nicotine levels from two of the leading brands, and found that:

·         The e-cigarettes did contain cancer-causing chemicals as well as harmful toxic chemicals, including one with an ingredient used in antifreeze that is known to be toxic to humans;

·         The manufacturers that produce e-cigarettes perform little to no quality control, exhibited by variable nicotine levels in e-cigarettes advertising the same nicotine content; and

·         E-cigarettes labeled as nicotine-free actually did contain low levels of nicotine.

Smokers may be drawn to e-cigs as a “safe alternative” to smoking, but even without extensive research, doctors suspect adverse effects for smokers using e-cigs to quit. Besides the possibility of e-cig vapor containing toxic chemicals and carcinogens, Dr. Seth Bilazarian from also notes that a smoker may use e-cigarettes to skirt anti-smoking laws, which could increase his or her daily intake of nicotine and result in an addiction to a higher level of nicotine, which may make quitting nicotine even harder in the long run.

When used as a smoking cessation tool, studies have shown that e-cigarettes do not result in any more successful quitting attempts than nicotine replacement therapy, like gum and patches.

Bilazarian also points out that the particles inhaled during “vaping” may lodge in the alveoli of the lung, which absorb oxygen from the air we breathe in to transfer to the bloodstream. This could cause long-term problems—and since e-cigarettes were invented in just the early 2000’s by Hon Lik, a Chinese pharmacist, the long-term effects are unknown and unstudied.

The e-cigarette doesn’t actually contain a simple nicotine-water mixture, as most people have been led to believe. The American Heart Association’s journal Circulation informs us that the most common liquid used to carry the nicotine is propylene glycol, which can produce respiratory irritation and even contribute to asthma attacks.

Often e-cigarettes also contain the oily substance glycerol, or glycerin, a common ingredient in skin lotions, the inhalation of which has been linked to a type of pneumonia.

The American Heart Association recommends that indoor e-cigarette use be banned anywhere that smoking is banned due to their contribution to indoor air pollution. The lack of quality control has caused concerns over whether the plastic e-cig could malfunction and leak toxic liquid nicotine onto its user.

Nicotine can be absorbed through the skin, as with the nicotine patch. Nicotine is an addictive stimulant which has also been used as a pesticide and is toxic to humans in doses as small as 60 mg, or one drop of pure nicotine. With ‘e-juice’ concentrations as high as 54mg of nicotine per milliliter on the market, that presents a danger not only to the adult user but also to children.

E-cigarette liquids, or “e-juices,” are available in a wide variety of such appealing flavors as blueberry, bubble gum, vanilla shake, and cola, presenting a real threat to children who live in a house with an e-cigarette user.

“A standard size eye dropper of the liquid nicotine of this strength would be enough to kill four toddlers,” Dr. Lolita McDavid, of Rainbow Babies and Children’s Hospital, stated at a poisoning prevention event.

In 2013 America saw three times the accidental poisonings due to liquid nicotine compared to 2012, with over half of the cases being children under the age of 5.

Besides being dangerous to young children, e-cigarettes may lure teens to try nicotine for the first time. The Center for Disease Control reports that e-cigarette use among middle and high school students has more than doubled from 2011-12.

With their fun flavors, cool looks, celebrity endorsements and promise of the effects of nicotine without the danger, smell, or taste of cigarettes, kids may be attracted to the slim plastic tubes, which could pave the path to nicotine addiction and eventual cigarette use. Some cities and states have enacted regulations prohibiting the sale of e-cigarettes to minors, but as of yet there are no federal regulations because the devices do not contain tobacco. The FDA recommended in April 2015 that the government ban the sale of electronic cigarettes to minors, but the proposed legislation has not yet been put into place.

So what do you need to know about e-cigarettes? They do NOT operate with harmless water vapor as marketing would leave you to believe. Some e-cigarettes contain carcinogens, and all contain respiratory tract irritants. There is no way to tell which ones are safer, because quality is inconsistent even within brands. They present a poison threat to children and adults alike.

Nicotine is an addictive substance no matter the delivery method, and these e-cigarettes attract a younger audience. We do not know the long term effects of e-cig use. Smokers: if you want to quit, use an FDA approved aid, along with counseling. On base, the Health Promotion Flight, 375th Medical Group/Aeromedical Medicine Squadron is a great resource. Call us at 256-7139 and ask about getting help to quit.

Non-smokers: don’t start using e-cigarettes or any other nicotine delivery device, for that matter. Non-nicotine vaporizers come along with all of the problems described here, minus the nicotine, and even that is not guaranteed.