Electronic cigarettes (e-cigarettes) were invented to help people get away from the carcinogenic content of real cigarettes and they were thought to help people in the process to quit smoking as well.
In the October 2014 issue of the BC Medical Journal a review article is entitled: “Electronic cigarettes: Do we know the benefits vs. the risks?” In it Dr. Roy Purssell, the Chair of the Emergency Medical Services Committee in BC, Canada reviewed the literature about e-cigarettes (Ref.1). He pointed out that several studies have shown that the number of cigarettes used may have declined with the use of e-cigarettes, but the quitting rate on e-cigarettes is not higher than when quitting conventional cigarettes.
Why were e-cigarettes developed?
Originally they were marketed as an alternative to cigarette smoking with the thought that they would only contain the nicotine, but not the myriad of cancer producing chemicals. However, studies now show that this is not the case. As explained earlier people use e-cigarettes, but they often still smoke real cigarettes on the side, in effect just reducing the number of cigarettes smoked per day. Says Dr. Purssell: “Reducing the number of cigarettes smoked per day is much less effective than quitting entirely for avoiding the risks of premature death from all smoking-related causes of death” (also based on Ref. 2).
Chemical composition of e-cigarettes
E-cigarettes are battery-operated vaporizers that give you the feel of smoking a tobacco cigarette. The container inside the e-cigarette can be refilled with “e-juice” that can be bought through the Internet. The liquid contains highly concentrated nicotine, propylene glycol, glycerin, and flavorings (you can choose from cinnamon to cherry flavor and more). The liquid is vaporized by a heating element and the vapor is inhaled. No long-term experiments are available at this time with regard to the safety of these inhaled chemicals in humans. Only short-term experiments are behind the FDA’s declaration that propylene glycol would be “generally recognized as safe” (GRAS) as a food additive. But there is still a difference between inhaling and ingesting propylene glycol, and the same is true for glycerin.
The manufacturers of e-liquid (or e-juice) always put this disclaimer on their products: “Warning: Always keep e-cigarette liquid in a safe place and out of reach from children and pets. Nicotine in its pure form is a poison, and can cause harm if ingested by a child.”
Toxic effects of e-juice (e-liquid)
From September 2010 to February 2014 there were 2405 reports to the poison control centers in the US about e-cigarette exposures. In the month of February 2013 there were 70 calls, in February of 2014 there were 215 calls, a 300% increase. More than 50% of these cases involved young children.
In BC, according to Dr. Purssell the Drug and Poison Information Centre received 70 calls between July 1, 2013 and June 30, 2014. 50% of these involved children who were younger than 4 years old. There was no case of serious toxicity. If, however, enough fluid is swallowed, there can be deaths from nicotine overdose, particularly in children and in pets. Seizures can be caused by nicotine overdoses and poisoning of the breathing center in the brain stem.
Nicotine is highly addictive. In children and in adolescents nicotine has a negative effect on brain development. Here is a report from the Minnesota Poison Control Center, which reports poisoning incidences with e-juice that was swallowed by young children and it reports also about adolescents who overdosed on e-cigarettes.
It appears that the nervous system is more sensitive for toxic effects of nicotine at a younger age.
Regulations of e-cigarettes
At this point e-cigarettes are illegal because the FDA is still examining the pros and the cons. The situation in Canada is similar: Under the Canadian Food and Drugs Act regulations it is currently illegal to sell e-cigarettes containing nicotine. The international Union against Tuberculosis and Lung Disease has issued a position statement saying that its preferred opinion is to regulate e-cigarettes as tobacco products. The UK will be following this advice.
Dr. Purssell commented: ”This is a reasonable course of action for a product that delivers a highly addictive substance with negative effects on brain development and can cause serious poisoning.“
While the Internet merchants are busy marketing these products, it is important that the legislators around the globe take swift action to draft policies and regulations now to protect children and adolescents.
In conclusion it can be stated that smoking e-cigarettes will not have any benefits whatsoever. Smokers still smoke, as the addictive substance (nicotine) in e-cigarettes undermines their efforts to quit. It may be true that they are not exposing themselves to lung cancers as much as those who puff away on regular cigarettes, but instead their cardiovascular system is exposed to the nicotine that causes heart attacks and strokes. It sounds very sobering that they just traded one cause of unnecessary death (lung cancer) for another one (cardiovascular disease leading to strokes and heart attacks).
More information on:
1. Causes of lung cancer: http://nethealthbook.com/cancer-overview/lung-cancer/causes-lung-cancer/
1.BC Medical Journal Vol. 56, no.8, October 2014 (www.bcmj.org)
2.US Department of Health and Human Services. The health consequences of smoking – 50 years of progress: A report of the surgeon general. Atlanta, GA: Centers for Disease Control and Prevention and Health Promotion, Office on Smoking and Health, 2014.
Last edited Nov. 16, 2014