Four Things You Must Know About E-Cigarettes

The Trump administration in the United States announced that it would soon ban all flavored e-cigarette products to prevent the increasing number of young users from using e-cigarettes. Meanwhile, a serious lung disease related to vaping has emerged, resulting in 6 deaths and hundreds of illnesses. There are four things we must understand about e-cigarettes, which are highlighted below:
 
1. Are e-cigarettes safer than smoking?

In fact, we do not know for sure; unlike cigarettes, e-cigarettes do not burn. This device has been on the market in the United States since 2006, and it works by heating a liquid to create vapor that users inhale. Therefore, e-cigarette users do not come into contact with approximately 7,000 compounds found in conventional cigarettes, and there is no known link between e-cigarettes and cancer. However, this liquid contains highly addictive nicotine. According to a 2018 study by the National Academies of Sciences in the United States, e-cigarettes also contain other compounds that are considered potentially harmful.

There is solid evidence that the vapor from e-cigarettes contains trace amounts of metals, which either come from the coils used to heat the liquid or from other parts of the e-cigarette device. Some flavoring substances also contain diacetyl, a chemical associated with a severe and very rare lung disease. Although most studies suggest that the toxicity of e-cigarettes is much lower than that of smoking, researchers currently do not understand the long-term effects of e-cigarettes on population morbidity and mortality, which may take decades of research to determine. Most of this research was conducted before the outbreak of the serious lung disease in the United States, and researchers are currently investigating 450 cases.

2. Investigations in the United States

Initial symptoms in American patients included difficulty breathing and chest pain, and some were sent to hospitals to use ventilators. According to attending physicians, several teenagers became comatose due to the drugs, and one patient even required a lung transplant. The health department in New York is focusing its investigation on counterfeit cartridges containing vitamin E oil, but federal authorities have not yet identified a substance common to all cases.

Doctors have reported that they found patients suffering from acute lipoid pneumonia, a non-infectious respiratory disease that occurs when fats or lipid-containing substances enter the lungs. However, researchers are currently uncertain why these cases have only been reported in the United States and whether they are new cases or were misdiagnosed earlier.

3. Actions by local governments

In June of this year, San Francisco became the first city in the United States to ban the sale and manufacture of e-cigarettes, followed closely by Richmond, Virginia. The manufacturer JUUL responded to San Francisco's ban by stating that it would push successful adult smokers who transitioned to vaping back to deadly cigarettes. According to a study published in NEJM in February involving 886 patients from the UK National Health Service, this statement is correct.

The one-year cessation rate for e-cigarette users is 18%, while the cessation rate for participants using nicotine replacement products such as gum or patches is 9.9%. However, these transitions are not all one-way; recent studies have shown that e-cigarettes provide a pathway to full smoking among teenagers.

4. Regulation or prohibition

The e-cigarette industry is firmly against minors using such products and states that it will take more measures to prevent sales to them. In the United States, selling e-cigarettes to individuals under 18 or 21 is already illegal, depending on the state. Additionally, smoking bans also deprive addicted adult smokers of valuable tools for quitting. Denying smokers the right to use e-cigarettes may not be a good decision.