Concerns About the Harm of E-Cigarettes: See What the Experts Say

Concerns About the Harm of E-Cigarettes: See What the Experts Say
 
Concerns about the harm of e-cigarettes focus on the following points:

1. Many people who use e-cigarettes to quit smoking continue to use them after one year, and some individuals use both traditional cigarettes and e-cigarettes long-term.

2. The intake of nicotine is related to cardiovascular diseases. The nicotine content in one cartridge of e-liquid is equivalent to that in a pack of cigarettes.

3. E-cigarettes have been found to contain tobacco-related toxins similar to those in traditional smoking, but at lower concentrations; using both simultaneously can lead to an additive effect of toxins.

4. Short-term use of e-cigarettes can cause dysfunction in the autonomic nervous system, raise blood pressure, increase heart rate, and elevate C-reactive protein (a marker of inflammation associated with cardiovascular diseases). Long-term use may increase the risk of cardiovascular diseases, including heart attacks and strokes.

5. One important component of e-cigarettes, flavoring agents, also harms cardiovascular function. A report published in May this year in the Journal of the American College of Cardiology (JACC) indicated that these flavoring agents have strong cytotoxicity and can disrupt endothelial function.

As a physician, I often face patients seeking smoking cessation advice, and discussions about e-cigarette use will become increasingly common.

Doctors should thoroughly understand the specific situations of their patients and provide reasonable, effective, and safe smoking cessation advice. Given the current knowledge and experience, they should be familiar with the harms and potential benefits of e-cigarettes to determine whether the short-term harms of e-cigarettes are worth enduring to achieve cessation of traditional smoking. It is essential to follow up on patients' smoking cessation processes, ensuring that short-term use of e-cigarettes is quickly stopped to reduce and avoid long-term side effects.

The long-term toxic side effects of e-cigarettes may take 10 or even 20 years to manifest, similar to the long-term studies required to understand the health hazards of smoking. Currently, we lack long-term data on e-cigarettes, and we cannot say that their users are safe. The American Heart Association (AHA) stated in a 2014 policy statement that short-term use of e-cigarettes could be considered to achieve smoking cessation if other FDA-approved cessation methods fail. Patients need to be informed that the long-term safety of e-cigarettes is unknown and should also aim to quit.