George Washington University
Joon Young Jung
Electronic cigarettes are amongst many products that are meant to promote a smoker to be able to quit. E-cigarettes are similar to ordinary cigarettes in appearance; however, they lack the tobacco ingredients that compose the traditional cigarettes. The e-cigarettes are made up from a metal tube and a battery-like structure that produces a lot of heat to cause vaporization of liquid nicotine. The propylene glycol fluid contains other chemicals that produce the vapor (smoke) that people inhale or exhale (Kaplan, 2015). While the e-cigarettes may appear to have certain short-term or intangible benefits such as lack of ash, tobacco smell, and transition agent for quitting smoking, we contend that vapor cigarettes are just as harmful as regular cigarettes. Thus, the primary thesis of this paper is that electronic cigarettes are as much a threat to individual and public health as regular cigarettes.
The smoking of e-cigarettes can produce significant amount of smoke that causes pollution and impairs air quality (Schober et al., 2014); the smokers are therefore under restriction to avoid polluting public places and working environments (Evangalista, 2010). The US Food and Drug Administration (FDA) has been conducting research on the vapor solutions and has serious concerns about the risk of increased nicotine addiction. Some of the provisional results have shown a substantial concern in public health (Pursell, 2014). The FDA analysis of the e-cigarette has indicated that smoking of these e-cigarettes is becoming a global threat. The e-cigarettes were first found in China, and they became available later in the U.S.
Research suggests that a substantial number of young men and women are attracted to using the new method of smoking (Choi et al., 2012). The fundamental concern for the FDA is the safety of people consuming these products and how these chemicals are marketed. The FDA believes that the nicotine found in e-cigarettes may attract even the non-smokers to start smoking and may even develop addiction. (Nichter, 2015). The Center for Drug Evaluation and Research under the FDA carries various analyses on the minuscule samples from the cartridges available from varying companies. The analysis shows that the chemicals such as diethylene glycol that is vital in antifreeze are in the smoke; this chemical is very toxic to humans. Other chemical ingredients include various carcinogen compounds that have adverse effects on the health of users. Since there is no sufficient data and information indicating any advantages to the electronic cigarettes, the products should not be licensed (Van Zyl-Smit, 2013). Regulations should be available to inhibit the distribution of the cigarettes to the smokers, irrespective of their age.
A research study was conducted by California scientists in 2010 concerning the health effects of the e-cigarette (Pursell, 2014). One of the health effects studied was pulmonary function; the research involved people of all ages and tested for lung function at intervals of hours or days following the consumption of e-cigarettes. While the e-cigarettes had no significant effects on the lungs in acute exposures, but several measurements from the experiment indicated a rise in airway resistance by about 18.4% (Pursell, 2014). Moreover, smoking e-cigarettes for long periods could cause asthma, especially in people with the long history of airway resistance (Pursell, 2014; Li et al., 2000). In addition, consumption of e-cigarettes leads to constriction of lung peripheral systems; this occurs as a result of consuming chemicals such as propylene glycol. Chronic lung disorders such as bronchitis and emphysema may also occur from prolonged inhalation of the toxins in e-cigarette vapors (Snider, 1989; Hogg, 2004).
While most research studies that has been carried out show no strict relationship between nicotine and cancer (Wua et al., 2006), but there exist a genetic variation component of contribution in certain individuals (Thorgeirsson et al., 2008). In addition, while there is no sufficient evidence to suggest that nicotine causes cancer, research does indicate nicotine-derived nitrosamines play a role in tobacco-cancers (Hoffmann, & Hecht, 1985). Moreover, e-Cigarettes have propylene and glycol that may produce large volumes of formaldehyde substances. The formaldehyde particles have the potential to cause cancer disorders such as leukemia and nasopharyngeal cancers (University of Utah Health Care, 2015). For cancer patients, nicotine does not play any role in their treatment to help them recover from the disease. Smoldering particles and smoke in addition to hot, poisonous gases are the chemicals that cause the damage to human tissues (Farsalinos, & Polosa 2014). Contrary to the belief of many, nicotine is not a toxic drug by itself. Effects of nicotine are similar to the effects of caffeine. However, the elimination of cigarette smoking and e-cigarette is likely to save about 6 million lives across the world (Fairchild, Baye & Colgrove, 2014).
Nicotine has similar adverse health effects as caffeine. For instance, nicotine has effect on the cardiovascular system (Benowitz et al., 1988). It has the effect of increasing the heart rate in addition to the blood pressure. Another health hazard that results from nicotine is the fetal development in female smokers (Ernst, Moolchan & Robinson, 2001). Most people confuse the harm that smoking causes to the body for nicotine not putting into consideration that many different substances that the smokers inhale together with nicotine. E-cigarette also contains propylene glycol that has adverse health effects on secondhand smokers (Farsalinos, & Polosa 2014). For instance, short-term exposure of children to the chemicals results in irritation of the throat, eyes and the airway (Flouris et al., 2014). In case of long-term inhalation exposure can lead to the young people acquiring asthma (Bernstein et al., 2008).
Extensive research has been carried out to identify the health risks associated with nicotine. Experience with nicotine in clinical studies suggests that medicinal nicotine is a beneficial and safe drug (Grana, Papova &Ling, 2014). However, withdrawing from nicotine usage is likely to be disruptive and cause health problems to the body of the users (Stolerman & Jarvis 1995). Therefore, utilization of nicotine by persons who stopped smoking has certain health benefits and as such the prospects for e-cigarettes are promising. E-cigarettes offer most of the pleasures individuals perceive in smoking, but with minor adverse impacts. However, doing away with the unpleasant experience of smoking is better and it completely lowers the cost, in health and monetary terms.
The introduction of e-cigarettes may have effects in increasing the number of smokers contrary to the argument put forward by many. All the same, a good number of individuals unwilling to research for more acceptable reasons base their argument on products that are not as dangerous as cigarettes. They argue that these products are likely to be more hazardous, thus preventing a good number of smokers from quitting. A survey that has been carried out disapproves that and suggests that usage of e-cigarette helps many to kick their tobacco habit (Grana et al., 2014). Globally, the use of e-cigarette is rising dramatically suggesting that a good percentage of smokers are turning to the devices that will then help them reduce the amount they smoke or quit smoking altogether. However, it is not advisable to persons who have not been smoking to engage in e-cigarette usage as it has got its adverse health effects.
Contrary to what many believe, there is no relationship between e-cigarette and the rising number of adolescent smokers. The number of e-cigarette users is increasing day by day out among school-age youngsters. However, the above is not sufficient evidence that e-cigarette has made the number of young smokers to rise; it only reflects the habits of adults in the society. Its harmfulness depends entirely on personal thinking. The possibility is high that the use of the e-cigarettes has been displacing smoking among the young generation. Data from the American research shows that e-cigarette smoking is encouraged as it helps quite a good number of smokers quit the habit (Caponnetto, 2011). Therefore, e-cigarette smoking is mostly common to those who have been smoking and are willing to leave the behavior other than the youths.
There has been a misconception that e-cigarette advertisements target the adolescents as their clients. It is a major evidence-free accusation against the producers asserting that their target customers are kids. It is very clear that manufacturer targeting children will be acting against codes and ethics in addition to putting themselves at the risk of losing their reputation (Nichter, 2015). . The primary goals of the manufacturers are the already existing smokers that are willing to change their smoking habit or quit smoking all the same. However, in the European Union, advertisement on tobacco has been banned as it causes 500,000 deaths annually in the EU. Such a ban is not in place with e-cigarettes. There is a probability that e-cigarettes will have a protective effect on the smokers, reducing the number of deaths in the near future.
Advertisements on e-cigarettes are paramount globally as a method of persuading people to stop smoking. Communication with smokers is essential, to build brands that can be trusted and to reward innovation in order assist smokers come over to vaping. It is possible to persuade non-smokers to vape. The health risks that have a relationship e-cigarette is thus minimal in comparison the health benefits. Therefore, putting into consideration the advantages and disadvantages, benefits outweighs the risks, thus encouraging use of e-cigarette by the people who have already engaged in the smoking habit.
Some medical specialists argue that nicotine is one of the most addictive substances of tobacco. They also state that tobacco is a drug that is mostly meant to transfer nicotine into the body of users. Some medical doctors compare nicotine to cocaine without a sound proof, thus making the argument lack a base. Putting into consideration several lines of evidence including physical dependence potential and death patterns together with pharmacologic addiction measures, every single line of evidence is prevailing in the comparison between cocaine and nicotine. From the analysis, it is very clear that addiction to nicotine is far much lower in comparison to cocaine (Caponnetto, 2011). Nicotine just by itself is not addictive as many people think. The capacity to addiction depends on speed of delivery. In addition, the extent of effects also depends on the availability of sensory together with behavioral reinforcements.
There is the belief that e-cigarette normalizes smoking. However, it is clear that competitive products seldom normalize each other. The proof they provide is not sufficient to say that e-cigarette normalizes tobacco smoking. Alongside nicotine, e-cigarette smoking introduces other psychoactive substances to the body of the smoker. The above substances have the addictive properties that make most smokers end up in addiction (Van Zyl-Smit, 2013). Therefore, saying that smoking is addictive will be quite accurate rather than saying that nicotine is addictive. However, e-cigarette contains fine and ultrafine particles that are likely to cause respiratory problems, the epitomes being asthma in addition to constricting arteries that are likely to trigger the heart attack.
According to the above arguments, e-cigarettes have merits that outweigh the conventional cigarettes. However, firm data is lacking concerning the products. Variations in product formulation, ingredients and potential poisoning make it a challenge to deal with electronic cigarettes. E-cigarettes may be vital in influencing smoking cessation, but the supportive information is lacking in most relevant sources. The e-cigarettes may avail minimum health effects than the regular cigarettes. However, clear evidence of minimal effects after smoking for long periods is not in existence. There has been a notable attractiveness for electronic cigarette and other devices for tobacco-dependent individuals. The presence of increasing technology and the different flavors may raise an appeal to the young consumers.
A significant gap between health hazards and the information for e-cigarettes is very apparent. Developing of standards on these products has been a challenge; the process should address issues regarding quality, materials, and manufacturing procedures. There is a substantial limitation of data in the area of impacts that occur as a result of long-term use of aerosol and nicotine. In addition, the consumption of flavors and PG can increase the effects of smoking. The impacts of aerosols on the amount of nicotine in the e-cigarettes are is clear from the analysis.
The cigarettes have the ability to cause significant effects on public health. The control and regulation of the e-cigarettes are different from one nation to the other. Surveillance to determine the availability and management of the e-cigarettes has been ongoing in 33 countries that have been responding to WHO since 2011; of these nations, 13 are reporting the unavailability of the products. Of the 16 countries reporting on the prevalence of the e-cigarettes, seven of them regulate the distribution and use of the cigarettes (Van Zyl-Smit, 2013). Although the marketing of the cigarettes is open in some nations such as U.S, some states are employing policies of restrictions based on the available health effects to develop an efficient control method. If the e-cigarettes are not under control, the whole population in individual states may suffer substantially. There is no adequate data to provide for the merits of the e-cigarettes on public health among smokers and the whole population at large.
Along with personal perception to dealing with the cigarette addiction, a definite conducive environment is a requirement to encourage e-cigarette smokers who are willing to quit smoking. Dealing with tobacco addiction is one of the vital parts of the entire nicotine prevention policy along with strategies such as heavy taxation and price fluctuations. Advertisement inhibitions and dissemination of data and foundation of public smoking zones would also help reduce the practice of nicotine consumption to a substantial level. The available recommendations suggest an extended framework for handling the treatment of nicotine reliance (Goniewicz, Kuma, Gawron, Knysak &kosmider, 2012). In this context, the relevant authorities can progressively select least, extended and major recommendations as they enhance their resources and necessary capacities.
The suggested framework recommends a combination of three strategies. One of the strategies involves an approach in the public health docket that seeks to alter the social environment and facilitate the development of a supportive environment for both the users and non-smokers. The other strategy employs the health forums approach that concentrates on supporting and developing clinical excellence practices. The behavioral and pharmacological activities assist nicotine-dependent victims maximize their chances of stopping, reducing or stopping smoking frequency. The third approach requires an apparent surveillance. Broader research and data collection approaches that facilitate the exchange of data and knowledge to raise awareness are important to altering the social beliefs and taboos as a way of mitigating health hazards.
The Word Health Organization believes that without heavy dependence of priorities and existing financial support, a nation, State or a region can create an efficient way of dealing with e-cigarette dependence (Goniewicz et al., 2012). The countries should prepare to develop a State policy strategy for the treatment of e-cigarette addiction. The international communities should aim at developing a system of sharing and mobilizing information. In addition, writing up strategies, reviewing of recommended practices, funds contributions and the establishment of partnerships will help in mitigating the issue of nicotine addiction.
In conclusion, e-cigarettes may appear to have certain short-term benefits and can help people quit smoking. However, the e-cigarettes are just as harmful as regular cigarettes and hence electronic cigarettes are as much a threat to individual and public health as regular cigarettes.
References
Benowitz, N. L., Porchet, H., Sheiner, L., & Jacob, P. (1988). Nicotine absorption and cardiovascular effects with smokeless tobacco use: comparison with cigarettes and nicotine gum. Clinical Pharmacology & Therapeutics, 44(1), 23-28.
Bernstein, J. A., Alexis, N., Bacchus, H., Bernstein, I. L., Fritz, P., Horner, E., & Tarlo, S. M. (2008). The health effects of nonindustrial indoor air pollution. Journal of Allergy and Clinical Immunology, 121(3), 585-591.
Caponnetto, P., Polosa, R., Russo, C., Leotta, C., & Campagna, D. (2011). Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series. J Med Case Rep, 5(1), 585.
Choi, K., Fabian, L., Mottey, N., Corbett, A., & Forster, J. (2012). Young adults’ favorable perceptions of snus, dissolvable tobacco products, and electronic cigarettes: findings from a focus group study. American journal of public health, 102(11), 2088-2093.
Electronic cigarettes. Nicotine & Tobacco Research, nts103.
Ernst, M., Moolchan, E. T., & Robinson, M. L. (2001). Behavioral and neural consequences of prenatal exposure to nicotine. Journal of the American Academy of Child & Adolescent Psychiatry, 40(6), 630-641.
Evangalista, A. (2010). Thirdhand smoke worries researchers.
Fairchild, A. L., Bayer, R., & Colgrove, J. (2014). The renormalization of smoking? E-cigarettes and the tobacco “endgame”. New England Journal of Medicine, 370(4), 293-295.
Farsalinos, K. E., & Polosa, R. (2014). Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Therapeutic advances in drug safety, 5(2), 67-86.
Flouris, A. D., Chorti, M. S., Poulianiti, K. P., Jamurtas, A. Z., Kostikas, K., Tzatzarakis, M. N., & Koutedakis, Y. (2013). Acute impact of active and passive electronic cigarette smoking on serum cotinine and lung function. Inhalation toxicology, 25(2), 91-101.
Goniewicz, M. L., Kuma, T., Gawron, M., Knysak, J., & Kosmider, L. (2012). Nicotine levels in
Grana, R.A, Popova, L. & Ling, P. M. (2014).A longitudinal analysis of electronic cigarette use and smoking cessation.JAMA Intern Med, 174 (1): 812-813.
Hoffmann, D., & Hecht, S. S. (1985). Nicotine-derived N-nitrosamines and tobacco-related cancer: current status and future directions. Cancer research, 45(3), 935-944.
Hogg, J. C. (2004). Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. The Lancet, 364(9435), 709-721.
Kaplan, K. (2015, January 21). E-cigarettes can produce more formaldehyde than regular cigarettes, study says. Los Angeles Times, pp. 1-2.
Li, Y. F., Gilliland, F. D., Berhane, K., McCONNELL, R. O. B., JAMES GAUDERMAN, W., Rappaport, E. B., & Peters, J. M. (2000). Effects of in utero and environmental tobacco smoke exposure on lung function in boys and girls with and without asthma. American Journal of Respiratory and Critical Care Medicine, 162(6), 2097-2104.
Mason, R. J., Broaddus, V. C., Martin, T., Gateway, M. B., King Jr, T. E., Schraufnagel, D. &
Nichter, M. (2015). Lighting up: The rise of social smoking on college campuses
Pursell, R. D. (2014). Electronic cigarettes: Do we know the benefits vs. the risks?BCMJ, 56
SAMJ: South African Medical Journal, 103(11), 833-833.
Schober, W., Szendrei, K., Matzen, W., Osiander-Fuchs, H., Heitmann, D., Schettgen, T., & Fromme, H. (2014). Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers. International journal of hygiene and environmental health, 217(6), 628-637.
Snider, G. L. (1989). Chronic obstructive pulmonary disease: risk factors, pathophysiology and pathogenesis. Annual review of medicine, 40(1), 411-429.
Stolerman, I. P., & Jarvis, M. J. (1995). The scientific case that nicotine is addictive. Psychopharmacology, 117(1), 2-10.
Thorgeirsson, T. E., Geller, F., Sulem, P., Rafnar, T., Wiste, A., Magnusson, K. P., & Oskarsson, H. (2008). A variant associated with nicotine dependence, lung cancer and peripheral arterial disease. Nature, 452(7187), 638-642.
Van Zyl-Smit, R. N. (2013). Electronic cigarettes: The potential risks outweigh the benefits.
Wua, W. K. K., Wonga, H. P. S., Yua, L., & Choa, C. H. (2006). Nicotine and cancer. Alcohol, Tobacco and Cancer, 253.
