What is an E-CIGARETTE?
E-cigarettes are electronic cigarettes / devices that produce an aerosol that the user inhales . It contains a solution often called as e- liquid which comes through and heating element which produces the aerosol . The process of using e cigarette is known as vaping. this closely resembles tobacco smoking which makes e-cigarettes an attractive alternative to smokers but it has produced much of controversy and concern also .
E-cigarettes create an aerosol, commonly called vapor, made of particulate matter. The vapor typically contains propylene glycol, glycerin, nicotine, flavors, and traces of toxicants, carcinogens, heavy metals, and metal nanoparticles. Its exact composition varies, and depends on several factors including user behavior.
The health effects of electronic cigarettes remain uncertain, but they are likely less harmful than smoking tobacco. E- cigarettes vapor contains fewer toxic chemicals, in lower concentrations, than cigarette smoke, but also contains harmful chemicals not found in tobacco smoke.
Nicotine is toxic and highly addictive.Young people are particularly susceptible to this, and most (90%) smokers start before the age of 18. Among first-time users 32% of people who try nicotine become addicted. People who vape are more likely to start smoking. For smokers who are unable or unwilling to quit using conventional smoking cessation methods such as NRT, vaping has a role in tobacco harm reduction.
The use of e cigarettes has increased in the recent times, its use is highest in China, The US and Europe .most probably it is due to advertising to young people, the low cost compared to tobacco and the perception that they are safer than tobacco smoking.
The increase is also due to strong marketing and advertising campaigns showcasing celebrities, popular activities ,creative images and appealing flavours.
A survey stated that vapes have less social stigma, ie lesser behavioural stigma than tobacco smokers.
Some people want to quit tobacco smoking by vaping and others vape to circumvent smoke-free laws and policies, some to cut back on smoking and others believe that it is safer than tobacco.
Also they feel that they need not get concerned about stains on teeth for tobacco odour from smoke on clothes . Some try due to their curiosity in technology, some for experimentation ,peer pressure or because a relative or a friend was using it. Marketing, which says that they are new or they are cheaper, easier to use in smoke-free situations motivating youngsters to use it. Marketing messages say that it includes good taste, sociability, freedom and that they are useful for smoking cessation, availability of various flavours.
There are two types of e-cigarettes , 1 is a disposable e-cigarette, resembles tobacco cigarette and the other one is rechargeable e-cigarette.
Inexperienced users , women, etc, tend to prefer no or low nicotine e cigarettes while experienced ones prefer medium and high and rechargeable
e-cigarettes
Disadvantages of e cigarettes-
Common issues reported are - devices were are hard to refill, cartridges would leak, altering the dose was difficult,
also the Gateway theory or the Gateway hypothesis in context of drugs says that using harmful drugs can lead to a future risk of more harmful drug or crime.
It mimics tobacco smoking so instead of quitting e-cigarettes are just displacing tobacco cigarettes
There is little or limited research for re evaluation of electronic cigarettes and it's subsequently potential transition to tobacco smoking.
Health effects of e-cigarettes-
They produce high levels of fine and ultrafine particles in the air same as tobacco, it is also associated with the change in gene expressions that is related to cancer and suppressing immune system, according to a study,
although they do contain some toxins but they are far at lower levels than in tobacco.
Pregnant women, who have been smoking tobacco chooses to use any cigarette which helps her to quit smoking and stay smoke free, also it does not have adverse effect on breastfeeding according to a health survey.
Vaping causes less weight gain after smoking cessation, there is increased exercise tolerance and reduced mortality compared to tobacco smoking.
it has a better effect on mouth and Airways leading to reduce spitting, reduce sore throat and lesser cough also a better effect on lungs by reducing shortness of breath.
E cigarettes can reduce smokers exposure to carcinogens and other toxic chemicals found in tobacco but the argument for harm reduction does not take into account the adverse effect of nicotine.
Quitting smoking is the most effective strategy to tobacco harm reduction tobacco contains hundreds of known carcinogens 900 potentially cancer-causing chemicals and e cigarette contains less of potential carcinogens than found in tobacco but e-cigarettes cannot be considered safe as there is no safe level for carcinogens they just play a role in tobacco harm reduction.
Research says that e-cigarettes are slightly better than nicotine patches for quitting smoking. people who vape,
Study says that e cigarettes have no benefit for smokers who tried to quit and that the high rate of dual use indicates that they are used for supporting their nicotine addiction.
the other kinds of nicotine replacement products are usually covered by health systems but because
e-cigarettes are not medically licensed they are not covered
Evidence indicates smokers are more frequently able to completely quit smoking using tank devices compared to e cigarettes- which may be due to their more efficient nicotine delivery.
e cigarettes without nicotine may reduce tobacco cravings because of the smoking related physical stimuli.
According to a study the efficacy and safety of vaping for quitting smoking during pregnancy is unknown. No research is available to provide details on the efficacy of vaping during pregnancy and it is not effective for quitting smoking among adolescents it is not recommended for cancer patients
Safety-
There is little data about their safety and the considerable variety of liquids that are used as carriers. the risk of early death is anticipated to be similar to that of smokeless tobacco.
Since the vapour does not contain tobacco and combustion users can avoid harmful constituents like Ash, tar and carbon monoxide due to presence of nicotine it cannot be considered risk free.
What are the adverse effects of vaping-
It is addictive in nature , it can cause irritation to eyes blurry vision and burns in case of e cigarette explosion
It can cause irritation, cough and increased airway resistance, increased heart rate, chest pain and increase blood pressure also vomiting nausea and stomach pain.
Serious side effects related to e-cigarettes can be seizure, chest pain rapid heartbeat, disorientation, congestive heart failure, reduced lung and cardiac muscle function and increase inflammation but to a much lower extent than traditional cigarettes.
According to 2014 WHO report ENDS - electronic nicotine delivery system - use poses serious threats to adolescence and foetuses apart from toxicity in normal use, there is risk of misuse, accident such as nicotine poisoning, contact with liquid nicotine can cause fire by vaporizer malfunction, explosions resulting from extended charging unsuitable charges and design faults.
E- Liquids -
Liquid usually comprises of three main components diluents, nicotine and flavorings
Diluents contains propylene glycol aur vegetable glycerine and accounts for the majority of the e liquid solution nicotine is included at a wide range of concentration most popular strength as in the UK being 13 to 18 mg) ml
Nicotine free e liquids are available flavorings are often added as both nicotine and elements are tasteless flavours like fruit menthol mint or tobacco may be used.
The cytotoxicity of a liquid varies and contamination with various chemicals have been detected metal parts of e cigarettes in contact with a liquid can contaminate it with metal particles, many chemicals including carbonyl compounds such as formaldehyde can be produced when nichrome wire ie the heating element touches the e liquid and chemically reacts with the liquid.
The later generation and tank style e cigarettes with higher voltage main generate equal or higher levels of formaldehyde compared to smoking.
Nicotine is associated with cardiovascular diseases, possible birth defects and poisoning.
The e liquid consists of propylene glycol, glycerine, nicotine, flavours, small amounts of toxicants, carcinogens, heavy metals, metal nanoparticles and other substances also.
Workplace safety standards-
They do not recognise exposure to certain vulnerable groups such as people with medical conditions or ailments children and infants who may be exposed to secondhand vapour.
e cigarette used by a parent may lead to inadvertent health risk to offspring.
there is limited information available on environmental issues around production and disposition of e-cigarettes that use cartridges. Also there is problem of electronic waste and regulation for consumer safety.
History-
It is stated that modern e-cigarette was invented in 2003 by a Chinese pharmacist Hon Lik,
But tobacco companies have been developing nicotine aerosol generation devices since as early as 1963.
95% of e cigarettes were made in China as of 2018
In 2013 a subculture had emerged calling itself the vaping community.
the members of community say that e-cigarettes as a safer alternative to smoking and some view it as a hobby
E cigarettes are illegal in Japan and forces the market to use heat-not-burn tobacco products for cigarette alternative.
because of the potential relationship with tobacco laws and medical drug policy , e-cigarette legislation is being debated in many countries.
Many countries such as Brazil, Singapore Europe and India has banned e cigarettes.
Large tobacco companies have greatly increased their marketing, as of 2014 there were 466 brands of e cigarettes and global sales way around 19.3 billion dollars in 2019.
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