Details
Category: Volume 07 Issue 09 September 2019
Hits: 1056

Title: E- Cigarettes: An Emerging Health Problem on the Horizon

Authors: Mukul Bajpai, Rigvardhan

 DOI: https://dx.doi.org/10.18535/jmscr/v7i9.88

Abstract

  

Despite extensive efforts, smoking remains a modern-day epidemic with profound health consequences. Advent of E-cigarettes (EC) was based on the assumption that by eliminating the toxic chemicals found in combustible tobacco, these products would have less impact on smokers’ health and minimize the health-related consequences and thus a multi-billion industry started in 2003.  Currently, the medical community is divided on its opinion about the use of e-cigarettes as a smoking cessation device. The scientific evidence that e-cigarettes are a useful aid for smoking cessation remains limited. Main health concerns about EC usage is the potential for toxic aldehyde emissions, which are known to be formed following heating of the EC-liquid main components propylene glycol and glycerol and other contaminants inhaled by an EC-smoker during a “vaporization” session which can be o-methyl-benzaldehyde, carcinogenic nitrosamines, terpenic compounds such as limonene (which are probably used by the manufacturers as flavoring agents), as well as heavy metal and silicate particles (> 1 μm) including nanoparticles (< 100 nm) . Emerging data suggests that these are a cause of multitude health problems including death. Thus there is an urgent need to implement strict regulation or complete ban on its use.

Keywords: E-cigarette, health  risk, nicotine dependence.

References

  1. Chakma JK, Dhaliwal RS, Mehrotra R.  White paper on electronic nicotine delivery systems. Indian J Med Res 2019 : 574-583. DOI: 10.4103/ijmr.IJMR_957_19
  2. Lichtenburg K. E-cigarettes: Current evidence and policy. Missouri Medicine 2017; 114:5:335-338.
  3. Bhatnagar A, et al, Electronic Cigarettes: A Policy Statement From theAmerican Heart Association. Circulation. 2014;130: 1418-1436.
  4. Smith I, Brar K. E-cigarettes; how safe are they? The Journal of Family Practice. 2016;655:380-385.
  5. Conference of the Parties to the WHO Framework Convention on Tobacco Control, Seventh Session. Electronic nicotine delivery systems and electronic non-nicotine delivery systems (ENDS/ ENNDS). Delhi, India; 7-12 November, 2016 .
  6. Korfei M. The underestimated danger of E-cigarettes-also in the absence of nicotine. Respiratory Research 2018; 19:159-162.
  7. El Dib R, Suzumura EA, Akl EA, Gomaa H, Agarwal A, Chang Y, et al. Electronic nicotine delivery systems and/or electronic non-nicotine delivery systems for tobacco smoking cessation or reduction: A systematic review and meta-analysis. BMJ Open 2017; 7 : e012680.
  8. Willett JG, Bennett M, Hair EC, Xiao H, Greenberg MS, Harvey E, et al. Recognition, use and perceptions of JUUL among youth and young adults. Tob Control 2019; 28 : 115-6.
  9. Goniewicz ML, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, Prokopowicz A, Jablonska-Czapla M, Rosik-Dulewska C, Havel C, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014;23:133–9.
  10. Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P. Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLoS One. 2013;8:e57987.
  11. Zhang Y, Sumner W, Chen DR. In vitro particle size distributions in electronic and conventional cigarette aerosols suggest comparable deposition patterns. Nicotine Tob Res2013; 15 : 501-8.
  12. Solanki A, Kashyap K, Kashyap S. Electronic cigarettes: Facts and myths. Indian J Chest Dis Allied Sci 2014; 56 : 263-5.
  13. Yu V, Rahimy M, Korrapati A, Xuan Y, Zou AE, Krishnan AR, et al. Electronic cigarettes induce DNA strand breaks and cell death independently of nicotine in cell lines. Oral Oncol 2016;52 : 58-65.
  14. Qasim H, Karim ZA, Rivera JO, Khasawneh FT, Alshbool FZ. Impact of electronic cigarettes on the cardiovascular system. J Am Heart Assoc 2017; 6 . pii: e006353.
  15. Scott A, Lugg ST, Aldridge K, Lewis KE, Bowden A, Mahida RY, et al. Pro-inflammatory effects of e-cigarette vapour condensate on human alveolar macrophages. Thorax2018; 73 : 1161-9.
  16. NYT & Agencies. Cases of vaping related lung illness double to 450 in US, toll rises to 5. Sunday Times of India; 8 Sep 2019:6.
  17. Wallace AM, Foronjy RE. Electronic cigarettes: not evidence-based cessation. Transl Lung Cancer Res 2019;8(Suppl 1):S7-S10.
  18. Cobb NK, Byron MJ, Abrams DB, Shields PG. Novel nicotine delivery systems and public health: The rise of the “e-cigarette”. Am J Public Health 2010; 100 : 2340-2.
  19. Weaver SR, Huang J, Pechacek TF, Heath JW, Ashley DL, Eriksen MP. Are electronic nicotine delivery systems helpingcigarette smokers quit? Evidence from a prospective cohort study of U.S. adult smokers, 2015-2016. PLoS One 2018; 13 : e0198047.
  20. Ghosh S, Drummond MB. Electronic cigarettes as smoking cessation tool: Are we there? Curr Opin Pulm Med 2017; 23 : 111-6.
  21. Cummings KM, Dresler CM, Field JK, Fox J, Gritz ER, Hanna NH, et al. E-cigarettes and cancer patients. J Thorac Oncol 2014; 9 : 438-41.
  22. Electronic Nicotine Delivery Systems: An update on a rapidly evolving vapour market, Report 2, January 2017. UK: Ernst & Young LLP; 2016.
  23. Kennedy RD, Awopegba A, De León E, Cohen JE. Global approaches to regulating electronic cigarettes. Tob Control 2017; 26 : 440-5.

Corresponding Author

Dr Rigvardhan

Professor, Dept of Pathology, Saraswati Medical College, Unnao (UP) – 209859, India