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Are e-cigarettes more harmful than regular cigarettes?

    Every one of us has had the thought that it’s time to quit smoking. After a while, this idea is forgotten, because it does not have the proper motivation. Today, along with my medical brand names, I will tell you what e-cigarettes are.

    E-cigarettes: What are they?

    The WHO report “Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Product Delivery Systems” (2016) contains data that “absolute exposure of non-users to e-cigarette vapor can cause adverse health effects.” Levels of certain metals, such as nickel and chromium, in exhaled air from e-cigs are higher than those from conventional secondhand smoke and higher when compared to background levels of ambient air. For example, acetaldehyde levels have been found to be 2-8 times higher in exhaled air and 20% higher in formaldehyde.

    What is an electronic cigarette?

    The full name of e-cigarette is “electronic nicotine delivery system”. This device is similar in principle to an inhaler. The difference with an ordinary cigarette, cigar or pipe is that the inhaler works by boiling a special liquid and creates an effect that only visually resembles tobacco smoke. The vapor is released from the flavored liquid filled into the cartridges.

    The cartridges can be:

    • nicotine/non-cocotine,
    • Refillable (with capsules)/reusable,
    • battery-operated/rechargeable.

    The cartridges are divided into groups according to nicotine content: strong, medium, light, non-nicotine. According to the manufacturers, the e-cigarette can control both physical (cartridges with different nicotine content) and psychological (reproducing the ritual of smoking) addiction.

    Nicotine-containing liquids are used most often by those who switch from conventional cigarettes to electronic cigarettes. It creates the effect of substitution necessary for the gradual withdrawal of nicotine, as in the widespread patches and pills (for example – Nicorette).   This is stated by some manufacturers who claim that e-cigarettes are almost a cure-all for people who decide to quit smoking over time.

    The harm of electronic cigarettes: what is really in the smoking solution?


    Liquid (e-liquid) to produce an aerosol often contains flavorings, usually in a solution of propylene glycol and/or glycerin. It also contains glycols, aldehydes, volatile organic substances, polycyclic aromatic hydrocarbons, tobacco-specific nitrosamines, metals, silicate particles, and other elements. Dicarbonyls (glyoxal, methylglyoxal, diacetyl) and hydroxycarboxylic (acetol) are also considered important compounds in the aerosol composition. Many of these substances are toxic and are known to have health effects and cause pathological changes. Most of these substances are present in tobacco smoke from smoking regular cigarettes and are health hazards (toxic and carcinogens).

    The amounts and levels of known toxic substances, can vary greatly within a single brand, and sometimes reach higher levels than in tobacco smoke (e.g., lead, chromium, nickel, formaldehyde). This may be due, among other things, to the increased thermal decomposition of the ingredients of the e-liquid when the temperatures used the increase in open-system e-cigarettes.

    Propylene glycol, glycerin is the main components of e-cigarettes. These substances when inhaled for a long time cause irritation of the respiratory tract, mucous eyes, nervous system disorders. Particularly pronounced cytotoxic effect on the respiratory tract. Experimental data were obtained in animal experiments. Rats were placed in a chamber, the nicotine-free aerosol was pressurized, imitating the process of smoking, and after killing on 7, 40 and 60 days the lungs were examined. Already on the 7th day the lungs were edematous, eczematous areas, and atelectasis. The bronchi showed mucus hypersecretion, edema, full-thickness, single leukocytes. Cases of specific pneumonia in e-cigarette users have been described.

    The composition of e-cigarette liquid may be different – it all depends on the manufacturer. Some certain rigid production standards still do not exist, so no one is immune from getting into the liquid toxic substances.

    E-cigarette aerosol contains nicotine – an addictive component of tobacco products. Besides addiction, nicotine can have an adverse effect on the development of the fetus during pregnancy, contribute to cardiovascular disease. Although nicotine itself is not a carcinogen but it can act as a “tumor stimulant” and is involved in the biology of malignant tumors as well as neurodegenerative diseases.  There is enough evidence to warn children and adolescents, pregnant women, and women of reproductive age against the use of e-cigarettes and nicotine.

    There is information about the existence of 8,000 unique flavors for e-liquids. The health effects of heated and inhaled flavors used in e-liquids are not well researched. Heated and inhaled flavors that smell like popcorn, cinnamon, and cherry are potentially harmful. The literature on this topic indicates that most flavors, especially sweet ones, can create health hazards when consumed over the long term.  Many are irritants that can increase respiratory inflammation.

    The components can be bought separately, so self-blending is also practiced. Well, and often in mixtures nicotine is used in different proportions: from 0.5 to 3.6 percent. Although it can be without nicotine at all.

    By the way, when making self-mixes, nicotine is dangerous because an inexperienced vaper can overdo it and take an extremely toxic dose, up to and including lethal (13 mg per kilogram of body weight). In ready-made liquids, the risk of this is minimal.

    E-cigarettes help smokers quit: what the science says

    In small doses, nicotine does help quit smoking. But only with a special technique, with special means clinically tested and under the supervision of a doctor. In electronic cigarettes, the principle of harm reduction is dangerous. Just a little more nicotine in the e-cigarette is enough, and it reinforces addiction and leads to an uncontrolled increase in dose. It is not an alternative to smoking cues. The scientific evidence regarding the effectiveness of e-cigarettes in aiding smoking cessation is lacking.

    E-cigarettes encourage young people to use nicotine and smoke

    Studies (World Health Organization) show that underage use of e-cigarettes doubles the chance that they will start smoking.

    Some experts believe that the use of e-cigarettes can attract even those who have never tried smoking before.

    The World Health Organization insists on strict measures regarding e-cigarettes. And it believes that they should be subject to the same bans that apply to conventional cigarettes. And it says flavored liquids should be banned altogether because pleasing flavors appeal to children and teens.