Health Risks of Vaping

Dr. Manoj Fernando / Dr Ruwan M Jayatunge

An electronic cigarette or vape is a device that simulates tobacco smoking. Electronic cigarettes were introduced as an alternative to cigarette smoking to save people from tobacco’s harmful effects. E-cigarettes have become a rapidly evolving product. Over the years vaping tobacco has become a harm reduction method for nicotine abuse.

The basic function of all e-cigarettes is to generate a heated aerosol typically containing nicotine, that is inhaled through a mouthpiece (Abafalvi et al., 2019). Vaporized elements go from the mouth through the upper airway, ultimately reaching the alveoli.

The use of e-cigs is constantly and rapidly growing, and it is a multibillion-dollar industry. The industry is attracting young consumers, and the e-cig market is expanding. E-cigarettes are becoming popular, and it has decreased the progress fight against tobacco use. E-cigarettes have become an obstacle to nicotine cessation.

The tobacco industry is promoting vaping tobacco as a healthy way to quit combustible cigarette smoking. However, vaping should not be considered safer than smoking (Laucks &Salzman, 2020).  E-cigarettes are believed to have similar toxicity as existing nicotine replacement therapies (Cahn & Siegel, 2011). 

New research demonstrates that vaping is not risk-free.  The general health consequences of vaping have been identified.  There are potential health-related problems related to vaping. E-cigarettes emit a number of potentially toxic substances. Most e-cigarettes contain nicotine which is addictive. E-cigarettes contain chemicals including acrolein which can cause acute lung injury and COPD (Bein & Leikauf,2011).

E-cigarette smokers endure an acute inflammatory process in the lungs that disrupts the lung endothelial and epithelial barriers (Marrocco et al., 2022). E-cigarette aerosol can negatively affect multiple aspects of lung cellular and organ physiology and immune function (Gotts et al., 2019). Moreover, e smoking can cause cytotoxicity and neutrophilic inflammation (Park et al., 222). Peruzzi and team (2020) concluded that vaping can increase cardiovascular risk.

At the beginning e-cigarette users were current smokers attempting to quit smoking. Nonetheless, the demography changed drastically. The E-cigarette industry is mainly targeting teens.  Adolescents have misperceptions about vaping, and they are not fully aware of the addictive nature of e-cigarettes.  The epidemic of teen vaping has caused a large number of vaping-related lung injuries. Teen vaping could lead to subsequent use of tobacco cigarettes. Smoking is dangerous to teens. Nicotine can be harmful to the developing adolescent brain by interfering with memory and attention processing (Printz, 2020).

Intervention for vaping and smoking cessation has become a public health matter. Health professionals ought to pay attention to vaping in young people.  Health education, counseling, and behavioral management play a key role in curbing smoking habits. Youth cessation interventions should be implemented. Physicians can use motivational interviewing techniques in smoking cessation. Some patients may need pharmacologic assistance in quitting. The media should educate the public about the possible health risks associated with the use of e-cigarettes. 

  

Dr Manoj Fernando

 

Dr Manoj Fernando studied at the Faculty of Medicine, University of Colombo, and then worked with Professor Diyanath Samarasinha attached to Mel Medura - Addiction Treatment Center in Colombo. Currently, he is working as a  Senior lecturer at Rajarata University of Sri Lanka

References

Abafalvi, L., Pénzes, M., Urbán, R. et al. Perceived health effects of vaping among Hungarian adult e-cigarette-only and dual users: a cross-sectional internet survey. BMC Public Health 19, 302 (2019). https://doi.org/10.1186/s12889-019-6629-0.

Bein ,K., Leikauf GD. (2011) Acrolein - a pulmonary hazard. Mol Nutr Food Res 55(9):1342-60. doi: 10.1002/mnfr.201100279.

Cahn Z, Siegel M. Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes? J Public Health Pol. 2011;32(1):16–31. doi: 10.1057/jphp.2010.41.

Gotts JE, Jordt SE, McConnell R, Tarran R. What are the respiratory effects of e-cigarettes? BMJ. 2019 Sep 30;366:l5275. doi: 10.1136/bmj.l5275. Erratum in: BMJ. 2019 Oct 15;367:l5980. PMID: 31570493; PMCID: PMC7850161.

Laucks P, Salzman GA. The Dangers of Vaping. Mo Med. 2020 Mar-Apr;117(2):159-164. PMID: 32308243; PMCID: PMC7144697.

Marrocco A, Singh D, Christiani DC, Demokritou P. E-cigarette vaping associated acute lung injury (EVALI): state of science and future research needs. Crit Rev Toxicol. 2022 Mar;52(3):188-220. doi: 10.1080/10408444.2022.2082918. Epub 2022 Jul 13. PMID: 35822508; PMCID: PMC9716650.

Park JA, Crotty Alexander LE, Christiani DC. Vaping and Lung Inflammation and Injury. Annu Rev Physiol. 2022 Feb 10;84:611-629. doi: 10.1146/annurev-physiol-061121-040014. Epub 2021 Nov 1. PMID: 34724436; PMCID: PMC10228557.

 Peruzzi, M., Biondi-Zoccai, G., Carnevale, R. et al. Vaping Cardiovascular Health Risks: an Updated Umbrella Review. Curr Emerg Hosp Med Rep 8, 103–109 (2020). https://doi.org/10.1007/s40138-020-00219-0. 

Printz C. Fighting the teen vaping epidemic: With rates of adolescent vaping on the rise, experts caution that new federal rules targeting e-cigarettes may not be strong enough. Cancer. 2020 Mar 15;126(6):1147-1148. doi: 10.1002/cncr.32779. PMID: 32108947.