Electronic Cigarettes: Device and E-Liquid
Electronic cigarettes (e-cigarettes) are battery-powered devices that aerosolize a liquid, commonly termed e-liquid. This e-liquid typically contains nicotine, flavorings, propylene glycol, and vegetable glycerin, along with other chemical additives. The user inhales this aerosol.
Principal Health Risks of E-cigarette Use
The use of e-cigarettes is associated with multiple health risks. They are not harmless and expose users to toxic substances.
Core Adverse Health Effects
- Nicotine Exposure and Addiction: The majority of e-cigarettes deliver nicotine, a highly addictive substance. Nicotine adversely affects adolescent brain development, which extends into the early to mid-20s. It also has acute cardiovascular effects, such as increasing heart rate and blood pressure.
- Toxic Aerosol Components: The aerosol produced by e-cigarettes is not benign water vapor. It contains harmful and potentially harmful constituents, including:
- Ultrafine particles that can penetrate deep into the lungs.
- Flavoring chemicals, such as diacetyl, which is linked to bronchiolitis obliterans, a severe lung disease.
- Volatile Organic Compounds (VOCs).
- Known carcinogens and other toxic chemicals.
- Heavy metals (e.g., nickel, tin, lead), which can leach from the device’s heating coil.
- Pulmonary System Damage: E-cigarette use is linked to lung inflammation, oxidative stress, and impaired lung function. Cases of severe acute lung injury, such as E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI), have been reported.
- Cardiovascular System Strain: Beyond nicotine’s acute effects, concerns exist regarding the long-term impact of e-cigarette aerosol components on cardiovascular health, potentially contributing to endothelial dysfunction and increased risk of cardiovascular events.
- Risks to Specific Populations:
- Adolescents and Young Adults: This demographic is highly vulnerable to nicotine addiction and the neurodevelopmental effects of nicotine. Early initiation also increases the risk of long-term use.
- Pregnant Individuals: Nicotine exposure during gestation is harmful to fetal development and can lead to adverse pregnancy outcomes.
Comparative Harm: E-cigarettes versus Combustible Cigarettes
E-cigarettes generally expose users to lower levels of many toxicants found in the smoke from combustible tobacco cigarettes. For adult smokers who completely transition from combustible cigarettes to e-cigarettes, this may represent a reduction in exposure to certain harmful substances. However, e-cigarettes are not safe, and “reduced harm” does not mean “no harm.” The practice of dual use (concurrently using both e-cigarettes and combustible cigarettes) offers no significant health advantage over exclusive smoking of combustible cigarettes.
Long-Term Health Consequences: Knowledge Gaps
The widespread adoption of e-cigarettes is a relatively recent phenomenon. Consequently, comprehensive data on the full range of long-term health effects resulting from sustained use are still being gathered. Continued research is essential for a complete understanding of the chronic health risks posed by e-cigarettes.
