E- cigarettes: Why vaping is harmful and how it affects humans

Electronic cigarettes (e-cigarettes) are marketed as a smoking cessation aid and its popularity and use has dramatically increased over the last decade especially among youth.

Electronic cigarettes are battery-operated devices that heat a liquid producing an aerosol (vapors) which is then inhaled. Unlike conventional cigarettes, which burn tobacco and generate smoke, e-cigarettes have a cartridge containing a liquid (“vape juice”). The liquid contains usually nicotine or at times also have marijuana and other harmful substances. They are available in more than 7000 flavours which are particularly attractive to teenagers, who haven’t smoked before.

There is substantial evidence of over five decades to show that there are numerous chemicals inhaled during tobacco smoking that have harmful impact on lung but so isn’t the case with vaping. Short or long term effects are still being explored and a lot is still uncertain.

Contrary to the popular belief that vaping doesn’t expose to any toxic chemicals because there is no tar or gases such as carbon monoxide being produced, there are numerous other harmful and toxic chemicals in e- cigarettes. More so when users fill empty cartridges with any of the substances at hand it further increases the risk when heated.

Vaping and severe lung disease

Recently in 2019, Centres for Disease Control and Prevention (CDC) reported over 2000 cases of a severe lung disease due to the use of e cigarettes, known as e-cigarette, or vaping, product use associated lung injury (EVALI). It is a severe and life threatening lung disease with most of the patients recovering completely however 68 deaths have been reported out of a total of 2800 cases till now. Patients present with gradual onset of cough, breathlessness or chest pain requiring hospital admission and almost one-third may progress and require ICU or ventilator support. Strongest risk factor has been Vitamin E acetate that is usually present in cartridges obtained from informal or illicit or illegal source.

Other effects on lung function

Earlier when in 2003, e-cigarettes were launched, one of the earliest study concluded that vaping is 95% healthier than smoking. Although limited but recent studies have challenged this fact. It has been shown that e-cigarette use is associated with respiratory symptoms (cough or phlegm), regardless of cigarette smoking status, although the risk might be lower than that with cigarette smoking.

However, an observational study published last year compared lung function between vapers, cigarette smokers or those who didn’t smoke any of the above. It revealed that vaping has similar detrimental effects on pulmonary function as smoking. In addition, increasing vaping uptake among youth could stimulate uptake of cigarette smoking, creating a smoking-dependent generation.

Flavouring agents seemingly have disastrous effects on lung cells and structure especially sweet and cinnamon flavours

Then flavours such as cherry and sweet flavoured e-cigarettes have chemicals that have major impact on lung function. Hence although information on impact of vaping on lung function is still emerging but what can be concluded that there are toxic chemicals in e-cigarettes which leads to unhealthy lungs and decline in lung function (more than normal) and chronic respiratory symptoms are observed with its regular use.

Long term studies about the risk of lung cancer with vaping are lacking and this area is yet to be researched.

If e-cigarettes are allowed where cigarette smoking is not, they could reverse the “de-normalization” of smoking behaviour brought about by the spread of smoke-free laws. It could renormalize tobacco use in places where cigarette smoking is not acceptable. Although vaping might help in smoking cessation but it is evident that it has its own risks and harmful effects on lung and heart and many of the long term effects are still uncertain.

The author is a Consultant, Cardiac Surgery and Heart Transplant, Sir HN Reliance Foundation Hospital Mumbai. Views are personal. 

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