Electronic Cigarettes: Are they really as safe as we think?

Vaping 19_

(Cianna Jolie, Unsplash)

This article was exclusively written for The European Sting by Ms. Nour Nassour, a 2nd year of medical school student from LeMSIC, one of the NMO associated with IFMSA. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


The WHO defines electronic cigarettes as devices that do not burn tobacco leaves but
instead vaporize a solution inhaled by the user [2]. Electronic cigarettes, or e-cigarettes aim to provide a similar sensation to inhaling tobacco smokes for the user; they are used
worldwide by millions of people as alternatives to real cigarettes and some studies shows
that they are effective in helping to quit smoking. The Centers for Disease Control and
Prevention (CDC) concluded that e-cigarettes can benefit adult smokers who are not
pregnant, as long as they completely replace any other nicotine or tobacco products. [1] However, are they really as safe as we think?

It has been found that the vapor contained in e-cigarettes is made out mainly of glycols,
nicotine and flavoring agents but also of particles, metals and Tobacco-specific nitrosamines (TSNAs), seeing as some of these ingredients are toxic when present at high dose, it is important to closely monitor their concentrations when inhaled. However, studies show that sometimes the product labels did not show the ingredients (e.g. flavors, solvent, nicotine) nor their concentrations (e.g. of nicotine) [3].

Let’s take a closer look at one of the major component of e-cigarettes: the Glycols (propylene glycol and glycerin); they are mostly considered safe for oral intake, but there is a major debate as to if a product is safe when ingested orally meaning it is safe to inhale it. In fact, it has been shown that exposure of glycols via smoke can easily reach threshold safety limits thus warranting some concern [3].

Furthermore, several brands often replace glycerol/propylene glycol by ethylene glycol [3, 5], a chemical associated with pronounced toxicological risks (3, 6). And diethylene glycol, a glycol also associated with pronounced toxicological risks, has been detected in small quantities in very few studies [3].

Unexpectedly, one of the major concerns of e-cigarettes has to do with the flavorings. Researchers have stated that that the chemicals that make up different flavors also produce different levels of free radicals, toxins that are often associated with cancer and other diseases [4]. In fact, workers who frequently inhaled diacetyl, a food sweetener also used as a flavoring agent in some e-cigarettes often developed airway obstruction caused by bronchiolitis obliterans, or “popcorn lung”, a rare obstructive lung disease [3]. However the danger of the flavoring agents varies with the one used and its concentration in the vapor; we should also mention that different brands, models and batch use various flavorings/concentrations [3], so it is quite hard to establish a concrete general assumption on the matter.

It is worthwhile noting that the research on the safety of e-cigarettes is relatively new and thus very challenging; one major problem is that any research applies only to the specific product brand, model and batch, with no certainty that the findings can be reproducible with different products. [3]

In conclusion, the only thing we know for sure is that the risks associated with smoking ecigarettes depend heavily on the specific situation of the consumer seeing as ex-smokers, non smokers, dual smoking, different brands and consumption rate all produce different outcome. Of course the safest way is always the smoke free way.

References
1. https://www.medicalnewstoday.com/articles/216550.php
2. https://www.who.int/tobacco/communications/statements/eletronic_cigarettes/en/
3.https://www.who.int/tobacco/industry/product_regulation/BackgroundPapersENDS3_4November-.pdf
4. https://www.hindustantimes.com/fitness/you-thought-e-cigarette-flavours-are-harmless-it-affects-a-lot-more-than-just-taste-buds/story-3NKiygOOfECEcwyVJK7muM.html
5. Hutzler C, Paschke M, Kruschinski S, Henkler F, Hahn J, Luch A. Chemical hazards present in liquids and vapors of electronic cigarettes. Archives of Toxicology. 2014;88(7):1295–308.
6. Hess R, Bartels MJ, Pottenger LH. Ethylene glycol: an estimate of tolerable levels of
exposure based on a review of animal and human data. Archives of Toxicology.
2004;78(12):671–80

About the author

My name is Nour Nassour from LeMSIC, one of the NMO associated with IFMSA. I am
currently serving as LeMSIC local director at the University of Balamand and executive board member for the term 2018/2019; I am also in my 2nd year of medical school studies at the University of Balamand in Lebanon. Thank you for this opportunity, it was a pleasure to research and write about e-cigarettes, their safety and risks as compared to tobacco leaves cigarettes.

the sting Milestone

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

Gender parity has a huge role to play in the fight to save our oceans

UN chief praises Malaysia’s death penalty repeal as ‘major step forward’

3 ways to fight short-termism and relaunch Europe

Amid ongoing fighting in northeast Syria, hundreds cross Iraqi border in search of safety

Terrorists potentially target millions in makeshift biological weapons ‘laboratories’, UN forum hears

At least 2.5 million migrants were smuggled in 2016, first UN global study shows

Syria: WHO appeals for funding to sustain critical health care for millions trapped by conflict

Living to 100: why we should plan for more sushi, chocolate and work

FEATURE: Niger’s girls find sanctuary in fistula treatment centres

Foreign direct investments the success secrete of Eurozone

What makes us happy? AI scanned 700,000 journal entries to find out

European Elections: “Web giants” are urging users to vote

Pandemic versus fear

G20 LIVE: World Leaders in Turkey for G20 Summit. Global Economy will be discussed in Antalya

Council Presidency: Floundering with the EU 2014 budget

Antisemitism, intolerance, can be unlearned, Guterres tells New York commemoration

3+1 issues to haunt tomorrow’s EU Summit

What keeps me up at night? Two strategists reply

Ride-hailing apps are making the developing world’s traffic problems worse

Cultivating mental well-being while tackling food insecurity

EU mobilises emergency assistance following floods in Ukraine

High anxiety calls for innovation in digital mental health

Google once more under EU crossfire from a possible record fine and new Right to be forgotten case

Africa must ‘value youth’ in the drive towards lasting peace, young envoy tells Security Council

Rule of law in Hungary: Parliament calls on the EU to act

Polluted lungs: health in the center of environment discussion

UN gears up emergency food aid for hurricane-struck region of Bahamas, as death toll rises

ILO and EIB join forces for more and better quality employment

Monday’s Daily Brief: WFP mulls ‘last resort’ Yemen aid suspension, top peacekeeping awardee announced, abuzz over Bee Day, Ebola threat ‘very high’

Parliament asks for the termination of EU-US bank data deal

Ending extreme poverty crucial to sustainable future for all: UN chief

Military operation in northeast Syria could see unintentional release of ISIL affiliates: UN chief

Guterres condemns killing of Bangladeshi peacekeeper in South Sudan, during armed attack on UN convoy

Trump ostracized by his party and world elites but still remains in course; how can he do it?

How COVID-19 has changed what we search for online

The EU slams Theresa May’s Brexit option; sets base for own European defense, security platform

25 years on from landmark conference, millions of women and girls still in danger: UN deputy chief

Unity, regional cooperation and international support needed for Horn of Africa to develop sustainably

The European Parliament wants to stay in one place

With millions of girls ‘at risk’ today of genital mutilation, UN chief calls for zero tolerance

State aid: Commission refers Greece to Court for failure to recover incompatible State aid from mining company Larco

5 reasons why the role of WTO Director-General matters

Q&A on the 19th China-EU Summit to be held on 01-02 June 2017 in Brussels

Powering through the pandemic

A new catastrophic phase in the Syrian carnage

Ensuring the ‘lungs of the planet’ keep us alive: 5 things you need to know about forests and the UN

European Youth Capital 2019 announced: Novi Sad, Serbia

Facebook and Google to treat Europe as the 51st State of the USA

Climate change and health: creating global awareness and using earth resources wisely

The growing cyber-risk to our electricity grids – and what to do about it

Germany and OSCE support an east-west dialogue in Ukraine without exclusions

ECB settles the bank resolution issue, makes banking union tangible

UN rights chief ‘alarmed’ by upsurge in attacks against civilians in Syria’s Idlib

Is Universal Health Coverage really available for all in the European Union?

Top UN officials sound alarm as Yemen fighting nears vital hospital in port city of Hudaydah

Brexiteer May gets lip-service from Trump and Turkish promises from Erdogan

Oslo leads the way in ‘Breathe Life’ campaign for cleaner cities in climate change era

‘Education transforms lives’ says UN chief on first-ever International Day

Still recovering from devastating cyclones, Mozambique, in UN address, warns of global warming’s ‘nefarious consequences’

Statement by Frans Timmermans, Executive Vice-President for the European Green Deal, on the announcement to postpone the COP26

More Stings?

Advertising

Comments

  1. “Furthermore, several brands often replace glycerol/propylene glycol by ethylene glycol”

    Can you please tell us which brands these are? This would be vital information.

  2. So 2 of your cited articles (note articles, not peer-reviewed studies) are to dead links. This is undergrad level stuff. Try reading some literature from Prof. Jean-Francois Etter, Dr Konstantinos Farsalinos, Prof. Peter Hajek, Karl Fagerstrom, etc. Really, there is so much scientific research out there these days, you really don’t need to write an article based on newspaper cuttings.

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s