Electronic or conventional cigarettes – which is safer?

smoking vaping.png

(Chloe Andrews, Unsplash)

This article was exclusively written for The European Sting by Ms. Mariana Marçal, a 23-year-old medical student from Lisbon, currently attending the 4th year at NOVA Medical School. 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.


When it was suggested back in 1939 that cigarettes were a responsible factor for the rise in lung cancer, this idea seemed laughable at the time. Today, it is well established that tobacco is harmful and is strongly linked to cancer [1]. The recent rise in alternative products such as electronic cigarettes, however, has led to uncertainty about its true long-term effects on health. Electronic cigarettes (or e-cigarettes) are battery-operated devices that electrically heat and vaporize “e-liquids” to produce inhalable vapours without combusting tobacco. E-cigarettes started being commercialized in 2003 in China and entered the European markets in 2006.

These products present a challenge for public health due to their alarming increase in popularity. In 2017, about 15% of the European population had tried e-cigarettes at least once in their life [2]. Another study from the US showed that between 2017 and 2018, the number of high school students that reported current use of e-cigarettes increased from 12% to 21% [3]. Evidence suggests that e-cigarettes are being used among teenagers for alternative behaviours such as dripping, smoke tricks, use of flavours, and use of other substances such as marijuana [4].

The effects of chronic use of e-cigarettes are still largely unknown, and levels of toxic and carcinogenic compounds may vary greatly depending on the brand. Many e-cigarettes contain misleading or missing information on product ingredients, but across all brands, the main components are nicotine, propylene glycol, glycerol, and flavourings. Many studies found other harmful substances such as metals, carcinogenic tobacco-specific nitrosamines and carbonyls [5]. E-cigarettes do not produce the tar that is contained in traditional cigarettes. However, studies have found that it produces formaldehyde, acetaldehyde and acetone a known carcinogen at levels above recommended levels [6]. The overall health risks associated with e-cigarettes remain uncertain but they cannot be considered safe. A recent study found daily e-cigarette use is associated with increased risk of myocardial infarction [7]. In 2018, a study of mice found that e-cigarette smoke could cause mutations in DNA that could increase the risk of cancer [8]. However, we remain shockingly ignorant about the toxicity of chronic exposure to these products.

E-cigarettes have been widely marketed as a tool for smoking cessation and a safer alternative to conventional cigarettes. Although some small studies suggest that e-cigarettes could be an effective strategy to quit smoking in some people [9], there are no large, high-quality studies to support this claim thus far. There are also some concerns that e-cigarette use may be a gateway to nicotine dependence among adolescents. In 2016, the World Health Organization (WHO) urged countries to restrict the sale, promotion, and use of electronic cigarettes [10].

Overall, more research is needed in order to compare the risks and long-term effects of e-cigarettes with tobacco products. As a society, we need to get ahead of this real public health issue. More regulation and restrictions are needed, as well as an international effort to make new policies, promote more research and educate citizens on this issue.

References

[1] Viswanath, Kasisomayajula, et al. “Tobacco and Cancer: An American Association for Cancer Research Policy Statement.” Cancer Research, American Association for Cancer Research, 1 May 2010, cancerres.aacrjournals.org/content/70/9/3419.

[2] Special Eurobarometer 458 – Attitudes of Europeans towards tobacco and electronic cigarettes. Available at http://ec.europa.eu/commfrontoffice/publicopinion/index.cfm/Survey/getSurveyDetail/instruments/SPECIAL/surveyKy/2146. (accessed 25th April 2019)

[3] Cullen, Karen A., et al. “Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students — United States, 2011–2018.” MMWR. Morbidity and Mortality Weekly Report, 2018, doi:10.15585/mmwr.mm6745a5.

[4] Krishnan-Sarin, Suchitra, et al. “E-Cigarettes and ‘Dripping’ Among High-School Youth.” Pediatrics, vol. 139, no. 3, 2017, doi:10.1542/peds.2016-3224.

[5] Orellana-Barrios, Menfil A., et al. “Electronic Cigarettes—A Narrative Review for Clinicians.” The American Journal of Medicine, vol. 128, no. 7, 2015, pp. 674–681., doi:10.1016/j.amjmed.2015.01.033.

[6] Kosmider, Leon, et al. “Carbonyl Compounds in Electronic Cigarette Vapors: Effects of Nicotine Solvent and Battery Output Voltage.” Nicotine & Tobacco Research, vol. 16, no. 10, 2014, pp. 1319–1326., doi:10.1093/ntr/ntu078.

[7] Alzahrani, Talal, et al. “Association Between Electronic Cigarette Use and Myocardial Infarction.” American Journal of Preventive Medicine, vol. 55, no. 4, 2018, pp. 455–461., doi:10.1016/j.amepre.2018.05.004.

[8] Lee, Hyun-Wook, et al. “E-Cigarette Smoke Damages DNA and Reduces Repair Activity in Mouse Lung, Heart, and Bladder as Well as in Human Lung and Bladder Cells.” Proceedings of the National Academy of Sciences, vol. 115, no. 7, 2018, doi:10.1073/pnas.1718185115.

[9] Kulik, Margarete C., et al. “E-Cigarettes Associated With Depressed Smoking Cessation: A Cross-Sectional Study of 28 European Union Countries.” American Journal of Preventive Medicine, vol. 54, no. 4, 2018, pp. 603–609., doi:10.1016/j.amepre.2017.12.017.

[10] WHO Report to COP7 on ENDS/ENNDS. Available at http://www.who.int/tobacco/communications/statements/eletronic-cigarettes-january-2017/en/.

About the author

Mariana Marçal is a 23-year-old medical student from Lisbon, currently attending the 4th year at NOVA Medical School. In 2018, she joined Education Against Tobacco (EAT), an international non-governmental organisation run entirely by volunteer medical students and physicians from over 80 medical schools around 14 countries, whose work focuses mainly on school-based prevention of tobacco use. She is now the head of Scientific Department at her school’s EAT group and hopes their work reaches more students and further expands across more schools and countries.

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

Better sanitation for India is in the pipeline

As India’s lockdown ends, a mental health crisis is just beginning

Fighting against the Public Health System dismantling means guaranteeing assistance to all

Under fire, UN refugee agency evacuates 135 detained in Libya to Niger

Safe spaces offer security and dignity for youth, and help make the world ‘better for all’: Guterres

WEF Davos 2016 LIVE: “If we do not do properly the Paris agreement, then all 16 remaining goals will be undermined”, UN Secretary General Ban Ki-moon cautions from Davos

‘Spectre of poverty’ hangs over tribes and indigenous groups: UN labour agency

The staggering loss of the Arctic Ocean’s oldest sea ice shown in time-lapse

Rare earths are the new battlefront in the US-China trade war. But what are they?

Indonesia has a plan to deal with its plastic waste problem

Eurasian Union begins: the giant modelled on the EU is Moscow’s biggest challenge

A day that Berlin and Brussels would remember for a long time

Preparing Africa for ravages of climate change ‘cannot be an afterthought’ – COP24

How the United States can win back its manufacturing mojo

European Accessibility Act: Parliament and Council negotiators strike a deal

Millions at risk if Syria’s war moves to last redoubt of Idlib, warns senior aid official

South Eurozone needs some…inflation and liquidity

Three ways the world must tackle mental health

How can we produce enough protein to feed 10 billion people?

Future-proofing the European banking market – removing the obstacles to exit

Millions denied citizenship due to ideas of national, ethnic or racial ‘purity’: UN rights expert

“As long as we work together through thick and thin, more benefits can be delivered to the people of Eurasia”, China’s Premier Li Keqiang highlights from ASEM in Brussels

10 Downing street: Another desperate attempt to unite Britain on Brexit

Humanitarian Aid: EU allocates €55 million in Sudan

UN report sheds light on ‘unimaginable horrors’ faced by migrants and refugees in Libya, and beyond

Biblioburro: The amazing donkey libraries of Colombia

These floating homes could protect people from flooding as sea levels rise

Nigeria: Top UN officials say more support needed to ease humanitarian crisis and rebuild lives in conflict-ravaged north-east

Trump’s blasting win causes uncertainty and turbulence to the global financial markets

Malaysia can show the way towards a holistic model for human rights

Have we reached peak smartphone?

JADE Handover Ceremony at the European Parliement

This start-up is 3D-printing an entire neighbourhood in Mexico

The mental health of health professionals: is it worth it?

Trade, entrepreneurship and the future of ASEAN’s economy

Coronavirus: Pandemic alert should be trigger for countries to do more against COVID-19

European Youth Forum on Summit on Jobs and Growth

Service and Sacrifice: Guinean peacekeepers make their mark in Mali

These are the world’s best universities for recycling and sustainability

Yemen blast kills 14 children, leaves others fighting for their lives in Sana’a

Almost there: Equal healthcare for LGBTQI+

Spring 2020 Economic Forecast: A deep and uneven recession, an uncertain recovery

Ebola: EU provides an additional €30 million to tackle the outbreak in the Democratic Republic of Congo

Japan’s workforce will be 20% smaller by 2040

Mali: Presidential elections critical to consolidate democracy, says UN peacekeeping chief

Gender is where the feminist and LGBTI movements meet. Here’s why

Who should pay for workers to be reskilled?

Global economy: ‘we must do everything possible’ to avoid global ‘fracture’ caused by US-China tensions, urges Guterres

Trump reshapes the Middle East at the expenses of Europe

European Youth Forum warns of a Peter Pan generation as a result of financial crisis and response to it

What does the world really think about the UN Sustainable Development Goals?

5 ways blockchain can transform the world of impact investing

24 new European Universities reinforce the European Education Area

Siemens-Alstom merger: Will the EC succumb to Franco-German pressures for the sake of May’s EU Elections?

UN evaluates progress in improving peacekeeping performance

This graphene battery can recharge itself to provide unlimited clean energy

Doctors vs. Industry 4.0: who will win?

COVID-19 and German constitutional court decision top meeting with ECB’s Lagarde

Tanzania’s Dual Burden

Waste-free consumption: 3 reasons why cities will lead

More Stings?

Advertising

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