Electronic cigarettes – The alternative we’ve been looking for?

vaping smoke

(Spencer Davislash, Unsplash)

This article was exclusively written for The European Sting by Mr. David Andre de Carvalho Fernandes Gil, a 2nd year student of medicine (Nova Medical School) in Lisbon, Portugal. He 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.


According to the World Health Organization, tobacco is responsible for the death of 7 million people each year [1]. Although the addictive substance of tobacco is nicotine, it plays a minor role in smoking-related diseases [2]. As such, electronic nicotine delivery systems (ENDS) have been developed, of which electronic cigarettes (e-cigarettes) are the most common [3].

These products, also known as “vapes”, were first invented in 2003, by the Chinese pharmacist Hon Lik, quickly becoming a worldwide phenomenon. E-cigarettes were first sold in 2004, and in 2007 were introduced to the European and American markets. The quick dissemination of these products was caused by the labelling of e-cigarettes as a healthier and cheaper alternative to smoking, also working as a cessation aid [4].

These products have three basic components: a battery which provides energy to the electrical heater, which in turn produces aerosolized vapours from a liquid (e-liquid), inhaled by the user. The main components of the e-liquid are nicotine, flavouring agents and propylene glycol [3]. This last substance is linked with the alteration of “clock genes” [5], leading to unknown long term consequences.

Nicotine is highly addictive, due to the stimulation of pleasure and reward pathways in the brain [2]. Thus, it induces pleasure, controls mood, and reduces stress and anxiety [2]. Moreover, it has diverse effects on the cardiovascular system, culminating in the increase of blood pressure {6], formation of atherosclerotic plaques, and modifications of the architecture of the heart [6], all possible factors that conduct to heart failure.

In clear contrast to the conventional cigarettes, ENDS release aerosols, when the user exhales, making the “second hand” effects of e-cigarettes a possibility [7]. Furthermore, the surfaces that were exposed to ENDS vapours retain some nicotine, becoming a “third hand” source [8].

Up until 2014, there was no regulation regarding e-cigarettes. On February 26, 2014, the European Commission Directive published a statement about the safety and use of e-cigarettes [9].

Regarding the statements that e-cigarettes could be used as a smoking cessation aid, the conclusions are twofold: On the one hand, survey studies observe an increase of smoking cessation with the increase of e-cigarette use [10]. On the other hand, recent meta-analysis conclude that e-cigarette use is associated with reduced smoking cessation [11].

The scarier picture in this panorama is that ENDS might serve as an introduction to smoking to adolescents [12]. Even though youth smoking is declining in the same time period as the expansion of e-cigarettes, as it has been for the past decades, the correlation cannot be made with certainty. Furthermore, there was no clear sign of accelerated decrease of youth smoking since the introduction of the e-cigarette.

In conclusion, e-cigarettes present themselves as a less harmful method of nicotine delivery than regular smoking. Although the consequences of long term use are unknown, e-cigarette use reduces the exposure to tobacco carcinogens and tar, which is beneficial. The most worrying topic about e-cigarettes might be their role as an introduction to smoking, considering adolescent use.

References

  1. The WHO tobacco free initiative, Geneva, Switzerland. Cited April 25, 2019. https://www.who.int/en/news-room/fact-sheets/detail/tobacco
  2. Benowitz, N.L. 2010. Nicotine addiction. N. Engl. J. Med. 362: 2295–2303.
  3. The WHO tobacco free initiative, Geneva, Switzerland. Cited April 25, 2019. https://www.who.int/tobacco/communications/statements/eletronic-cigarettes-january-2017/en/
  4. Zhu, S.H. et al. 2014. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob. Control 23: 3–9.
  5. Lechasseur A, Jubinville É, Routhier J, et al. Exposure to electronic cigarette vapors affects pulmonary and systemic expression of circadian molecular clock genes. Physiol Rep. 2017;5(19):e13440. doi:10.14814/phy2.13440
  6. Benowitz NL, Burbank AD. Cardiovascular toxicity of nicotine: Implications for electronic cigarette use. Trends Cardiovasc Med. 2016;26(6):515–523. doi:10.1016/j.tcm.2016.03.001
  7. Czogala J, Goniewicz ML, Fidelus B, Zielinska-Danch W, Travers MJ, Sobczak A. Second hand Exposure to Vapours from Electronic Cigarettes. Nicotine & Tobacco Research. Jun 2014;16(6):655-662.
  8. Goniewicz ML, Lee L. Electronic Cigarettes Are a Source of Thirdhand Exposure to Nicotine. Nicotine Tob Res. Aug 30 2014.
  9. European Parliment. Manufacture, presentation and sale of tobacco and related products. [2014 Feb 26; accessed 2019 April 26]. Available from: http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-//EP//TEXT1TA1P7-TA-2014-0160101DOC1XML1V0//EN
  10. Zhu SH, Zhuang YL, Wong S, Cummins SE, Tedeschi GJ. E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys. BMJ. 2017;358:j3262. Published 2017 Jul 26. doi:10.1136/bmj.j3262
  11. Kalkhoran S, Glantz SA. E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. Lancet Respir Med. 2016;4(2):116–128. doi:10.1016/S2213-2600(15)00521-4
  12. Soneji S, Barrington-Trimis JL, Wills TA, et al. Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-analysis. JAMA Pediatr. 2017;171(8):788–797. doi:10.1001/jamapediatrics.2017.1488

About the author

David Andre de Carvalho Fernandes Gil is a 2nd year student of medicine (Nova Medical School) in Lisbon, Portugal. He is 20 years old, and is working on their college’s journal FRONTAL, as event manager. Besides college, he has been a scout since he was 8 years old, mostly doing camping and hiking activities, but working besides at their local voluntary groups as well. He also plays the guitar, due to his love for music. Furthermore, he enjoys reading and writing, with some poems published in his high school’s journal, and in the middle of writing his first novel.

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

the European Sting Milestones

Featured Stings

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

Here are six bold ideas to accelerate sustainable energy innovation

UK keeps its Brexit plan secret or there is no strategy at all whatsoever?

On World Day to Combat Desertification, UN shines spotlight on ‘true value’ of land

Eating less beef and more beans would cut deaths by 5-7%

The EU Commission implicates major banks in cartel cases, threatens with devastating fines

Agreement reached on digital copyright rules

5 ways for business leaders to win in the 2020s

‘Complacency’ a factor in stagnating global vaccination rates, warn UN health chiefs

Sustainability is now mission critical for businesses. Here’s why

The US is withdrawing from a 144-year-old treaty. Here’s the context

Parliament seals ban on throwaway plastics by 2021

UN chief ‘deeply alarmed’ over military offensive in south-west Syria

EU Parliament: Follow the fraudulent money and confiscate it

COP21 Breaking News_05 December: Carbon Price Needed for Climate Change Success

5 amazing schools that will make you wish you were young again

Climate change and health: an everyday solution

Golden Pen of Freedom Awarded to Murdered Saudi Journalist Jamal Khashoggi during World News Media Congress 2019

Meet Alice, the battery-powered plane that could herald the age of electric air travel

Europe had a record year for Measles – and it’s partly down to anti-vaccine campaigners

EU Budget 2019 to focus on young people

No hard drivers in sight to remodel the stagnating affairs of the EU

Veteran UN Syria Envoy to step down, pledges to work ‘until the last hour’ for peace

Is the West gradually losing Africa?

Sweden has invented a word to encourage people not to fly. And it’s working

France is about to start giving free breakfasts to disadvantaged schoolchildren

China is the first non-EU country to invest in Europe’s €315 billion Plan

Statistics show the ugly face of youth training schemes

We had the hottest June ever this year – this is what happened around the world

Do the giant banks ‘tell’ Britain to choose a good soft Brexit and ‘remain’ or else…?

UN food agency begins ‘last resort’ partial withdrawal of aid to opposition-held Yemeni capital

As monsoon rains pound Rohingya refugee camps, UN food relief agency steps up aid

Internet of Things: a Force for Good or Evil?

Strengthening the rule of law through increased awareness, an annual monitoring cycle and more effective enforcement

A Sting Exclusive: “Infrastructure can lay the groundwork for the Sustainable Development Goals” by Mr Fulai Sheng, UN Environment Senior Economist

China is sending science students to live with rural farmers – and crop yields are skyrocketing

Forget about growth without a level playing field for all SMEs

Here are 10 of Nelson Mandela’s most inspirational quotes

Fake news: What it is, and how to spot it

Finland should do more to improve job prospects of low-skilled youth

2014 budget: The EU may prove unable to agree on own resources

Opening Remarks by H.E. Ambassador Yang Yanyi, Head of the Chinese Mission to the EU at the Chinese Fashion Night

WEF Davos 2016 LIVE: “European unity and cooperation is being called on question”, Vice President Joe Biden criticizes from Davos

Thursday’s Daily Brief: dire living conditions in Idlib, migrants at US southern border, end in sight for trachoma, Human Rights Council

Why South Africa is on a path of economic renewal

Can a Bavarian Oktoberfest beer indulger bring down the Berlin government?

Armenia should take vigorous measures against entrenched corruption

Why CEOs need to become activists in sustainability

Preserving biodiversity vital to reverse tide of climate change, UN stresses on International Day

Chernobyl nuclear disaster-affected areas spring to life, 33 years on

The Dead Sea is drying up, and these two countries have a plan to save it

European Youth Forum @ European Business Summit 2014: European Youth Unemployment

Who is to pay for Trump’s trade war against China?

Is it too soon to hope for a tobacco free Romania?

‘Virtual Biopsy’ device detects skin tumours in 15 minutes

The Schengen area is at a crossroads

The Commission neglects the services sector and favours industry

Yesterday’s “jokes” and sarcasm by Digital Single Market’s Vice President Ansip on EU member states’ right to protect their telco markets

Draghi sees inflationary bubbles

MWC 2016 LIVE: Mobile Connect availability hits 2B

Is Europe misjudging its abilities to endure more austerity and unemployment?

More Stings?

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