Electronic cigarettes, or e-cigarettes, were thought to be the answer in helping those addicted to traditional tobacco cigarettes switch to a safer alternative, and ideally quit such products altogether. As e-cigarettes contain the addictive component nicotine but no tobacco, the carcinogenic risk was much lower. The continued use of nicotine and the act of inhaling would ideally satisfy an individual hoping to quit traditional tobacco cigarettes.
Then came increasing concerns of young people, as early as late elementary and middle school students, using e-cigarettes in and out of the classroom. Many of the devices look very similar to flash drives, making it easier for kids to sneak them in to schools. The most popular brand, Juul, has been under intense scrutiny of late, as many of the flavors, such as mango, strawberry melon, chocolate milk, and cotton candy e-cigarettes are thought to be aimed at the juvenile market. Teens and tweens were becoming avid users, vaping regularly, and potentially becoming addicted to nicotine. Early studies showed that kids who vape are more likely to go on to smoke traditional tobacco cigarettes. In recent weeks, there have been close to 400 cases of severe acute lung disease from vaping, and at least six deaths due to e-cigarette use. Most of these events were thought to be due to vaping liquid being contaminate with THC (tetrahydrocannabinol), one of the active substances in cannabis.
But even before these recent acute events of lung disease and death, vaping was still causing chronic lung damage. After all, the mechanism of vaping is a heating element turning a liquid nicotine-containing solution to a vapor, which then gets inhaled. The main ingredient in the liquid is propylene glycol a viscous substance which is relatively harmless if ingested or touched (but not inhaled), mixed with flavored material called aldehydes. When combined and heated to a vapor, these substances have beeen shown to cause as much inflammation in the lung tissue as traditional cigarette smoke inhalation. While many consider vaping to be a much milder hit to the lungs than traditional cigarette smoke (it is), acute and chronic damage is still being done. While longer term data on chronic lung damage from vaping is yet to be assessed, investigators have evaluated what these inhaled aerosols can do to lung tissue, and it’s not good.
In one laboratory study, human lung cells were exposed to e-cigarette aerosolized liquid. The cells were re-examined after exposure, and demonstrated altered shape, and shorter cellular lifespan. What’s more, those cells exposed to flavored aerosolized vaping liquid showed even higher levels of inflammatory substances (known as interleukins). These substances are known to contribute to chronic inflammatory diseases of the airway and lungs, making individuals more susceptible to chronic bronchitis and pneumonia.
With recent sudden illnesses and deaths from vaping, some have even considered returning to traditional cigarettes, which, while risk factors are known, they are less unpredictable. In addition, some are already noticing that e-cigarettes contain higher concentrations of nicotine than traditional cigarettes, even more than they care to inhale. One just hopes that all of the negative press, and now devastating health events from e-cigarettes will not mean that more and more will be reverting back to traditional tobacco cigarettes. Indeed, we have not come a long way, baby.