‘Vaping raises likelihood of conventional cigarette uptake by nearly 3 times’: PGIMER’s Dr Sonu Goel

What are E-Cigarettes?

Electronic cigarettes (e-cigarettes) are devices that vaporize nicotine (which is highly addictive) the solution instead of burning tobacco leaves. E-cigarettes deliver nicotine-containing aerosol (vapour) to users by heating a solution usually composed of propylene glycol or glycerol (glycerin), nicotine, and flavouring agents.

What harmful substances do e-cigarettes contain and what are their effects on various populations?

As per the World Health Organization, e-cigarette emissions contain nicotine and various toxic substances like propylene glycol, glycerol, acetaldehyde, formaldehyde, acrolein, heavy metals, tobacco-specific nitrosamines and many more carcinogens which are harmful to both users and non-users exposed to second-hand aerosols.

For pregnant women, nicotine exposure can negatively impact foetal development, posing significant risks during pregnancy.

In children and adolescents, nicotine can impair brain development, potentially leading to long-term issues such as learning difficulties and anxiety disorders. It is also known to cause respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), pneumonia and various other respiratory, gastrointestinal, and cardiovascular (heart) diseases. Accidental exposure of children to e-liquids poses serious risks, as leaking devices or swallowed e-liquids can be highly poisonous.

Do the young associate e-cigarettes with a cool image, and do they increase the likelihood of conventional cigarette use?

The association is due to its appealing features, flavours, social enhancement, and sleek designs. Numerous epidemiological studies indicate that vaping significantly raises the likelihood of conventional cigarette uptake, particularly among non-smoking youth, by nearly three times.

Do e-cigarettes cause lung injuries?

E-cigarettes, specifically electronic nicotine delivery systems ((ENDS), cause lung injuries. In the United States,
an outbreak of severe lung injury associated with e-cigarette use, known as e-cigarette or vaping-associated lung injury (EVALI). EVALI is characterised by large spots in the lungs (tissue damage) and has symptoms like shortness of breath, fever and chills, cough, chest pain, diarrhoea, nausea, vomiting, abdominal pain, rapid heartbeat, rapid and shallow breathing. Vitamin E acetate (VEA), often used in ENDS products containing cannabis, is believed to have played a significant role in causing these lung injuries.

What factors determine the level of risk associated with e-cigarettes and tobacco products?

The safest choice is to avoid using either of them. E-cigarettes contain nicotine which is highly addictive and harmful. A non-smoker who uses e-cigarettes may become addicted to nicotine and struggle to stop using e-cigarettes or may even start using conventional tobacco products.

Additionally, many e-cigarettes allow users to control their nicotine levels, which can reach dangerously high concentrations.

Can e-cigarettes act as tobacco cessation tools?

E-cigarettes are marketed to help quit smoking, but they have not been approved by the Food and Drug Administration for this purpose. A recent study found that most individuals who intended to use e-cigarettes to quit smoking ended up continuing to use both traditional cigarettes and e-cigarettes.

Instead, tobacco cessation services can be provided by any healthcare professional with appropriate training. The Ministry of Health has initiated the National Tobacco Quit Line (toll-free number 1800-11-2356) to provide counselling services and the programme supports individuals willing to quit through text messaging via mobile phones (011- 22901701).

Are e-cigarettes banned in India?

Yes, the Indian government enacted the Prohibition of Electronic Cigarettes Act in 2019, which prohibits the production, manufacture, import, export, transport, sale, distribution, storage, and advertisement of e-cigarettes across the country.