As more and more of my patients switch to e-cigarettes or vaping when trying to quit smoking. What do you tell patients about vaping? In 2016 the number of middle schoolers who reported they used electronic cigarettes was 63% and 11.3 of high schoolers used e-cigarette reported by CDC.
One of my diabetes patients came in reporting that he had stopped smoking and had switched to vaping now. So is vaping better than smoking cigarette? There are now about 500 different brands of e-cigarettes. The academy of pediatrician reports that it is not vapor but is aerosol because there is particulate matter.
Brief history
2003-2007 the first commercially produced e-cigarettes were produced overseas in Asia and between 2006 and 2007 smokeless e-cigarettes were introduced in the US.
Most of the data reported were done with the first and second generations of e-cigarettes which did not have set amounts of nicotine. In the US we are now using the fourth generation of e-cigarettes. New e-cigarettes were more powerful, more liquid and are now more popular.
What is in the pods?
Ingredients can vary but most contain some toxicants and carcinogens and the pods come in a range of nicotine. Traditional cigarettes contain 10-30 mg of actual absorbable nicotine 0.05-3 mg. Compared to pods that range from 0 to 36 mg/ml. Most of the e-cigarette pods contain:
- propylene glycol
- glycerol (sugar)-fruit flavoring
- diacetyl- bronchiolitis obliterans (popcorn lung)
- aldehydes
- metals
- tobacco alkaloids, nitrosamines
- hydrocarbons
- flavors- over 7000 flavors
Toxicants and carcinogens are in less amount than in cigarettes. This are easily accessible in stores and online. One popular vapor product: sales up 641% over one year and had 515% increased in market share and went from 2.2 to 16.2 million in revenue.
In 2015 of the adults who used e-cigarettes:
- 29.8% were former smokers
- 58.8% were current smokers who also use e-cigarettes (dual users)
- 11.4% had never been regular smokers
In 2016 there were 3.2 % of US adults. In 2018 e-cigarettes are the most common tobacco product used in US youth. 40% of current ENDS users are age 18-24 years have never been cigarette smokers.
Teens who have used e-cigarettes are more likely than those who have not used e-cigarettes to go on to smoke real cigarettes.
FDA declared Teen Vaping an epidemic and now bans tobacco and e-cigarettes to people under age 18.
Does vaping help quit smoking regular cigarettes?
The FDA has not approved e-cigarettes the conclusion was that they are not associated e-cigarettes as smoking cessation products because in the studies done with 1st generation cigarettes were not associated with successful cessation.
The CDC in 2018 stated is not safe for kids, adolescents, pregnant women and any one who is not currently smoking. The American Cancer Society stated that current generation of e-cigarettes are less harmful than smoking tobacco, however long-term harms are unknown.
Known Risks
E-cigarettes can expose others to second hand smoke and third hand aerosol pollutants. Residual aerosol that acts as dust on surfaces that can be re-emitted.
Burns and injury- some have been known to explode
Toxicants and carcinogens
Risks to children of poisoning- children opening and drinking pod contents
Addictive- could be as addictive as cigarettes.
What advice would you give your patient?
First congratulate patients for stop smoking cigarettes. Then would advise patients to start to decrease amount of nicotine and amount of use and try to stop using e-cigarettes. Yf
