Last year, 18-year-old Nikita Singh came up against that notorious peer pressure to smoke. All her college friends were doing it, and they found her ‘stuck-up’ and ‘old-fashioned’ for being too health-conscious to light up.
She smoked her first cigarette a few months later, in June. Only it wasn’t a regular cigarette, but an electronic one.
“My father is a regular smoker, so I have always been aware of the hazards of smoking,” she says. “So I went on to the internet to find an alternative.”
That’s how the south Mumbai resident ended up ordering her e-cigarette online and smoking it four times a day.
“I thought I was escaping the harmful effects of smoking,” Singh says.
As she would soon be told by her doctor, the perception that e-cigarettes are harmless is a myth. “E-cigarettes are promoted in a way that gives an impression of them being nicotine-free, but in reality they do contain small amounts of nicotine or acrolein, a chemical aldehyde, which affects the endothelial cells in one’s lungs, causing inflammation and long-term damage,” says Dr Amita Nene, chest physician at Bombay Hospital. “When one lights an e-cigarette, it produces ultra-fine particles which get deposited in the smoker’s throat, causing irritation and infection. The liquid used in most e-cigarettes contains propylene glycol, which is known to dehydrate the throat. Infections can also be caused when people inhale too strongly, which leads to excess deposits of particles in the throat.”
Dr Nene treated Singh for a severe throat infection in December.
“I started feeling itchiness in my throat one week after I started smoking the e-cigarettes. As I began smoking them up to seven times a day over the next few months, the problem got worse,” says Singh. “My voice had started getting affected and I used to feel nauseous. I researched the harmful effects of e-cigarettes online but found contrasting reports, which further confused me.”
The good thing about Singh, Dr Nene says, was that she wanted to quit smoking and responded well to counselling. “I suggested nicotine chewing gum to help her handle the withdrawal,” she adds.
Singh says she hasn’t touched e- or regular cigarettes since, and has even weaned herself off the gum. “I have seen my mother worry because of my father’s smoking habit. I know the harm smoking causes and I don’t want to expose myself to it in any form,” she says.
Physicians equate e-cigarettes with a gateway drug, which paves the way for addiction to regular cigarettes. “The chemicals used to generate smoke can be volatile and in some cases, carcinogenic. E-cigarettes are especially harmful for youngsters because they get initiated into smoking believing that such cigarettes are a harmless option,” says Dr Lancelot Pinto, chest physician at Hinduja Hospital. “After a while, they switch to regular cigarettes, which cause even greater damage.”
“I have been a regular smoker for 12 years. In January, on a friend’s recommendation, I started smoking e-cigarettes in an attempt to quit,” says Rahul Ahuja (name changed on request), 34, a sales professional from Mumbai. Ahuja too contracted a throat infection and has been weaning himself off the e-cigarettes since April. “My doctor explained to me that chemicals in e-cigarettes can cause infections and damage the lungs. I rarely smoke e-cigarettes now,” he says.
“Whatever studies we have had on e-cigarettes aren’t adequate. These are short-term studies and tell us nothing about the long-term health impact of its use,” says Sonali Jhanjee, in-charge of the tobacco cessation clinic at the All India Institute of Medical Sciences’ (AIIMS) National Drug Dependence Centre. “We are not sure about the components of e-cigarettes, especially the ones that we get in India. The main concern is that e-cigarettes are increasingly being used by youngsters.”
“We don’t know enough about e-cigarettes to label them safe,” says Dr SK Khandelwal, head of psychiatry department in AIIMS. “Overall it seems more like a gateway product to smoking cigarettes, especially among kids.”