Vaping misconceptions: Are flavoured e-cigarettes safe or cause restrictive lung disease?

Updated on Oct 25, 2022 02:46 PM IST

In the past decade, nicotine–containing e-cigarettes have emerged as the most popular tobacco cessation tool among adolescents. Vaping has become pervasive even among middle and high school students. Are flavouring agents in e-cigarettes safe or cause restrictive lung disease?

Vaping misconceptions: Are flavoured e-cigarettes safe or cause restrictive lung disease? (Lemkhanzar)
Vaping misconceptions: Are flavoured e-cigarettes safe or cause restrictive lung disease? (Lemkhanzar)
ByZarafshan Shiraz, Delhi

In the past decade, nicotine–containing e-cigarettes have emerged as the most popular tobacco and nicotine delivery modality among adolescents and were introduced in the United States tobacco market in 2007, as a tobacco cessation tool. E-cigarettes have gained widespread popularity among adolescents and vaping has become pervasive among middle and high school students.

Earlier when in 2003 e-cigarettes were launched, one of the earliest study concluded that vaping is 95% healthier than smoking. Although limited but recent studies have challenged this fact and it has been shown that e-cigarette use is associated with respiratory symptoms (cough or phlegm), regardless of cigarette smoking status, although the risk might be lower than that with cigarette smoking.

However, an observational study published last year compared lung function between vapers, cigarette smokers or those who didn’t smoke any of the above. It revealed that vaping has similar detrimental effects on pulmonary function as smoking and in addition, increasing vaping uptake among youth could stimulate uptake of cigarette smoking, creating a smoking-dependent generation.

In an interview with HT Lifestyle, Dr Sanket Jain, Consultant Chest Physician - Pulmonologist at Masina Hospital in Mumbai, revealed, “E-liquid aerosols are associated with direct harm to respiratory epithelium, leading to altering of lung function, lung inflammation, decrease mucociliary clearance and lung histology. Most E cigarettes contain three components: 1. Nicotine, 2. A solvent, 3. Chemical flavours. Nicotine leads to serious adverse effects on all organ systems, but when inhaled leads to specific harm. A solvent contains propylene glycol and vegetable glycerin which can lead to specific harm to lungs. Findings suggest that propylene glycol contains oral and nasal irritants and cause squamous cell metaplasia.”

He added, “Flavours are highly variable given the enormous variety of available flavors in e liquids. Flavoring ingredients is said to be harmful, resulting in brochities obliterans. In around 2019, there was random increase in the cases of acute respiratory failure due to E cigarettes or vaping products use associated lung injury (EVALI). The e cigarette users have been divided into two subtypes - 1. Active smokers seeking to quit traditional cigarettes - When compared to other forms of nicotine replacement therapy, e cigarettes found to be very effective. 2. Recreational users - Regards to recreational users, a specific group of youth who never smoked a traditional cigarette."

He highlighted that there are many misconceptions that:

1. Aerosols from e-liquids are less addictive than traditional cigarettes

2. Does not contain any nicotine

3. Has become a style statement amongst youth

Dr Sanket Jain concluded, “The rise in e-cigarette use has been increased due to numerous factors such as features of it being small, sleek, technologically advanced in terms of nicotine and salt formulations and also, attractive flavours. There has been conflict regarding the use of e-cigarettes as smoking cessation tool but there are direct effects on lungs due to vaping which have been proved by many studies published in various journals. Also, there is a public misconception which is playing a major role in the increases of vaping among people.”

Bringing his expertise to the same, Dr Sandeep Attawar, Director, Lung Transplant at Sir HN Reliance Foundation Hospital, insisted, “Flavouring agents have been shown to have disastrous effects on lung cells and structure especially sweet and cinnamon flavours. Then flavours such as cherry and sweet flavoured e-cigarettes have chemicals that have major impact on lung function. Hence although information on impact of vaping on lung function is still emerging but what can be concluded that there are toxic chemicals in e-cigarettes which leads to unhealthy lungs and decline in lung function (more than normal) and chronic respiratory symptoms are observed with its regular use. Long term studies about the risk of lung cancer with vaping are lacking and this area is yet to be researched.”

Vaping should be viewed as a "lesser of evils" for current cigarette smokers but still, there is a lot about vaping we need to educate on. One way we’ll learn more is by revealing the possible or current health problems that result from vaping. These cases of severe lung disease among people who vape raise important questions about the safety of vaping. Nicotine is the primary instrument in regular cigarettes and e-cigarettes and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is a toxic substance, rising your blood pressure and spiking your adrenaline, causing increases in heart rate likely to suffer from a heart attack.

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