may be a new, dangerous trend for teens who
Teenagers and Oral Health
When looking at e-cigarettes and oral health, especially in relation to teenagers, its important to remember that an e-cigarette is still primarily a nicotine delivery device and theres little debate as to the effects of nicotine on the body.
The truth is, no one is completely
sure about the long-term health effects of e-cigarettes
which can make them a particular concern for adolescents.
Many teenagers are smoking e-cigarettes because they feel
they are safe or cool. Regardless of how its
delivered, however, nicotine is still a highly addictive
drug that should be avoided by everyone, especially growing
teens. With few laws banning their use among young people,
its important to educate your children about the
potential hazards of this growing trend.
Damage Lung Cells
The researchers tested both mice and
human cells, exposing them to cigarette and e-cigarette
smoke with and without nicotine. They found that nicotine in
both types of cigarettes caused lung damage. Interestingly,
the nicotine-free e-cigarettes also contained a substance
that damaged lung cells. So, are e-cigarettes really a
better option than cigarettes? While it may not seem that
way right now, more research is needed to confirm.
What made you decide to try the e-cigarette? After reading this article, share your comments and read what others have to say.
You can smoke them virtually anywhere. Many say they will help you quit smoking, a plus for people with COPD who often struggle with smoking cessation. Others are skeptical and afraid to try them. The FDA would like to regulate them as medical products. The e-cigarette industry feels that the FDA has no substantiated reason to do so.
There's a lot of talk going on about e-cigarettes, so before making a decision to use them, learn the facts about their pros and cons.
What are E-Cigarettes?
Electronic cigarettes, or e-cigarettes for short, are battery-powered devices filled with liquid nicotine (a highly addictive chemical) that is dissolved in a solution of water and propylene glycol. Many of them look like real cigarettes, with a white cylindrical tube, brown filter, and red-glowing tip. Others come in less conspicuous, darker colors.
How Do They Work?
Often termed "vaping," when you take a puff on the end of the e-cigarette tube, a battery heats up the nicotine, which creates a vapor that is then inhaled into the lungs. The end result is a sensation of smoke in the mouth and lungs without really smoking.
The Upside to E-Cigarettes
Unlike tobacco products, there are no current laws in effect prohibiting the use of e-cigarettes in public places. Case in point, I work in a hospital and a fellow nurse smokes them right there in the nursing station.
Here's what current research says about the positive aspects of this product:
The Downside of E-Cigarettes
If you are a savvy consumer, both positive and negative aspects of the the product you are considering should be scrutinized before you purchase it. The e-cigarette is no exception. Take a look at what some of the research says about the negative aspects of the e-cigarette:
The Best Way To Quit Smoking
How you choose to quit smoking is a matter of personal choice. The best method is the one that works for you. With this in mind, doing whatever it takes to be successful -- and safe -- is how many people ultimately approach it.
Consult your health care provider about different stop smoking aids, including nicotine replacement therapy, quit smoking medications such as Clonidine and Wellbutrin, quit smoking support groups, and educational materials.
If you decide to try the e-cigarette, be sure to discuss this with your doctor and do your homework. Understand the pros, cons, and safety concerns, and then make an informed decision. The most important thing to remember is, no matter how you do it, you are making the best decision of your life when you finally decide to quit smoking, especially if you have COPD.
If you're interested in purchasing an e-cigarette starter kit, compare prices here.
Etter JF, Bullen C. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction. 2011 Nov;106(11):2017-28. Epub 2011 Jul 27.
Bullen C, McRobbie H, Thornley S, Glover M, Lin R, Laugesen M. Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control. 2010 Apr;19(2):98-103.
Caponnetto P, Polosa R, Russo C, Leotta C, Campagna D. J. Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series. Med Case Reports. 2011 Dec 20;5(1):585.
Evangelopoulou, Gregory N. Connolly and Panagiotis K. Behrakis Constantine I. Vardavas, Nektarios Anagnostopoulos, Marios Kougias, Vassiliki. Acute pulmonary effects of using an e-cigarette: impact on respiratory flow resistance, impedance and exhaled nitric oxide. Chest; Prepublished online December 22, 2011.
Fagerström KO, Hughes JR, Rasmussen T, Callas PW. Randomized trial investigating effect of a novel nicotine delivery device (Eclipse) and a nicotine oral inhaler on smoking behavior, nicotine and carbon monoxide exposure, and motivation to quit. Tob Control. 2000 Sep;9(3):327-33.
Fagerström KO, Hughes JR, Callas PW. Long-term effects of the Eclipse cigarette substitute and the nicotine inhaler in smokers not interested in quitting. Nicotine Tob Res. 2002;4 Suppl 2:S141-5.
Food and Drug Administration News and Events: Public Health Focus. http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm. Accessed 1/24/2011.
Anna Trtchounian and Prue Talbot. Electronic nicotine delivery systems: is there a need for regulation? Tob Control published online December 7, 2010.
Q&A: Are e-cigarettes safe?
Answer: In 2010, Wisconsin implemented the Smoke-free Air law and almost five years later 86 percent of Wisconsinites enjoy and expect smoke-free air. E-cigarettes have recently exploded on the market and this new popular trend has created confusion regarding the statewide Smoke-free Air law. This new trend is invading the clean air we have come to expect.
An electronic cigarette is an oral device that can be used to simulate smoking and that produces an aerosol of nicotine or other substances. The term e-cigarette is use to reference and array of products including, e-hookahs, hookah pens, vape pens, vaporizers, e-cigars, and e-pipes.
You may be asking yourself, "But are they healthy?" As many as 10 different toxic or carcinogenic chemicals have been identified in e-cigarettes including, highly addictive nicotine. Studies have also found some e-cigarettes contain high levels of formaldehyde and diacetyl chemicals harmful to the human body. Currently, e-cigarettes aren't regulated and haven't been proven to be safe.
E-cigarettes are being marketed as a healthy alternative to smoking, an effective cessation strategy and a way around existing smoke-free air laws. But smokers who use e-cigarettes for cessation often continue to smoke regular cigarettes. In addition, allowing e-cigarettes to be used indoors where cigarettes are not allowed undermines the smoke-free air law. The use of e-cigarettes indoors threatens Wisconsin's standard of clean air and makes enforcement confusing.
Overall, more research is needed to show the long-term health consequences of e-cigarettes. Every month more information is coming out about what is actually in e-cigarettes and e-juice. It's more than just water vapor.
The Central Wisconsin Tobacco Free Coalition strives to reduce tobacco/nicotine related death and disability through education and advocacy, creating a community environment that encourages tobacco free living.
Destinee Coenen is a public health
educator with the Marathon County Health Department who is
part of the Central Wisconsin Tobacco Free Coalition. Have a
question about public health? Email it to
concerns raised over teen e-cigarette use
The report, released Monday by the American Academy of Pediatrics, is based on a study that found overall smoking prevalence among youth in Southern California declined, but the combined e-cigarette or cigarette use was substantially greater than before e-cigarettes became available.
The conclusion raises the question of whether e-cigarettes are merely substituting for cigarettes or being used by teens who wouldnt otherwise be smoking.
In 2014, the Centers for Disease Control and Prevention reported e-cigarettes were the most commonly used tobacco product among middle and high school students, with an estimated 2 million users in that age group.
Cigarette smoking declined among American teens in recent years, but the use of other tobacco products like e-cigarettes and hookahs increased, the report says.
More teens now try vaping than smoking
The potential safety of e-cigarettes, devices that heat a liquid consisting of nicotine, flavorings and other chemicals to create a vapor, is hotly debated. Unlike traditional cigarettes, e-cigarettes do not contain tar or other chemicals generated by the combustion of tobacco that are responsible for harmful tobacco-related diseases. They are, therefore, seen as a safer alternative to conventional tobacco use, the leading cause of preventable death in the U.S.
Health care experts worry e-cigarettes could normalize cigarette use and create a new generation of smokers and nicotine addicts that will be likely to transition to more traditional tobacco products.
But Brian Carter, the director of scientific communications at The Consumer Advocates for Smoke-free Alternatives Association, a group dedicated to ensuring the availability of smoking alternatives, asks why someone who prefers not to smoke but tries e-cigarettes would make the transition to a really nasty alternative.
Aruni Bhatnagar, lead author of the American Heart Associations policy statement on e-cigarettes, said even if teens dont switch to other tobacco products, nicotine itself isnt benign. It increases heart rate and blood pressure and can, over time, contribute to cardiovascular and heart disease, he said.
We are not entirely convinced that (e-cigarettes) are innocuous and contain minimal harm, said Bhatnagar, who also teaches medicine at the University of Louisville. We dont know what the harm is, its not clear cut yet.
Tobacco use and addiction mostly begin during youth and young adulthood. Nicotine exposure during adolescent years, a critical time for brain development, can have lasting adverse consequences, according to the CDC report.
Harold Farber, policy chair at the American Academy of Pediatrics Section on Tobacco Control and pediatric pulmonologist at Texas Childrens Hospital, said the adolescent brain is highly malleable, so addiction to nicotine is much more severe and difficult to kick in those who start using at a young age.
E-cigarettes, which are sold in a variety of different flavors, are like a highly addictive candy directly marketed to youth, Farber said.
Gregory Conley, president of the American Vaping Association, an advocacy group that champions vapor products for smokers looking to quit, argued most teens who do use e-cigarettes arent necessarily using vapes that contain nicotine.
A 2015 National Institute on Drug Abuse report says over 60% of middle and high school students reported vaporizing just flavoring. However, some products labeled nicotine-free may actually contain nicotine, it added.
The Food and Drug Administration issued new rules in May that for the first time extended federal regulation to e-cigarettes, with the intent to keep tobacco products out of the hands of minors.
The new rules ban the sale of e-cigarettes to anyone under 18 and require manufacturers to register with the FDA, disclose detailed reports of their products ingredients and obtain permission to sell their products.
FDA went way too far on e-cigarettes
While these regulations are a move in the right direction, Bhatnagar says they could have gone even farther by increasing the age to 21, banning the different e-cigarette flavors and regulating advertisements on TV and in magazines.
Bhatnagar says smoking was de-normalized when it was banned from public spaces and discouraged from display in TV and movies, which he credits for the major gains in decreased tobacco use and addiction. But vaping, which people do publicly in a variety of different environments, reverses these gains, he said.
Carter, who has a background in clinical psychology, argues it is highly premature to conclude that something bad is going on with youth e-cigarette use.
At best, this is a study that offers some small potential clue about what may be happening, he said. To suggest anything more concrete than this is to be very unscientific by touting speculation as fact.
Farber says e-cigarettes are a huge experiment to be conducting on our future generations.
With e-cigarettes were
seeing a step back in our battle, he said. But
Im hoping we realize the errors of our ways and decide
its worth protecting our children.
4 Facts You Need to
Know About E-Cigarettes
We do know that traditional cigarette smoke contains upwards of 7000 toxins, including 250 poisonous and 70 cancer-causing chemical compounds. No level of secondhand cigarette smoke is considered safe to breathe.
E-cigarette emissions on the other hand contain far fewer toxins, in part because the vapor is not a byproduct of burning organic matter, but of heating the nicotine-containing liquid, which causes it to vaporize.
While e-cigarettes are less hazardous than traditional cigarettes, they're not harmless. Let's take a closer look at the issues you should be concerned with if you're thinking about using e-cigarettes as a smoking alternative or a quit aid.
1. Electronic Cigarettes are Not Regulated
In the United States, tobacco products that are regulated must adhere to strict rules imposed by the U.S. Food and Drug Administration (FDA).
Currently, regulated tobacco products include cigarettes, cigarette tobacco, smokeless tobacco, and roll-your-own tobacco.
The FDA plans to extend their umbrella of control over more tobacco products soon. They are: e-cigarettes, cigars, pipe tobacco, nicotine gels, hookah tobacco and dissolvables.
These products would be subject to the rules noted above and would also have to include health warnings, not be sold in vending machines at locations that are accessible to children, and adhere to minimum age and I.D. restrictions for sales.
How Lack of Regulation Hurts Consumers
The current lack of regulation on e-cigarettes means that you can't trust that the product you're buying contains the amount of nicotine it claims to, or that it is produced with any quality control. Pharmaceutical grade nicotine is used in all U.S. NRT products, but consumers can't count on that with unregulated tobacco products.
Similarly, information on packaging regarding nicotine-free cartridges cannot be trusted. They may, and often do contain nicotine. This is especially bad if you're using e-cigarettes as a quit aid and trying to decrease nicotine gradually to zero.
Finally, the quality of electronic cigarette devices themselves vary widely, which can affect vapor composition and toxicity.
2. E-Cigarettes Contain Some Surprising Toxins
In a study reviewing available information about e-cigarette liquid, cartridges, vapor and exhaled emissions, authors noted the presence of a number of toxins in varying amounts, including formaldehyde, acetaldehyde, acrolein, o-Methyl benzaldehyde, acetone, volatile organic compounds, phenolic compounds, polycyclic aromatic hydrocarbons.
While the amounts of these chemicals are much less in e-cigarettes than in traditional cigarettes, there is a risk of exposure to some of the same chemicals that are hazardous in cigarette smoke.
TSNAs in e-Cigarettes
E-Cigarette liquid and vapor has been shown to contain TSNAs, a group of four chemical compounds that are thought to be some of the most potent carcinogens in tobacco products and tobacco smoke. TSNAs are present in green tobacco and processed tobacco, including liquid nicotine.
TSNAs are associated with lung cancer, oral and esophageal cancer, liver cancer and pancreatic cancer. There is growing evidence that TSNAs may contribute to cervical cancer.
Heavy Metals in e-Cigarettes
Researchers studying e-cigarette emissions have identified chromium, a metal not present in cigarette smoke, as well as a number of other heavy metals that are, including zinc and lead. The concentrations are much lower than in traditional cigarette smoke, but are not zero. Nickel is present in levels 4 times higher than in regular cigarette smoke.
It appears that the metals probably come from the cartridges and that standardizing the quality of their construction may reduce these toxins.
3. E-Juice is Poisonous
The "active" ingredient in e-cigarettes and the reason people use them is nicotine, and nicotine is a poison. It has been used in insecticides for years and is the addictive ingredient in both cigarettes and e-cigarettes.
According to a CDC study that reviewed calls to poison centers across the United States involving e-cigarette liquid containing nicotine, the incidence of accidental poisoning has skyrocketed in the last few years as e-cigarettes have gained in popularity.
There was just one call per month pertaining to liquid nicotine in September of 2010 and 215 calls per month by February of 2014. Approximately half of the calls involved children under the age of 5 being exposed to e-cigarette liquid, and 42 percent from people over the age of 20.
E-liquid comes in several sweet, candy flavors, which is appealing to kids. Poisoning occurs when nicotine-laced e-liquid is inhaled, ingested or absorbed through the skin or eyes.
In December, 2014, what may be the first death of a child due to liquid nicotine occurred in upstate New York state when a one year old who ingested liquid nicotine died soon after. Local police didn't confirm that the liquid nicotine was associated with e-cigarettes, however it is likely.
And, earlier in 2014, a puppy in Britain got hold of an e-liquid cartridge and was dead within hours of chewing through it and ingesting a small amount of the liquid.
4. E-Cigarettes are a Smoking Alternative, Not a Quit Aid
It's probable that e-cigarettes will be a regulated product in the future. When that occurs, it's also likely that a physician designed and endorsed regimen for smoking cessation using electronic cigarettes will eventually become available.
When and if that happens, consumers will be able to count on a consistent level of manufacturing quality and nicotine quality and content. They will also have a program for stepping down and off of nicotine completely, which is the purpose of any quit aid.
People are already using the e-cigarette as a means to quit nicotine altogether, and some are achieving success with it. On the flip side, many e-cigarette users either transfer their addiction from tobacco to the device, or eventually go back to smoking traditional cigarettes full-time because they're still actively addicted to nicotine.
If you're thinking of using the
e-cigarette to quit smoking, do some research first on the
quit aids available on the market today, and have a
discussion about them with your doctor, who can offer advice
on the best choice for you.
U.S. Food and Drug Administration. FDA proposes to extend its tobacco authority to additional tobacco products, including e-cigarettes. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm394667.htm . Accessed March 2015.
British Medical Journal. Chemical Evaluation of Cigarettes. http://tobaccocontrol.bmj.com/content/23/suppl_2/ii11.full . Accessed March 2015.
University of Southern
California. Secondhand E-Cigarette Smoke: Healthier Than
Regular Cigarette Smoke, But Still Contains Some Toxic
. Accessed March 2015.
3 reasons to say no
to e-cigarettes - Kaiser Permanente
1. Safety concerns
After analyzing e-cigarette samples, the U.S. Food and Drug Administration (FDA) found that some products contain cancer-causing agents and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze.
2. No convincing evidence they will help you quit
In fact, there is evidence suggesting the opposite: A 2014 study by researchers at the University of California, San Francisco, revealed that smokers who use e-cigarettes are a third less likely to quit than those who dont use them.
3. Whats proven to work still works
Evidence shows the most effective way
to quit is to use a combination of FDA-approved medications
(like the nicotine patch, gum, lozenge, or bupropion) and
counseling support. Choose what works for you: Kaiser
Permanentes Wellness Coaching by Phone, tap into the
power of a group in a Health Education stop smoking class,
or try the online, self-paced program called
HealthMedia® Breathe.(TM) Learn more at kp.org/quitsmoking.
Tobacco (read e-cigarettes too) surely was designed to poison and destroy mankind - Philip Freneau