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Tobacco Products and the Rise of E-Cigarettes

This is an excerpt from Live Well Middle School Health With Interactive Web Text by Karen E. McConnell,Terri D. Farrar & Charles B. Corbin.

E-Cigarettes

E-cigarettes have many different names, such as e-cigs, vape pens, vapes, mods, tank systems, and ENDS, which stands for electronic nicotine delivery systems (figure 11.4). E-cigarettes are battery-operated devices that heat a liquid and produce an aerosol. The aerosol that e-cigarette users inhale and exhale can contain the following: nicotine, flavorings, ultrafine chemical particles that can be inhaled into the lungs (from the e-juice and from the metal in the heating coil of the e-cigarette), cancer-causing chemicals, and heavy metals such as nickel, tin, and lead. Using an e-cigarette is often known as vaping. Vaping is the act of inhaling and exhaling aerosol produced by an e-cigarette.

E-cigarettes come in many shapes and sizes. Some look like regular cigarettes and are usually disposable. Others look like USB flash drives or pens while others are tank systems, which are larger devices known as mods. The e-cigarettes that are in the form of USB drives, pens, and mods all have internal batteries and are all rechargeable.

Regardless of the type of e-cigarette, they usually have a battery, a heating element, and a place to hold liquid. The liquid, often referred to as e-juice, usually contains nicotine, flavoring, and other chemicals. The amount of aerosol produced by the e-cigarette affects how much nicotine is consumed.

E-juice comes in a number of flavors, including strawberry, bubblegum, orange, peppermint, coffee, cola, and pie flavors. The use of flavors is also part of the appeal to teens; they don’t view it as smoking since it doesn’t smell like traditional cigarettes. Teens cite the flavors as the leading reason for using e-cigarettes. The e-juice flavors are a problem because they are available and appealing to teens, which promotes the use of e-cigarettes. For this reason, flavored e-cigarettes, flavored cartridges, and flavored pods (with the exception of menthol), such as the brand JUUL, have been banned. Even though the cartridges and pre-filled pod devices have been banned, the e-juices can be used in tank systems.

Who Uses E-Cigarettes?

According to the CDC more than 3 million teens in middle school and high school use e-cigarettes. Because of the wide variety of flavors available, e-cigarettes are increasingly popular with teens who have never smoked cigarettes before and may never have intended to. The CDC has found that teens and young adults who are using e-cigarettes are at an increased risk to smoke cigarettes later in their lives, due in part to the addiction of nicotine. Some cigarette smokers, both young and older, are using e-cigarettes in places where cigarette smoking isn’t allowed. By using both cigarettes and e-cigarettes people are increasing their total exposure to nicotine and its harmful effects. Overall, the use of e-cigarettes seems to be more socially acceptable than smoking cigarettes because the aerosol doesn’t smell bad like cigarette smoke does and doesn’t make your breath or clothes smell bad. While the smell certainly isn’t a good reason to use e-cigarettes, it is one of the more popular reasons people are using to justify their e-cigarette use.

E-Cigarettes Are a Dangerous Alternative to Smoking

E-cigarettes have been advertised as a safe alternative to smoking and as a method to help people try to quit smoking. A study by Harvard Health found that while some participants in their study stopped smoking, many began using e-cigarettes instead. At this time there is little evidence that using e-cigarettes reduces cigarette smoking or can lead to the complete stoppage of smoking.

Whether a person is smoking a cigarette or an e-cigarette, nicotine is usually a part of the reason for doing so. Nicotine is the highly addictive component of tobacco and although tobacco is not used in an e-cigarette, nicotine can be. Vaping an average-sized e-cigarette is equal to 12 cigarettes, and most tobacco cigarettes contain between 8 mg and 20 mg of nicotine. Much of the nicotine is burned out of the cigarette because smokers don’t usually smoke all the cigarette. They do use all the e-juice though, so they get more nicotine in an e-cigarette than in a tobacco cigarette. It’s possible to buy e-juice that does not contain any nicotine, but users don’t always know the difference and may purchase e-juice based on the flavor and the price, rather than whether it contains nicotine.

Health Risks and E-Cigarettes

Since e-cigarettes are fairly new, there is still a lot to be learned about the long-term health effects. Many of the health risks we are aware of are similar to those of smoking tobacco while some are specific to vaping (figure 11.5).

  • Most e-cigarettes contain nicotine, which is highly addictive and can harm the parts of the brain that control attention, learning, mood, and impulse control.
  • There have been some defective e-cigarette batteries that have caused fires and explosions, resulting in some serious injuries.
  • It is unclear what all the ingredients are that make up e-juice flavors, which means all the side effects of e-juice are unknown at this time. It could take years before this information is available.
  • There have been some children and adults poisoned by swallowing, breathing, or absorbing e-juice through their skin and eyes. There are over 4,000 calls per year to the Poison Control Center about e-juice poisonings.
  • The aerosol from e-cigarettes contains cancer-causing chemicals, metals such as lead and tin, and ultrafine particles that can be inhaled into the lungs.
  • Vaping can cause lung and cardiovascular diseases, asthma, lung cancer, irregular heartbeats, high blood pressure, fainting, and dizziness, and can reduce how well your immune system works.

Figure 11.5 Side effects of vaping.
Figure 11.5 Side effects of vaping.