Speaker: Elif Dali, Professor Pediatric pulmonology Turkey
Elif Dagli’s talk about e-cigarettes sparked a lot of interest in the Q&A session and it’s clear that we currently have more questions than answers on what risks are entailed and what can be done to stop the trend. According to projected calculations the number of vapers globally are estimated to over 86 million people. The global prevalence of current and ever-users in younger individuals is 16.8%1.
E-juices are harmful cocktails
Although branded as “cleaner” alternative than cigarettes, e-liquid still contains a concerning mixture of chemicals. An e-liquid, or e-juice, contains propylene glycol, glycerol and flavorings as excipients2. While most aromas are developed for the food industry and considered safe for oral consumption, it doesn’t make them safe to inhale. In fact, several chemicals in the e-cigarette emissions have toxic effect on respiratory cells.2
Nicotine – and other addictions
The nicotine can be added in the form of salt-based nicotine, a form that makes it more comfortable to consume high doses in one sitting, which is likely to increase nicotine dependency.3 Nicotine is highly addictive and exposure to nicotine can have negative effects on the developing brain,4 which is concerning considering the widespread use in teens. The tobacco industry is also looking to expand the market. One such signal is Phillip Morris International’s investments in the pipeline of inhaled pharmaceutics – more specifically inhaled cannabis.
General health effects
Some of the health effects may take years to develop, and the adolescent decision to try vaping probably doesn’t consider health risks twenty years ahead. However, it has been shown that the risk of cardiovascular disease, stroke or metabolic dysfunction from e-cigarette use is in the same range as cigarette smoking.5
What can we do?
Let’s not repeat the same mistakes as with tobacco cigarettes, prof. Elif Dagli says – waiting 50 some years to take action and not until solid documentation of the harm already done. The industry should be made responsible for demonstrating that a product is safe for use, she exclaimed. Finally, she urged respiratory professionals to organize to deal with the tobacco industry and to make policy makers understand that these new nicotine products are a real threat to public health.
Erika Petersson
Medical Digital Content Manager, Chiesi
References
- Salari N, Rahimi S, Darvishi N, Abdolmaleki A, Mohammadi M. The global prevalence of E-cigarettes in youth: A comprehensive systematic review and meta-analysis. Public Health Pract (Oxf). 2024 May 16;7:100506. doi: 10.1016/j.puhip.2024.100506. PMID: 38817636; PMCID: PMC11137589.
- Krüsemann EJZ, Havermans A, Pennings JLA, et al
Comprehensive overview of common e-liquid ingredients and how they can be used to predict an e-liquid’s flavour category
Tobacco Control 2021;30:185-191. - Cho YJ, Mehta T, Hinton A, et al. E-Cigarette Nicotine Delivery Among Young Adults by Nicotine Form, Concentration, and Flavor: A Crossover Randomized Clinical Trial. JAMA Netw Open. 2024;7(8):e2426702. doi:10.1001/jamanetworkopen.2024.26702
- Castro EM, Lotfipour S, Leslie FM. Nicotine on the developing brain. Pharmacol Res. 2023 Apr;190:106716. doi: 10.1016/j.phrs.2023.106716. Epub 2023 Mar 1. PMID: 36868366; PMCID: PMC10392865.
- Glantz SA, Nguyen N, Oliveira da Silva AL. Population-Based Disease Odds for E-Cigarettes and Dual Use versus Cigarettes. NEJM Evid. 2024 Mar;3(3):EVIDoa2300229. doi: 10.1056/EVIDoa2300229. Epub 2024 Feb 27. PMID: 38411454; PMCID: PMC11562742.
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