DT News - India - Interview: "With E-Cigarettes it is a see-saw game of good and bad"

Dr.Niranjan Prabhakar

Wed. 29 August 2018

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E-Cigarettes, formally known as Electronic Nicotine Delivery Systems (ENDS) and are commonly reffered to as E-cigs, E-hookah, Vape sticks and Vape pens. Dr.Jagannath P,Former State Consultant for National Tobacco Control Program in Karnataka discusses about the good and bad of E -cigarettes with Dr.Niranjan Prabhakar, DT SEA

DT SEA:What is an e-cigarette?

Dr.Jagannath P : E-cigarettes are relatively new products that deliver nicotine through a liquid consisting of glycerin and/or propylene glycol, as well as flavorings such as fruit, bubble gum, candy and other flavors very attractive to youth. The basic components of an e-cigarette are a cartridge containing a nicotine solution, a heating element that aerosolizes the solution and a power source for the heating element, which is usually a rechargeable lithium battery.

Why is e-cigarette used?

E-cigarettes are primarily used as an alternative to conventional cigarettes to avoid the ill effects of tobacco from smoking conventional cigarettes. The liquid nicotine in an e-cigarette vaporizes to give the similar psychoactive effect that is obtained by smoking the nicotine content of tobacco in a conventional cigarette. This apart, the user perceives vaping as a habit that seems more stylish than smoking a conventional cigarette. With the advent of e-cigarettes in several attractive flavors and designs, youths in the digital era are fascinated by these products. Several online surveys with current e-cigarette users indicate that e-cigarettes may be effective in reducing traditional cigarette use or for complete smoking cessation.

Are e-cigarettes safe?

E-cigarettes are only relatively safe when compared to conventional cigarettes. This is because of the absence of tobacco which is a known carcinogenic. However, there are many ingredients in an e-cigarette such as high levels of nicotine, formaldehyde, glycerin and propylene glycol, flavours such as diacetyl and heavy metals such as nickel, tin and lead. Since nicotine is one of the most addictive substances in the world, an e-cigarette can be out rightly questioned for its safety. Apart from this, no e-cigarette has been approved by the Food and Drug Administration (FDA) as a cessation aid. Another risk to consider, involves, defective e-cigarette batteries that have been known to cause fires and explosions, some of which have resulted in serious injuries. Most of the explosions happened when the e-cigarette batteries were being charged.

What are the harmful health effects of e-cigarette use?

Chronic nicotine exposure may lead to insulin resistance and type-2 diabetes. Inhaled nicotine increases heart rate and blood pressure. Nicotine is highly addictive in its own right and it may lead to changes in the brain that increase the risk of addiction to other drugs, especially in young people. Flavored e-cigarettes may pose another health threat. They often contain a chemical compound called diacetyl, which is associated with a rare lung disease called bronchiolitis obliterans that causes permanent damage to the bronchioles (the tiniest airways in the lungs).

Propylene glycol and glycerol, the major components of e-liquids, are not thought to be dangerous on their own. However, they may decompose when heated by the vaporizer and be transformed into toxic compounds such as formaldehyde. This is more common with newer vaporizers that use high wattages.

Is there substantial evidence about e-cigarettes being safe or unsafe?

Scientists are still working to understand more fully the health effects and harmful doses of e-cigarette contents when they are heated and turned into an aerosol, both, for active users who inhale from a device and for those who are exposed to the aerosol second hand. It is advised to refrain from the use of e-cigarettes until concrete evidence erupts out of further research.

Can a dental or medical practitioner prescribe e-cigarettes as a tobacco cessation aid?

The answer is a strict “NO” for several reasons. The main reason being, the Ministry of Health and Family Welfare in its recent advisory dated 28 August 2018 has banned the sale, manufacture, distribution, trade, import and advertisement of e-cigarettes and other similar vaping products containing nicotine except for the purpose as approved under the Drugs and Cosmetics Act 1940 and its rules.

Thank you for the Interview.