Joseph R. Anticaglia M. D.
Medical Advisory Board
E-cigarettes and the United States
The Center for Disease Control (CDC) on August 30, 2019 issued a health advisory warning the public and clinicians about severe pulmonary disease associated with using e-cigarette and vaping products.
According to the CDC, e-cigarettes (vaping) products “can contain harmful or potentially harmful substances, including nicotine, heavy metals (e. g., lead), volatile organic compounds, and cancer-causing chemicals.
Additionally, some e-cigarette products are used to deliver illicit substances that may be acquired from unknown or unauthorized sources. They are known by many different names and come in many shapes, sizes and device types.”
General Background
An earlier post described, e-cigarettes as “hand-held, battery powered devices designed to produce and deliver a vapor that contains nicotine, flavorings and other chemicals that are inhaled by the user. The individual does not inhale smoke since e-cigarettes do not burn or use tobacco leaves. They consist of three different components:
- A power source which is usually a rechargeable battery
- A replaceable cartridge which contains a liquid filled with nicotine, flavorings, propylene glycol and other chemicals
- It includes a heating element (vaporizer, atomizer) that heats and transforms the liquid in the cartridge into a vapor which the user inhales.”
Alarm Bells
Alarm bells are clamoring by health officials from California to Maine. The CDC notes, as of September 26, 2019, “There have been 805 cases of lung injury reported from 46 states and 1 U. S. territory. Twelve deaths have been confirmed in 10 states.” The number of cases of this mysterious lung disease surged compared to the previous week.
“Nearly three fourths (72%) of cases are male and two thirds (67%) of cases are 18 to 34 years old All reported cases have a history of e-cigarette product use or vaping and most patients have reported a history of using e-cigarette products containing THC.”
Patients have experienced “respiratory symptoms (cough, shortness of breath, or chest pain), and some have also experienced gastrointestinal symptoms (nausea, vomiting, or diarrhea) or non-specific constitutional symptoms (fatigue, fever, or weight loss) while others have experienced tachycardia and elevated white blood cell count.” The incidence of the number of cases of sickness and deaths associated with e-cigarettes will most likely increase in the U. S. in the coming weeks and months.
E-cigarettes and the United Kingdom
In the UK, no alarm bells are ringing concerning an epidemic of sickness or deaths with the use of e-cigarettes. E-cigarettes carry a fraction of the risk of conventional cigarettes and can be particularly effective in helping people quit smoking when combined with other quitting support programs according to England’s National Health Service.
The use of e-cigarettes among teenagers and young adults has not skyrocketed. And health officials cite statistics that indicate 20,000 Brits a year have overcome their addiction to conventional, combustible cigarettes with the aid of e-cigarettes.
Why does the UK have less health-related e-cigarette problems compared to the United States?
Several factors might explain the disparity between the two countries:
- The people in the UK seem to understand that e-cigarettes are used for a specific purpose — to replace conventional cigarettes to help them quit smoking
- Strict regulations on the marketing, advertising and promotion of e-cigarettes to the youth and young adults
- The level of nicotine, in general, is lower in such products compared to the U. S.
- Better quality control of the vaping products
- Vaping policies support smokers to quit and stay smoke free
It has been reported that e-cigarettes are 95% less harmful than combustible tobacco cigarettes. Although they have helped thousands of people to quit smoking, there’s still concern about the safety of e-cigarettes. E-cigarette fluids contain potentially toxic compounds. The CDC recommends that “Youth, young adults, pregnant women, as well as adults who do not currently use tobacco products should not use e-cigarettes.”
There are pros and cons of smoking e-cigarettes, but authorities should at a minimum insure the safety of such products — market e-cigarettes as a replacement for tobacco cigarettes and not allow advertising targeting youth and young adults.
References
- CDC Advisory — Severe Pulmonary Disease Associated with Using E-Cigarette Products; August, 30, 2019
- CDC; Smoking and tobacco Use; Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping; September 19, 2019
- National Health Service (England); E-cigarettes; Smoke Free
- David C. Christiani, M. D.; M. P. H; Vaping-Induced Lung Injury; New England Journal of Medicine; .September 6, 2019
- GOV. UK; PHE publishes independent expert e-cigarettes evidence review; Feb 6, 2018
- Joseph R. Anticaglia, M. D.; Is Vaping Safer Than Smoking? What You Need to Know About Electronic Cigarettes; Doctor’s Column, HC Smart, 2017
- Joseph R. Anticaglia, M. D.; Electronic Cigarettes, Pros and Cons; Doctor’s Column, HC Smart, 2017
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.