The use of electronic cigarettes is commonly called ‘vaping’ (‘vaping’, ‘vaporear’, ‘vaping’). Although these devices are thought to produce steam, they actually emit an aerosol composed of tiny particles, not water vapor.
Electronic cigarettes are used by smokers, smokers who want to quit smoking, and ex-smokers. Consumers have the false assurance that they are less harmful than tobacco, which is why they are often used as a transition to quit smoking. In fact, these devices were launched on the market as a novel and low-priced product, to facilitate their accessibility and promote low-risk consumption as an alternative to tobacco, as well as a possible tool for smokers who want to quit. The truth is that, despite being a widespread belief, until now there is no clear evidence of its effectiveness in helping to quit smoking.
The situation that is most worrying regarding the consumption of these cigarettes is consumption among adolescents., who prefer them over traditional cigarettes. Studies suggest that increased e-cigarette use among youth may represent a gateway to nicotine addiction and tobacco use.
According to figures obtained in the XXIV survey carried out by the Spanish Society of Family and Community Medicine (semFYC), 19.2 percent of adolescents between 14 and 18 years old smoke or consume some tobacco derivative, but vapers are the preferred ones. for one in five.
The World Health Organization (WHO) considers the fact that these products have been allowed on the open market as consumer products and are insistently marketed to young people to be worrying. They are even marketed to children through social media and influencers, sometimes using cartoons and stylish designs to appeal to younger generations.
Currently, vaping in Spain is prohibited in centers and offices of public administrations and public law entities, health centers (including outdoor or covered spaces within their premises), educational and training centers and means of public transport (taxis). , buses, subways, trains, boats and airplanes), as well as in playgrounds or children’s play areas, including outdoor spaces that have equipment specifically designed for children’s play.
COMPONENTS OF ELECTRONIC CIGARETTES
Electronic cigarettes include a battery, a cartridge or reservoir that contains the liquid, a heat source responsible for heating the liquid into an aerosol, and a mouthpiece or opening used to inhale the aerosol. They can be disposable, refillable using a charging container, or refillable with a single-use cartridge.
The liquid solution, known as e-liquid, can be composed of various substances, such as:
- Nicotine. It cannot exceed 20 mg/ml.
- Propylene glycol and vegetable glycerin. Both compounds are considered safe when consumed orally. On the other hand, its use in combustion has negative health effects.
- Flavorings (diacetyl).
- Flavorings.
The aerosol that is formed may contain formaldehyde, acetaldehyde, acetone, acrolein and metals such as copper, zinc and tin and lead, and PM2.5 particles.
MAIN HEALTH PROBLEMS RELATED TO VAPEING
The use or consumption of electronic cigarettes, as well as conventional tobacco or other tobacco products, are harmful to health. Although the electronic cigarette can be considered less toxic than smoking cigarettes, the risks associated with its use are the following:
- Eye and nose irritation.
- Headaches and nausea.
- Irritation of the respiratory tract and decreased lung immunity.
- Respiratory diseases and aggravation in diseases such as asthma, cystic fibrosis and chronic obstructive pulmonary disease (COPD).
- Increased heart rate and blood pressure, arrhythmias, vascular problems and heart diseases such as angina pectoris or heart attack. According to the report “Electronic cigarettes: a new threat to cardiovascular health”, prepared by the World Heart Federation (WHF), regular users of electronic cigarettes are 1.79 times more likely to suffer an acute myocardial infarction than non-smokers.
- Liver and kidney damage.
- Damage to the immune system.
- Brain and nervous system damage.
- Hormonal alterations.
- Alterations in pregnancy (premature and low birth weight babies).
- Cancer. According to a recently published study, similar DNA changes are found in cells from smokers and e-cigarette users. That is, e-cigarettes cause some epigenetic changes in cells in the mouth similar to those in smokers, and these changes may be associated with the future development of lung cancer and cervical cancer.
Current scientific evidence indicates that the consumption of electronic cigarettes is not harmless. Most of the scientific knowledge about the use of these devices and their impact on health is limited to short-term effects, given that their use is relatively recent. This underlines the need to investigate its effects over a longer period to better understand its long-term consequences.
PASSIVE SMOKERS OF ELECTRONIC CIGARETTES
The WHO warns that there is no safe level of passive exposure nor a safe consumption threshold, so any exposure will have negative health consequences.
Electronic cigarettes emit certain volatile substances that can be passively inhaled by people in closed spaces. Although these particles appear to be found in lower concentrations than in conventional tobacco products, they can penetrate deep into the lungs, posing a potential health risk. Therefore, scientific evidence supports the idea that electronic cigarettes can affect indoor air quality and that people who do not use electronic cigarettes also breathe these aerosols and their components.
Currently, the results of various studies on ‘passive vaping’ confirm this potential risk, being increasingly There is increasing evidence on the effects that exposure to passive nicotine vaping can have on people. (second hand aerosol). It is known that it increases the risk of suffering from certain health conditions such as bronchitis, respiratory distress, asthma exacerbations or chronic obstructive pulmonary disease (COPD). According to research published in the journal Thoraxexposure at home to nicotine vapor from electronic cigarettes increases the probability of suffering from bronchitis by 40% and the probability of having difficulty breathing by 53%.
Other recent studies also suggest that, due to the carcinogenic substances that are released in the combustion of this type of liquid, there is a risk of carcinogenesis in people who are exposed to its aerosol.
It is true that studies indicate that the health risk seems lower than that of people subjected to environmental smoke from traditional tobacco products and that more studies are needed on the effects of passive vaping. However, we cannot lose sight of the clear position of the WHO regarding these devices: “electronic cigarettes are devices that maintain or can generate an addictive disorder.” Furthermore, the organization states that “it has not been scientifically proven that electronic cigarettes can be an aid in the smoking cessation process.”
NEW TOBACCO PREVENTION AND CONTROL PLAN 2024-2027
On April 30, the Council of Ministers approved the Comprehensive Plan for the Prevention and Control of Smoking 2024-2027. The new plan includes lines of action related to the consumption of electronic cigarettes, such as:
- Regulate the sale and consumption of tobacco-related products (with and without nicotine), advancing in the equalization of legislation for tobacco products.
- Prohibition of additives that confer aromas in tobacco and related products.
- Advance in the study of the effects on addiction caused by certain aromas (menthol and derivatives) added to tobacco products and electronic cigarettes and their attraction to young people.
- Legislative expansion of spaces without tobacco smoke and without electronic cigarette aerosols and related products in certain spaces for public or collective use, especially those with the presence of minors.
This plan aims to enable the necessary instruments to be able to have a tobacco-free generation, in Spain and in Europe, anticipating the planned developments. Thus, before 2025, the European Commission will propose updating the Council Recommendation on smoke-free environments, increasing them, especially outdoor spaces, and expanding the coverage of these spaces to environments free of other emerging products, such as cigarettes. Electronics and Heated Tobacco Products.
References
Report on electronic cigarettes: current situation, available evidence and regulation. (2022). Tobacco Prevention and Control Unit. General Subdirectorate of Health Promotion and Prevention. General Directorate of Public Health. Ministry of Health.
https://www.sanidad.gob.es/areas/promocionPrevencion/tabaco/profesionales/docs/InformeCigarrilloselectronicos.pdf
Bianco E, Skipalskyi A, Goma F, Odeh H, Hasegawa K, Zawawi MA, Stoklosa M, Dalmau R, Dorotheo EU, Berteletti F, Mwangi J, Wang Y. E-Cigarettes: A New Threat to Cardiovascular Health – A World Heart Federation Policy Brief. Global Heart. 2021; 16(1): 72.
https://doi.org/10.5334/gh.1076
Herzog, C., Jones, A., Evans, I., Raut, JR, Zikán, M., Cibula, D., Wong, A., Brenner, H., Richmond, RC, & Widschwendter, M. (2024 ). Cigarette smoking and e-cigarette use induce shared DNA methylation changes linked to carcinogenesis. Cancer Research.
https://doi.org/10.1158/0008-5472.can-23-2957
Islam T, Braymiller J, Eckel SP, et alSecondhand nicotine vaping at home and respiratory symptoms in young adults. Thorax2022;77:663-668.
https://thorax.bmj.com/content/thoraxjnl/77/7/663.full.pdf
Comprehensive Tobacco Prevention and Control Plan (PIT) 2024-2027. (2024). Ministry of Health. General Directorate of Public Health and Health Equity.
https://www.lamoncloa.gob.es/serviciosdeprensa/notasprensa/sanidad14/Documents/2024/300424-Plan_Prevenci%C3%B3n_Tabaquismo_Plan_v29_04_18_35_1.pdf