So far, e-cigarettes have been found to be safer than regular tobacco-filled cigarettes. Smoke, the biggest danger from tobacco use, isn’t produced by e-cigarettes. Levels of dangerous chemicals found in e-cigarette vapor are a fraction than that found in traditional tobacco products.
"E-cigarettes may be less harmful than cigarettes," says M. Brad Drummond, MD. "But we still don't know enough about their long-term risks or the effects of secondhand exposure." Drummond is an assistant professor of medicine at Johns Hopkins University School of Medicine.
The Chinese created the first electronic cigarette, and it was introduced to local markets in 2004. They were then exported to major markets, with e-cigs hitting the U.S. market in 2007. Manufacturers say that e-cigs are alternatives to smoking tobacco products such as cigarettes, cigars and pipes. E-cigs are on track to outsell tobacco products by the end of the decade.
What is an electronic cigarette and how does it work?
E-cigs have detachable mouthpieces or cartridges that contain absorbent material to hold the liquid nicotine and flavorings. There is an atomizer inside the long tube, which attaches to the mouthpiece. That atomizer is a heating unit that turns the nicotine and various flavorings to water vapor, which the user then inhales and exhales. A lithium ion battery usually runs the whole deal, and you can find e-cigarettes in rechargeable set-ups. The newer versions of e-cigs contain a sensor that heats the elements as soon as you draw on the cigarette. Older versions have a button you press that will heat the element to vaporize the nicotine.
Nicotine and its Effects
Did you know that within 10 seconds of taking that drag off a cigarette, your brain has gotten a hit of nicotine? What happens next is the creation of a pleasure loop. Nicotine mimics a neurotransmitter that binds to “nicotine” receptors in the brain. In turn, these receptors stimulate certain neurons, and this increases the amount of dopamine circulating in the brain. New research has shown that nicotine decreases an enzyme responsible for breaking down dopamine. This means there is even more dopamine circulating through the brain and body. Dopamine activates reward pathways. This drives the craving for the next drag on the cigarette.
Nicotine also releases endorphins, the body’s natural painkiller. Endorphins can lead to feelings of euphoria, at times reward enough to keep smoking. Nicotine has been found to be as addictive as cocaine and heroin. More than 85 percent of those who quit will find themselves lighting up again within a week. Each year, 35 million smokers seriously try to quit, but less than 7 percent will achieve abstinence for a year. Serious stuff.
Why the opposition?
Opponents to e-cigarettes say that nicotine is a gateway drug to further tobacco use because of its addictive qualities. It is dangerous for people with heart problems and can cause strokes and hardening of the arteries. There is also the concern that advertising these as safe alternatives to regular cigarettes, the rates of smoking in the U.S. will begin to rise, undoing decades of anti-smoking campaigns.
Supporters’ Viewpoints
Others look at possible benefits for smokers. "Obviously, it would be best if smokers could quit completely," says Michael Siegel, MD, MPH, a professor at Boston University's School of Public Health. "But if that's not possible, I think they'd be a lot better off with e-cigarettes. They're a safer alternative."
Supporters say that vaping, smoking an e-cigarette, can be useful as a smoking cessation tool, similar to patches or gum. Tobacco smoke contains as many as 7,000 different chemicals, many toxic to humans. Eliminate the smoke, and you eliminate many of the problems of tobacco use.
Because nicotine levels can vary in the cartridges, those willing to quit must step down the level of nicotine to near zero. At this point, the user can use flavorings that taste like tobacco but are mostly tobacco free. One recent study out of the U.K. found that about 60 percent of those who used e-cigs as a smoking cessation tool succeeded, though the time these people stayed abstinent was not given.
“In my opinion, if taking nicotine for a short time can lead to complete cessation of smoking, e-cigarette included, then it will be beneficial to take nicotine for a short time as a bridge to smoking cessation,” says Chi-Ming Hai, a physiologist at Brown University, “However, our data suggest that long-term consumption of nicotine by e-cigarette smoking is likely to increase the risk of developing atherosclerosis by stimulating invasion of vascular smooth muscles cells.”
In this case, those smooth vascular muscle cells that surround your veins and arteries corkscrew, under the influence of nicotine, into the veins and arteries. This, in turn, creates plaques in those arteries, blocking blood flow and hardening the outer tissue. Researchers also are finding that e-cigarette users have lower lung function, airway resistance and cellular changes in the lungs similar to those exposed to nicotine smoke.
One Last Thing…
The last point to keep in mind is that the e-cigarette industry is not regulated. So there are government concerns over the safety of e-cigs as the U.S. Food and Drug Agency haven’t been able to evaluate vaping practices. Spot checks by the agency has discovered mislabeling problems as well as nicotine delivery problems with the e-cigarettes themselves. There are great differences as to how much nicotine and other flavors are released with the water vapor, so some users are getting much more nicotine than probably intended.
Though the jury is still out as to the usefulness of e-cigarettes to quit smoking, research has cautiously confirmed that e-cigs may be less dangerous than smoking traditional tobacco products. But don’t start vaping if you don’t smoke. Nicotine can be just as damaging to the body as smoking cigarettes though, as always, more research is needed.