E-cigarettes–sometimes called e-cigs, vaporizers, or hookah pens—are a relatively new form of addiction. They pose cancer, addiction, and intoxication risks.
I first learned about e-cigarettes when the 21-year-old son of a friend lit one up, inhaled deeply and exhaled what appeared to be a cloud of steam. My first impression, wrong as it turned out, was that this was perhaps a clean alternative to nicotine-laden smoke.
A visit to the Betty Ford Hazelden web site disabused me of this notion, and I have drawn significantly from their essay on the subject. The merger of Ford and Hazelden, has created a first rate operation for treatment and also free information.
I quit smoking in 1965 when the U.S. surgeon general’s report that year, provided proof that sucking nicotine laden cigarette smoke into my lungs would shorten my life.
Quitting smoking was a good decision then and it’s a good decision today especially when we consider the facts about “e-cigarettes,” as, among other things, potential cancer dispensers.
E-cigarettes are battery-powered devices that heat nicotine, marijuana, flavorings, and other chemicals in solution cartridges full of “e-liquid” or “e-juice,” so that users may inhale these chemicals in aerosol form.
Some e-cigs are made to look like traditional tobacco cigarettes, cigars, or pipes. Others resemble a modern take on the traditional cigarette or pipe, with fashionable clear or shiny metal bodies featuring sleek colors and textures.
Still other versions may be designed to look like everyday items, such as ballpoint pens or USB flash drives. Styles of electronic cigarettes very greatly among the hundreds of existing brands, and new styles enter the market regularly.
Invented in Beijing
Since the 2003 invention of e-cigarettes by a pharmacist in Beijing, China, research tells us that the worldwide use of, and concerns about, electronic cigarettes have grown. By 2007, the products’ marketing had spread to Europe, with the unsubstantiated claim that the devices were “tobacco-smoking cessation aids.”
Then in 2008, the World Health Organization announced that there was “no scientific evidence to confirm the product’s safety and efficacy.”
Marketers funded their own studies to make continuing claims about the differences between traditional and electronic cigarettes. But then, the following year, the United States’ Food and Drug Administration tested e-cigs marketed as “nicotine free,” and found low levels of addictive nicotine as well as carcinogenic diethylene glycol (antifreeze) among their ingredients.
By 2012, e-cigarette use among U.S. middle and high school students had doubled since the prior year, and by 2014, a greater number of students reported using e-cigarettes than traditional cigarettes in the past month. The number of students reporting ever having used “e-vapes” had risen to 2.5 million.
Electronic cigarettes remained new, relatively untested tobacco products until August 2016, when, like cigarettes, cigars, roll-your-own tobacco and pipe tobacco they became regulated by the United States Food & Drug Administration.
By 2015 survey results told us that approximately 10% of 8th graders and 15% of 9th through 12th graders used e-cigarettes at least monthly.
Research shows that students are generally unclear about the contents of their e-cigarettes. Among 12th-grade students who used e-cigarettes in 2015, 65% reported their e-cigs contained only flavoring, while 22% believed they contained nicotine, 6% thought they were vaping marijuana or hash oil, and a final 6% had no idea what they were vaping.
The confusion among students is understandable. E-cigs marketed as “nicotine free” often do contain nicotine. Even if not marketed as nicotine free, many brands do not specify how much nicotine or other chemicals their e-cigarettes contain. E-cigarette companies have not been obligated by any governing body to regulate or monitor the amount of each substance that goes into their products.
To highlight the inconsistency of nicotine concentration in e-cigarettes, researchers in the United Kingdom tested 16 different e-cigarettes. They found wide variations in nicotine levels per puff. Their findings suggested that nicotine concentration not only varies by brand, but also between inhalations of the same product.
More startling, nicotine levels per puff ranged from 0.5mg to 15.4mg in the study. The typical nicotine concentration in a puff of a tobacco cigarette is 1.54mg to 2.60mg. This means that e-cigarettes may deliver nearly six times the amount of nicotine a tobacco cigarette would.
Nicotine is widely known to be an extremely addictive chemical. Biological studies show that teens are much more susceptible to the development of nicotine addiction than are adults. Adolescents may develop nicotine dependency within just a day of use.
Alcohol in E-cigarettes
The FCD Student Attitudes and Behavior Survey, which is part of the Hazelden Betty Ford foundation, has found that in some communities, students are exposed to e-cigarettes sooner than they are to alcohol. Even more disturbing, new research suggests that students may be exposed to alcohol for the first time through their early use of e-cigarettes.
Many e-vaporizer liquid solutions contain alcohol to extract their flavors from base ingredients. Yale School of Medicine found that some commercially available electronic cigarette liquids contain enough alcohol concentrations to significantly impair users’ motor skills. When study participants were asked to perform a motor task, those under the influence of higher alcohol concentration e-cigarettes performed more poorly than those not under this influence.
Exposure to alcohol through e-cigarettes puts students at a long-term risk for addiction and a short-term risk for intoxication and impairment. Students who do not know that e-cigarettes can contain alcohol may unwittingly put themselves at risk not only for an addiction to nicotine, but also for an addiction to alcohol through vaping. Students using e-cigs may also drive under the influence of alcohol unknowingly or otherwise put themselves at risk for accidents and physical harm as a result of motor impairment.
Out of the dozens of e-liquids tested in the Yale study, one-third did not contain measurable alcohol, while 40% of e-liquids registered at 0.75% or less alcohol content, and another 23% contained 1-3% alcohol levels. Some e-liquid brands have been measured to contain over 23% alcohol content. As prior research has demonstrated, the concentration of such chemicals in e-cigarettes has not historically been regulated by manufacturers nor made known to consumers.
Studies to classify the contents of e-cigarettes have revealed a number of troubling substances known to be carcinogenic within the products, and respiratory damage, burns, and poisonings are also present.
There is also a risk of burn injuries. The Canadian Press reported on a 16-year old student who sustained significant facial and dental injury as a result of an e-cigarette explosion during use.
Emerging facts make it essential that we have a thorough understanding about this drug delivery system as we strive to keep our healthy kids healthy. In fact, the FCD Prevention Works Survey Database shows that among 6th-12th grade students who took the survey within the 2015-2016 academic year:
- 17% reported using e-cigarettes in the past year
- 10% reported use in the 30 days
- More students reported e-cigarette use than traditional cigarette use
- The top four most used substances by FCD students in the past year were:
- 33% alcohol
- 17% e-cigarettes
- 12% marijuana, and 11% traditional cigarettes