In these days of the coronavirus pandemic, there is unusual to talk about another health issue, such as smoking cigarettes, or the best way to stop it, for instance, smoking e-cigarettes. It is important to note that smoking tobacco and specifically chronic obstructive lung disease is the most likely risk factor to develop an extremely severe form of COVID-19 disease. In addition studies like the Global Burden of Disease Study have classified smoking tobacco as the second most risk for death in the world and is the second most dangerous after hypertension. 1
The electronic (e)-cigarette Vapour has significantly less harmful substances than tobacco smoke, is advertised as a healthy alternative to traditional cigarettes, and has been proven as a successful method for quitting smoking. 2 As as a result it has seen an explosion in the electronic cigarettes, especially for young people, with the result that e-cigarettes quickly became the most popular smoking product for tobacco in the USA. 3
The rapid growth in e-cigarette sales has raised concerns about adverse health consequences for teens in middle or high schools. 4 This issue is further confirmed by the recent announcement of vaping devices that contain high levels of nicotine like ‘JUUL’, without full knowledge of the health effects of long-term e-cigarette use.
Are e-cigarettes as harmful as smoking tobacco?
No, certainly not.
The majority of researchers agree that there is a major health risk stemming from the reports of the Center for Disease Control (CDC) as well as the Food and Drug Administration (FDA) and State Health Departments about severe pulmonary diseases and deaths among users of electronic cigarettes is likely to be due to the inclusion of vitamin E Acetate, primarily in the form of tetrahydrocannabinol found in e and vaping devices.
Do we think switching from tobacco cigarettes to electronic cigarettes is good for our boats?
Absolutely.
In reality, numerous studies are showing an improvement in the function of the endothelial cells as a result of switching from smoking cigarettes to electronic cigarettes. For instance, within one month after switching from smoking tobacco to vaping with e-cigarettes there was a noticeable improvement in the function of the endothelial cells and stiffness of the vascular system ( Figure 1). 5 Females had more benefit in the switch than males in all comparisons between groups. People who did the best at switching to electronic cigarettes showed the most significant increase.
Change in mean flow-mediated dilation switching from tobacco cigarettes to electronic cigarettes that have and without nicotine. (Upper Panel) Adjusted percent change in the mean dilation of the forearm with 95 95% confidence intervals for patients who smoke electronic cigarettes (EC) nicotine, EC-nicotine, and nicotine-free EC. The data was adapted from Reference. 5 with permission from the author. (c)2019 published by The American College of Cardiology Foundation. (Lower section) A schematic description of components and use of an electronic cigarette device.
What information do we haven’t gotten in the case of E-cigarettes?
There is a significant lack of understanding regarding the health effects for the general population of using electronic cigarettes. According to the study, the majority of studies available provide evidence that vaping e-cigarettes are less harmful than smoking tobacco, 6.7 but the number of studies that have been conducted over a long period and the quantity of mechanistic insight are limited. If we consider that e-cigarette vaping can cause an increase in the mean age among first-time (e)-cigarette users, then the healthier electronic cigarettes profile could easily be scuttled (or possibly reversed) due to the greater percentage of adolescents using. It is therefore possible that vaping with e-cigarettes can negatively affect the disability-adjusted population’s overall life span, resulting in more burdens of diseases.
What is the mechanism behind the cardiovascular, pulmonary, and cerebral adverse effects of E-cigarettes?
The rapid vaping of a single e-cigarette increases heart rate and triggers arteries to stiffen and malfunction of the lining of the endothelial arteries, even among healthier smoking. 8 It is crucial to know that the endothelium controls the proper dilation and constriction of blood vessels, shields tissues from harmful substances, and regulates blood clotting and inflammation processes. Endothelial dysfunction can be a factor in the progression of cardiovascular disease and, consequently, is a pre-eminent indicator of the risk of developing cardiovascular disease.
Research has shown that short-term vaping with e-cigarettes results in hypertension, inflammation of the brain, lungs, and blood vessels due to it triggering inflammation as well as an increase in oxidative stress. This is likely caused by the major toxicants found in emissions like acrolein formaldehyde and Acetaldehyde. The elimination of the phagocytic NADPH Oxidase (subtype NOX-2) significantly protects animals from cerebral and vascular negative effects from vaping like the endothelin-receptor blocking drug Macitentan. 8
A recent examination of published studies revealed little evidence that suggests that e-cigarette consumption may result in less adverse cardiovascular effects than traditional smoking cigarettes. 9 The studies within this report have demonstrated that e-cigarettes can cause adverse cardiovascular effects by utilizing a variety of ways, such as inflammation, oxidative stress arterial stiffness, DNA damage, and altered hemodynamics as well as platelet function, both separately or in combination together. These results suggest pathways through which e-cigarettes’ use over time may cause an increase in the risk of developing cardiovascular diseases. Therefore, more quality controlled studies that are randomized and of high quality are needed to determine conclusively the safety and effectiveness of e-cigarettes.
What are the suggestions from the regulators?
In the USA The FDA oversees all aspects of the sale and production of tobacco. In 2016 the FDA added e-cigarettes to the category of products from tobacco, which means they are also regulated in the same way as cigarettes made from tobacco. While the FDA permits sales of e-cigarettes, however, some groups within the USA have demanded the complete prohibition of e-cigarettes. The CDC advises that e-cigarettes of any kind should not be used by minors’ 10 and it is recommended that users avoid using vaping completely. 11
The World Health Organization (WHO) expressed doubts about the benefits of electronic cigarettes and raised fears about the risks they pose. 12 The American Heart Association (AHA) has launched an initiative to stop the sale of all electronic cigarettes. 13 The AHA is also claiming that there’s enough evidence linking e-cigarettes to teenagers’ addiction to nicotine, as well as with the attraction of smokers to nicotine.