The health implications of electronic cigarettes, often referred to as e-cigarettes or vapes, have been the focus of extensive research and concern due to their potential health effects.
While e-cigarettes are generally considered less harmful than traditional combustible tobacco products, it’s crucial to recognize that they are not without their own set of risks.
The entry of electronic cigarettes into the market happened without the rigorous preclinical toxicology testing or long-term safety trials that are typically required for conventional therapeutic or medical devices. Consequently, they cannot be categorically regarded as a cessation aid. Let’s delve into the various health effects and concerns associated with e-cigarettes.
Firstly, respiratory and cardiovascular health is a significant area of concern. E-cigarette aerosols can contain harmful substances, such as nicotine, ultrafine particles, and a cocktail of various chemicals. Inhaling these substances poses potential threats to respiratory and cardiovascular health. Some studies have even suggested an elevated risk of respiratory and cardiovascular problems associated with e-cigarette use, although the long-term effects are still under investigation.
Nicotine addiction is another pressing concern. Many e-cigarettes contain nicotine, a highly addictive substance that can lead to a range of health issues. These issues include an increased heart rate, elevated blood pressure, and unpleasant withdrawal symptoms when attempting to quit.
The rise in e-cigarette use among young people raises the specter of nicotine addiction and potential long-term health consequences in this demographic. Additionally, the outbreak of a vaping-related lung condition in 2019, known as “e-cigarette, or vaping, product use-associated lung injury” (EVALI), caused considerable alarm.
EVALI was linked to severe lung damage and was primarily associated with the use of e-cigarettes, particularly those containing THC and vitamin E acetate. However, it’s noteworthy that during the onset of the COVID-19 pandemic, information related to EVALI was removed from the US CDC site due to the overwhelming focus on the public health crisis.
Furthermore, the flavorings and chemicals present in e-cigarette liquids are an area of ongoing research. Some of these additives may pose risks when inhaled, but the specific dangers associated with different compounds remain to be fully understood.
There’s also concern regarding secondhand exposure; e-cigarette aerosols can expose non-users to harmful substances, albeit typically at lower levels than traditional cigarette smoke.
A significant concern is the potential for e-cigarette use to act as a gateway to traditional cigarette smoking, especially among young individuals who might develop nicotine addiction through e-cigarettes and later transition to combustible tobacco products.
Research has indicated that there are more individuals who (re)start smoking after using e-cigarettes than those who successfully quit smoking.
One central issue in assessing the long-term health effects of e-cigarettes is the lack of extensive data. E-cigarettes are relatively recent innovations, and scientific investigations into their long-term health impacts are ongoing.
However, it’s important to distinguish e-cigarettes from smoking cessation aids. They are designed as a smoking alternative rather than a cessation tool. Notably, the European Union has imposed stringent restrictions on e-cigarettes for new users, including a total ban on sales of nicotine pouches.
The absence of a licensing system for tobacco or nicotine shops underscores the EU’s stance on these products. In contrast, nicotine replacement therapy (NRT), such as nicotine patches, is available in pharmacies and is regarded as a more viable smoking cessation aid.
The goal of fostering a smoke-free generation has led to various measures, including the banning of tobacco product displays, limiting the sale of tobacco products in specific locations, expanding smoking bans in vehicles, imposing additional taxes on tobacco, and stricter monitoring and policies related to e-cigarettes. The prohibition of nicotine pouches is also part of this comprehensive strategy.
The latest data on the use of these products reveals important trends. A study by the US Food and Drug Administration and the US Centers for Disease Control and Prevention in 2022 found that a significant number of middle and high school students in the United States reported using e-cigarettes.
This included 14.1% of high school students and 3.3% of middle school students. The majority of these young users favored flavored e-cigarettes, and many used disposable e-cigarettes.
Similarly, the United Kingdom has witnessed a substantial increase in e-cigarette usage, with an estimated 4.3 million users, compared to around 800,000 a decade ago. This phenomenon is sometimes referred to as the “vaping revolution.” Nevertheless, health experts and medical professionals have voiced concerns regarding the potential negative effects of e-cigarettes.
Data from the latest ASH (Action on Smoking and Health) annual survey in 2023 indicates a noteworthy shift in public perception. In Great Britain, four out of ten smokers now believe that vaping is as risky as or even riskier than smoking, an increase from one-third in the previous year.
Furthermore, approximately 27% of smokers have never tried vaping, despite its recognized effectiveness as a quitting aid, and 2.9 million smokers have experimented with vaping but subsequently discontinued its use.
It’s important to mention that the tobacco industry has attempted to circumvent tobacco control measures by introducing heated tobacco products (HTPs), such as Veo containing Rooibos Tea by British American Tobacco (BAT) and LEVIA, which contains zero tobacco, by Philip Morris (PM).
Austria has responded to these innovations by banning flavored HTPs and imposing strict restrictions on e-cigarettes throughout the European Union. The rationale behind these measures is that these products do not fit neatly into either the pharmaceutical or tobacco product categories.
In summary, the health implications of e-cigarettes are a subject of ongoing research and concern. While they are generally regarded as less harmful than traditional tobacco products, they are not devoid of risks. Public health measures are being implemented to regulate these products and promote a smoke-free generation.
The use of e-cigarettes among young people remains a point of concern, and efforts are ongoing to better understand their long-term health effects.
There is a notable scarcity of available evidence regarding the health effects of E-cigarettes (E-cigs) and Pakistan is no exception to that. While an SRO (Statutory Regulatory Order) was issued in December 2022, to include warnings on Heated Tobacco Products (HTPs), the effective implementation of these regulations in the market remains inconspicuous. Another critical gap exists in the taxation protocols for HTPs.
However, the prevalence of these products underscores the need to ban these products and much stricter implementation of tobacco control laws.
Copyright Business Recorder, 2024
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