An Entirely Unexpected Consequence of Electronic Cigarettes: Epileptic Seizures!

We have emphasized that the claim that electronic cigarettes are less harmful than conventional cigarettes is often used to fuel the growth of the e-cigarette market in many articles over recent years . An even greater danger is the spread of e-cigarette use among young people and the early exposure of young brains to nicotine.

We know that nicotine, particularly for the developing brains of our young people, isnot a harmless substance. Early exposure to nicotine and addiction among never-smokers (mostly adolescents and young adults) increase public health concerns.

However, it has now become clear that e-cigarettes are not risk-free even for adults. There is now a large body of scientific evidence that e-cigarettes also pose health risks. Some chemicals in e-cigarettes are released at higher levels than in traditional cigarettes. We have also seen data suggesting that they can cause other health problems.

Recent ongoing studies suggest that, in addition to the potential for e-cigarette-related harm to affect the lungs directly, these products can adversely affect other health factors. There are particular concerns about their direct effects on the airways. This includes the potential for their use to cause changes in the airways that could precede cancer. Animal toxicology studies are currently underway to further evaluate the signals identifying these risks.

But recently we encountered a much more unusual consequence of e-cigarettes: the United States Food and Drug Administration (FDA) published reports on 3 April 2019 indicating that some people using electronic cigarettes, particularly adolescents and young adults, experienced epileptic seizures after use. Seizures or convulsions are potential adverse effects of nicotine poisoning and have been reported in the scientific literature in connection with intentional or accidental ingestion of nicotine-containing e-liquids. In the United States, between 2010 and 2019, a total of 35 seizure cases were reported after e-cigarette use. However, the FDA also noted that not all cases may be reported.

The report also stated that it is not yet known whether there is a direct relationship between e-cigarette use and the risk of epileptic seizures. Although the available data do not establish that e-cigarettes cause these episodes, the FDA felt it necessary to share this information with the public.

Most reports received to date do not contain enough information to identify a specific e-cigarette brand or sub-brand. Seizures have been reported among both first-time and experienced users. In a few cases, users had a prior history of epilepsy. Several cases also indicated that seizures occurred in association with other substances, such as cannabis or amphetamines.

Seizures were reported after a few puffs or a day after use. Many factors can lead to seizures. For example, e-liquids have varying nicotine concentrations, and some e-cigarette design features may allow users to obtain high nicotine levels rapidly (up to 20 times the nicotine of a conventional cigarette). E-cigarette use behavior also varies, and users may inhale more nicotine intentionally or unintentionally than otherwise occurs. In addition, some reported events may not be directly related to e-cigarette use—seizures may have been triggered by an underlying medical condition, other substance use, or other factors.

At the same time, because these case reports are voluntary, we should recognize that e-cigarette users may experience more seizures than are reported.

In the final part of its report, the FDA emphasized that, while continuing its scientific investigation, it would also continue working to better understand other potential risks associated with e-cigarette use.

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