Opening the electronic cigarette file!..

Electronic cigarettes first appeared on China’s market in 2004 and are among recent years’ most debated topics. This series seeks the truth about devices marketed with the slogan “helps you quit smoking”.

Despite their dramatic popularity, disagreements remain, particularly over long-term health effects.

Should we worry about the health effects of rapidly popularizing e-cigarettes?

Do e-cigarettes really help people quit smoking?

Some concerns arise from the lack of clear evidence that e-cigarettes help cessation.

Easy portability and availability everywhere, alongside incomplete knowledge of effects, have increased health professionals’ concerns.

A nicotine and tobacco study of American adults published last year found 37 percent opposed vaping in smoke-free spaces, while 40 percent were undecided.

This caution and uncertainty suggest doubts about safety.

Most e-cigarettes have a cartridge, battery and atomizer. The cartridge contains liquid heated and vaporized by the atomizer, then inhaled like ordinary cigarette smoke. Cartridges contain varying nicotine concentrations.

A report released last year by the United States Centers for Disease Control and Prevention found e-cigarette-related poison-center calls rose dramatically over 5 years: in 2010 there was only 1 monthly call, while in 2014 there were 215 monthly.

Could this increase indicate a poisoning risk?

Because more than half of affected people were children aged 5 or younger, some argued that e-cigarettes themselves did not pose a toxicity risk, emphasizing design and use rather than contents.

Researchers say childhood poisoning generally occurs through direct contact with expired cartridge liquid, ingestion, inhalation or skin and eye contact. Devices also lack adequate child protection; candy and fruit flavors create potential for continued poisonings.

The contents problem!

E-cigarette chemical contents remain uncertain and long-term effects cannot be predicted. Manufacturers claim safety, but studies question these assumptions.

The United States Food and Drug Administration (FDA) analyzed two popular brands, finding variable nicotine levels and toxic chemicals known to cause cancer. Formaldehyde and acetaldehyde are examples detected. The FDA consequently issued a warning about potential dangers.

Another study suggested that toxic levels of some heavy metals could potentially create greater problems than conventional smoking. Although e-cigarettes appear less harmful overall, metals toxic to humans, such as nickel and chromium, raise concern. Researchers believe these most abundant heavy metals originate from cartridges and call for better manufacturing standards.

A recent PLOS ONE study showed vaping weakened mouse lungs’ defense against microbes. Human and mouse biological nicotine responses differ, so human research is needed before recommending e-cigarettes as smoking alternatives.

The main ingredient is liquid nicotine. Nicotine occurs in the nightshade plant family and is a potent stimulant. It acts by affecting neurotransmitters, substances communicating between nerve cells. Temporary effects include increased energy, concentration and hand–eye coordination and reduced appetite. Over time, nicotine no longer produces expected neurotransmitter changes and tolerance develops, but addiction already exists. As pleasure diminishes, physiological and psychological dependence create distress with withdrawal symptoms. According to the American Heart Association, nicotine is historically among the hardest addictions to break; its biological and behavioral characteristics resemble heroin and cocaine addiction.

Supporters’ main arguments are that e-cigarettes help quit conventional smoking and nicotine alone has little or no harm. Studies suggest otherwise. An Oncotarget study published last year found nicotine-exposed cells developed changes resembling oxidative stress, a cancer-promoting condition. Although nicotine itself is not yet regarded as carcinogenic, prolonged exposure may trigger mutations associated with cancer development.

In conclusion, e-cigarettesrequire longer-term evidence before they can be called a safe alternative to conventional smoking. Long nicotine exposure may promote gene mutations and increase cancer risk. Although lacking most harmful substances in conventional cigarettes, e-cigarettes cannot be called harmless because of tar and other chemicals arising from burning liquid nicotine.