Since their introduction in 2010, electronic cigarettes have been growing in popularity but the Health department warns that they are not risk free. Incredibly, the number of users has tripled since 2010 equating to more than 700,000 users within the UK. The use of these devices commonly known as ‘vaping,’ has been heralded as a possible alternative to conventional cigarettes. There is great debate concerning their capabilities to reduce instances of cancer in which one in four cases is currently caused by smoking, totalling around 100,000 deaths per year.
Electronic cigarettes, primarily marketed as ‘E-cigs’, contain an atomiser that is either engaged by inhalation or by being switched on by hand. Once initiated, a heating coil within the atomiser begins to heat up a detachable cartridge containing water, propylene glycol or glycerine and liquid nicotine that is often flavoured and available in various strengths. This notion produces a mist that can be inhaled largely consisting of water vapour. They have been designed to mimic regular cigarettes by featuring an LED light that illuminates upon inhalation.
There could be a chance that in the near future the NHS will support the use of electronic cigarettes as quitting aids forNicotine Replacement Therapy, if they prove more useful than existing methods such as, nicotine gum and patches. Studies have shown that the use of E-cigs is 60% more effective in helping smokers to quit than other Nicotine Replacement Therapies. But contrasting evidence suggests that people may carry on using these devices after quitting and there is little knowledge of what effect this could have on health in the long-term. Clare Knight from Cancer Research UK, who is now funding further research expressed, “we know little about the safety of the propylene glycol in many E-cigarettes. And nicotine itself can be toxic in very high doses. So there are questions about the safety of leakage from cartridges and refill bottles.”
The theory is that fewer toxins are inhaled using these devices and therefore less carcinogens with cancer causing properties. Conventional cigarettes have been found to contain up to 4000 toxins that can include arsenic and even substances with radioactive qualities. Nonetheless, of various electronic products tested, some were found to contain toxins such as nitrosamines, acetahyde, acrolein and formaldehyde -a well known carcinogen.Furthermore, there is no limit on how long an electronic cigarette can be smoked for. The battery can be recharged as frequently as desired and the smoking duration is to suit. E-cigs are purposefully marketed at cheaper prices in order to target present smokers. But could this fact encourage individuals to smoke for longer periodsor more frequently, thanwith traditional cigarettesthat have limited burn duration? In this respect, users could still inhale toxins greater or proportional to standard cigarettes.
A study was conducted toinvestigate the short-term effects of the use of electronic cigarettes on the function of the respiratory system. It consisted of 32 participants encompassing smokers, non-smokers and those with respiratory diseases such as asthma. They were instructed to use a single electronic cigarette for the duration of 10 minutes. It was found that there was an increase in airway resistance directly following the use of the device, preventing air flow in and out of the lungs. The increase in airway resistance was found to be significant in both smokers and non-smokers, however for those with respiratory diseases there was no immediate effect observed. More in-depth research is required in this area to fully understand the risks.
The World Health Organisation (WHO,) advise against the use of these contraptions until further research has been conducted. Products are currently unregulated and there appears to be an infinite number of varieties available on the market. The rate at which new products are introduced means that it is impossible to verify what is in them. Although, from a small proportion of those tested, it is clear that there is lack of consistency in their ingredients. For these reasons, electronic cigarette companies are not currently able to market their products as quitting aids. On the contrary, they are not subject to the same advertising bans enforced on tobacco companies.
“Given reports of malfunctions, we’d like to see these products regulated to help ensure that the mechanical components in the device are safe and reliable and deliver consistent doses of controlled chemical contents,” Said Clare Knight from Cancer UK.
There have been reports of safety issues with the use of E-cigs. In one severe incident, the usage has led to the death of a Merseyside man. A spokesman from the local fire service explained, "The subsequent fire investigation identified that an e-cigarette that had been charging in the bedroom exploded, caught fire and ignited the oxygen tube of an oxygen concentrator, which may have been in use by the occupier." Although this was an extreme case, other fires have been reported due to the devices. 9 fires have been found to have ignited in Merseyside alone since January 2014 in relation to electronic cigarettes.
A common pattern seems to have emerged from these incidences. Kim Taylor, from the Aylestone area who left an E-cig charging in her car and came back minutes later to discover the rear seat alight, believes the fire started because she used a different make of adaptor. There was a lack of instructions included upon purchasing the device and hence no warning that using a different charger can pose as a danger.
Myles Platt an area manager from within the fire services urges people to, “always use electrical equipment in accordance with the manufacturer's instructions and guidance, always ensure that no electrical items are left charging overnight or left unattended for a long period when being charged, and do not mix parts from different e-cigarettes.” The official charger may feature a cut off point for when the battery is fully charged and power will no longer be supplied but using alternative chargers may cause the battery to overheat, due to continuous power supply.
The unknown dangers of these devices are worrying and there are currently concerns that children may use them as a gateway product to traditional tobacco usage. Though, there is little evidence available to support this.
What is being done?
From 2016, electronic cigarettes will be licenced as medicine in the UK. On 13th November 2014, an E-Cigarette summit will be held within London. The event will be attended by a variety of actors such as health professionals, regulators and policy providers, stakeholders, local authorities and also members of the scientific community. It is an opportunity for debate about recent scientific findings regarding health impacts and their applications to regulate the industry.
The key topics to be included at the conference are;
Other products available to help you quit smoking;
Nicotine replacement therapies can be purchased over the counter or can be prescribed by a local GP. They mainly consist of skin patches, chewing gum, inhalators that mimic cigarettes and administer nicotine, tablets, strips, lozenges, nasal sprays and mouth sprays. It is important to consider that no single treatment will be suitable for every smoker. The effectiveness depends completely on individual preferences. As quitting smoking requires behavioural changes and a great deal of willpower, it may be a case of trial and error and could even involve a combination of treatments.
There are currently 2 stop smoking medications available via prescription from a local GP known as Zybin and Champix. Although these medications have been found to reduce addictive tendencies and also mood swings that may result from quitting, in some cases they can produce side effects.
The NHS quit service has been found to triple the likelihood of successfully stubbing out altogether rather than quitting alone or using other Nicotine Replacement Therapies. You can order a free quit kit online at http://www.nhs.uk/smokefree.Or you can download an app that offers advice, keeps track of how many days you have been smoke free and how much money you have saved as a result.
To sum up, there is a distinct lack of long term research into the risks posed by electronic cigarettes. It is no wonder there is conflicting views regarding health implications and their effectiveness in helping smokers stop. E-cigs are thought to contain fewer toxins than standard cigarettes. However, their lack of regulation means that it’s a mystery as to what is contained within different varieties. Additionally the quality of the electrical components is not being moderated and in some cases this has posed as a fire hazard.
It is unclear whether this is just the tobacco industry’s response to the decline in social acceptability of smoking in public and hence reduction in tobacco sales. Similarly, there are no laws prohibiting the use of electronic cigarettes in public places such as pubs which has led to the rise in popularity. Quitting smoking is not easy; there are many other regulated treatments available. But if you do opt to use an electronic cigarette, ensure you purchase from a reputable supplier and only ever use the original adaptor supplied with the device.
Electronic cigarettes, primarily marketed as ‘E-cigs’, contain an atomiser that is either engaged by inhalation or by being switched on by hand. Once initiated, a heating coil within the atomiser begins to heat up a detachable cartridge containing water, propylene glycol or glycerine and liquid nicotine that is often flavoured and available in various strengths. This notion produces a mist that can be inhaled largely consisting of water vapour. They have been designed to mimic regular cigarettes by featuring an LED light that illuminates upon inhalation.
There could be a chance that in the near future the NHS will support the use of electronic cigarettes as quitting aids forNicotine Replacement Therapy, if they prove more useful than existing methods such as, nicotine gum and patches. Studies have shown that the use of E-cigs is 60% more effective in helping smokers to quit than other Nicotine Replacement Therapies. But contrasting evidence suggests that people may carry on using these devices after quitting and there is little knowledge of what effect this could have on health in the long-term. Clare Knight from Cancer Research UK, who is now funding further research expressed, “we know little about the safety of the propylene glycol in many E-cigarettes. And nicotine itself can be toxic in very high doses. So there are questions about the safety of leakage from cartridges and refill bottles.”
The theory is that fewer toxins are inhaled using these devices and therefore less carcinogens with cancer causing properties. Conventional cigarettes have been found to contain up to 4000 toxins that can include arsenic and even substances with radioactive qualities. Nonetheless, of various electronic products tested, some were found to contain toxins such as nitrosamines, acetahyde, acrolein and formaldehyde -a well known carcinogen.Furthermore, there is no limit on how long an electronic cigarette can be smoked for. The battery can be recharged as frequently as desired and the smoking duration is to suit. E-cigs are purposefully marketed at cheaper prices in order to target present smokers. But could this fact encourage individuals to smoke for longer periodsor more frequently, thanwith traditional cigarettesthat have limited burn duration? In this respect, users could still inhale toxins greater or proportional to standard cigarettes.
A study was conducted toinvestigate the short-term effects of the use of electronic cigarettes on the function of the respiratory system. It consisted of 32 participants encompassing smokers, non-smokers and those with respiratory diseases such as asthma. They were instructed to use a single electronic cigarette for the duration of 10 minutes. It was found that there was an increase in airway resistance directly following the use of the device, preventing air flow in and out of the lungs. The increase in airway resistance was found to be significant in both smokers and non-smokers, however for those with respiratory diseases there was no immediate effect observed. More in-depth research is required in this area to fully understand the risks.
The World Health Organisation (WHO,) advise against the use of these contraptions until further research has been conducted. Products are currently unregulated and there appears to be an infinite number of varieties available on the market. The rate at which new products are introduced means that it is impossible to verify what is in them. Although, from a small proportion of those tested, it is clear that there is lack of consistency in their ingredients. For these reasons, electronic cigarette companies are not currently able to market their products as quitting aids. On the contrary, they are not subject to the same advertising bans enforced on tobacco companies.
“Given reports of malfunctions, we’d like to see these products regulated to help ensure that the mechanical components in the device are safe and reliable and deliver consistent doses of controlled chemical contents,” Said Clare Knight from Cancer UK.
There have been reports of safety issues with the use of E-cigs. In one severe incident, the usage has led to the death of a Merseyside man. A spokesman from the local fire service explained, "The subsequent fire investigation identified that an e-cigarette that had been charging in the bedroom exploded, caught fire and ignited the oxygen tube of an oxygen concentrator, which may have been in use by the occupier." Although this was an extreme case, other fires have been reported due to the devices. 9 fires have been found to have ignited in Merseyside alone since January 2014 in relation to electronic cigarettes.
A common pattern seems to have emerged from these incidences. Kim Taylor, from the Aylestone area who left an E-cig charging in her car and came back minutes later to discover the rear seat alight, believes the fire started because she used a different make of adaptor. There was a lack of instructions included upon purchasing the device and hence no warning that using a different charger can pose as a danger.
Myles Platt an area manager from within the fire services urges people to, “always use electrical equipment in accordance with the manufacturer's instructions and guidance, always ensure that no electrical items are left charging overnight or left unattended for a long period when being charged, and do not mix parts from different e-cigarettes.” The official charger may feature a cut off point for when the battery is fully charged and power will no longer be supplied but using alternative chargers may cause the battery to overheat, due to continuous power supply.
The unknown dangers of these devices are worrying and there are currently concerns that children may use them as a gateway product to traditional tobacco usage. Though, there is little evidence available to support this.
What is being done?
From 2016, electronic cigarettes will be licenced as medicine in the UK. On 13th November 2014, an E-Cigarette summit will be held within London. The event will be attended by a variety of actors such as health professionals, regulators and policy providers, stakeholders, local authorities and also members of the scientific community. It is an opportunity for debate about recent scientific findings regarding health impacts and their applications to regulate the industry.
The key topics to be included at the conference are;
- How will implementation of the Tobacco Products Directive affect the current market and products available?
- Product diversity including flavours as an incentive for continued use. What should be considered?
- How safe are e-cigarettes -current clinical trials– what do we know and what do we still need to find out?
- Will e-cigarettes re-normalise smoking and act as a gateway into tobacco use or normalise “vaping” and lead people away from smoking.
- Use of electronic cigarettes in public places, what should be considered before making a decision either on a national or local authority basis or as private enterprise.
- Advertising and promotion, what are the issues and how will these be addressed both pre and post Tobacco Products Directive implementation.
- Conflicting interests that arise from the dual corporate ownership of tobacco products and harm reduction products – Is the problem ideological or a public health threat?
- How does use of e-cigarettes compare with existing nicotine replacement therapies – what should the medical community be saying to current smokers?
- Tobacco on the NHS payroll – electronic cigarettes on prescription that are developed and manufactured by the tobacco industry. Is this important or irrelevant?
Other products available to help you quit smoking;
Nicotine replacement therapies can be purchased over the counter or can be prescribed by a local GP. They mainly consist of skin patches, chewing gum, inhalators that mimic cigarettes and administer nicotine, tablets, strips, lozenges, nasal sprays and mouth sprays. It is important to consider that no single treatment will be suitable for every smoker. The effectiveness depends completely on individual preferences. As quitting smoking requires behavioural changes and a great deal of willpower, it may be a case of trial and error and could even involve a combination of treatments.
There are currently 2 stop smoking medications available via prescription from a local GP known as Zybin and Champix. Although these medications have been found to reduce addictive tendencies and also mood swings that may result from quitting, in some cases they can produce side effects.
The NHS quit service has been found to triple the likelihood of successfully stubbing out altogether rather than quitting alone or using other Nicotine Replacement Therapies. You can order a free quit kit online at http://www.nhs.uk/smokefree.Or you can download an app that offers advice, keeps track of how many days you have been smoke free and how much money you have saved as a result.
To sum up, there is a distinct lack of long term research into the risks posed by electronic cigarettes. It is no wonder there is conflicting views regarding health implications and their effectiveness in helping smokers stop. E-cigs are thought to contain fewer toxins than standard cigarettes. However, their lack of regulation means that it’s a mystery as to what is contained within different varieties. Additionally the quality of the electrical components is not being moderated and in some cases this has posed as a fire hazard.
It is unclear whether this is just the tobacco industry’s response to the decline in social acceptability of smoking in public and hence reduction in tobacco sales. Similarly, there are no laws prohibiting the use of electronic cigarettes in public places such as pubs which has led to the rise in popularity. Quitting smoking is not easy; there are many other regulated treatments available. But if you do opt to use an electronic cigarette, ensure you purchase from a reputable supplier and only ever use the original adaptor supplied with the device.
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