What can you tell me about e-cigarettes and their effects on health?

Dear E-Cig, 

E-cigarettes, or e-cigs, are part of a broader category of products known as electronic nicotine delivery systems (ENDS). While some users say e-cigs have helped wean them off traditional cigarettes and helped them nix their nicotine addiction, the evidence is mixed. The research is also inconclusive on the effectiveness of ENDS compared to nicotine replacement therapy (NRT) products such as gum and the patch. Even those studies that suggest ENDS are effective for cessation caution against their use due to the potential harmful side effects, including serious lung illness and death. While the FDA has started regulating the manufacturing of ENDS products, they haven’t approved the use of e-cigs as a cessation tool. Instead, NRT products, medication, counseling and social support, and individualized quit plans may be a better option for the best chance of quitting. 

What is nicotine? 

Nicotine is a chemical compound that’s found in tobacco plants. It’s an addictive compound and can be toxic to humans. Nicotine has been found to reduce lung function and can react with the environment to create compounds that can cause cancer. It can also lead to heart disease as it can increase heart rate and blood pressure and causes blood vessels to constrict.  

Many ENDS products, though not all, contain nicotine.  

What are e-cigs? 

E-cigs are small, battery-powered vaporizers. They come in varying levels of nicotine and often a variety of flavors. When you inhale, these devices trigger a sensor that heats up the nicotine-containing cartridge inside and creates vapor. Hence the term “vaping” which many use to describe their use.  

Some versions of e-cigs are designed in size, shape, and color to resemble traditional cigarettes. Others, however, appear vastly different donning bright enticing colors or varying shapes   

What are the side effects of e-cigs?   

In the last decade, e-cigs have gained attention as a potential harm reduction tool for nicotine addiction. Although they may reduce the harm caused by traditional cigarettes, e-cigs aren’t without damaging side effects, some of which are fatal. These devices deliver nicotine directly to the lungs, which can damage lung tissue. In fact, as of 2018, all new ENDS products that contain nicotine must have a warning label alerting consumers that nicotine is an addictive chemical. E-cigs also come with an increased exposure to heavy metals as compared to standard cigarettes causing cancer risk to also increase fivefold.  

What if you use e-cigs without nicotine? 

As you explore quitting options, it might be helpful to first think about your goals.  Are you hoping to reduce health effects from smoking? Or maybe you want to reduce your nicotine use? Regardless, recent studies have found that e-cig vapor with and without nicotine, can cause an increase in cell death, particularly to the cells inside the mouth, esophagus, and other parts of the body. Additionally, e-cigs use has been associated with increased inflammation and inhibited wound healing ability. This could be attributed to the flavorings and other additives, some of which have been found to be harmful to human health. Additionally, the devices themselves can cause injury, as malfunctioning batteries have caused fires and explosions.   

What are other options for quitting? 

Are e-cigs considered a smoking cessation aid? Some say they help. However, researchers agree that the short- and long-term effects need to be further studied. Instead, the FDA recommends using NRT products, such as the nicotine patch (slow release) and nicotine gum, lozenge, inhaler, or nasal spray (rapid release). These are designed to wean the body off cigarettes and supply it with nicotine in controlled amounts. These products can also help avoid the other harmful chemicals found in ENDS products.  

It’s also been noted that NRT may be even more effective when combined with behavioral counseling, quit-smoking medications, and individualized quit plans. For those struggling to quit, it may help to reach out to a health care provider to discuss the best options for you. 

Overall, avoiding both traditional and e-cigs is recommended, as each presents its own health risks. NRTs and medication are currently recognized as effective cessation aids and have been identified as a lower-risk option than an e-cigs. If you’re hoping to quit, here are many tobacco cessation programs to help you start this journey! No matter how it’s done though, quitting smoking has immense health benefits. If you’re considering whether to kick (cigarette) butt soon, Smokefree.gov has several resources on quitting that may be helpful on your journey. 

Here's to happy lungs,