Over the last decade, the use of electronic cigarettes, often called e-cigarettes or vapes, has skyrocketed globally. These battery-powered devices work by heating a liquid solution, called e-liquid or vape juice, that usually contains nicotine, flavorings, and other chemicals to create an aerosol that users inhale. Proponents argue that e-cigarettes are less harmful than combustible cigarettes and can help smokers quit or cut down on smoking. However, the long-term health impacts of vaping are still uncertain.
E-cigarette use among youth has become a major public health concern in recent years. According to data from the US Centers for Disease Control and Prevention (CDC), e-cigarette use among high school students increased by 78% between 2017 and 2018 alone. This rapid rise can be attributed to attractive marketing of fruit and candy flavors that appeal to younger consumers. Public health experts warn that vaping could get a new generation addicted to nicotine and potentially hook them on smoking in the long run. Vaping also poses unique risks to brain development and health in adolescence and young adulthood.
Health Effects of Vaping
While long-term evidence is still emerging, several studies have found links between vaping and adverse health impacts:
- Lung Injury: Hundreds of cases of vaping-associated pulmonary illness emerged in 2019, largely attributed to vitamin E acetate added to THC vapes. Severe lung injuries requiring hospitalization and even deaths were reported. The CDC recommends avoiding use of e-cigarettes or vaping products containing THC.
- Nicotine Addiction: The liquid E-cigarettes solutions, many of which come in fruit and candy flavors, are often highly addictive. Nicotine can harm brain development up to age 25 and may prime the brain for addiction to other substances.
- Cardiovascular Risks: Studies link vaping to an increased risk of heart attacks, strokes and coronary artery disease due to damage from chemicals and nicotine intake. Scientists still do not know the long-term cardiovascular effects of inhaling vaped substances.
- Respiratory Issues: Vaping may cause or worsen respiratory ailments like asthma, COPD, bronchitis and pneumonia by altering the lungs and immune system response. Chemicals in some vaping solutions have been found to damage lung tissue over time.
- Cancer Risk: The International Agency for Research on Cancer has classified e-cigarette use as “possibly carcinogenic.” Some vaping vapor contains formaldehyde and acrolein, known carcinogens. Long-term effects of vaping on cancer risk are unclear but a concern.
Regulating the Vaping Industry
With awareness growing around the risks of these products, especially to younger consumers, regulators worldwide have taken action. In the United States, the FDA finalized a rule in 2022 banning flavored e-cigarette cartridges, other than menthol and tobacco flavors. While this prevents certain flavors shown to appeal more to youth, critics argue it does not go far enough in curbing the teen vaping epidemic.
Some other jurisdictions have imposed much stricter regulations. San Francisco became the first major American city to effectively ban all e-cigarette sales in 2018. The European Union introduced new rules in 2016 to regulate e-cigarettes as consumer products rather than tobacco. This included safety and quality standards, as well as health warnings on packaging.
India took the most drastic step globally by prohibiting the manufacture, use, import, export, transport, sale, and advertisement of e-cigarettes in 2019. With over 300 million tobacco users, the Indian government aimed to discourage vaping uptake as a safer alternative or route to conventional smoking. However, concerns remain that such a strict ban could drive use underground without public education.
Balancing Risks and Benefits
For current adult smokers aiming to quit combustible cigarettes, vaping may offer a less harmful option when accompanied by other cessation methods, according to some experts. Public Health England even recommends e-cigarettes as a safer stop-smoking aid. At the same time, non-smokers and youth should avoid vaping entirely due to the health and addiction risks. More research is still needed to fully understand the long-term effects of e-cigarette and vaping product use.
As regulators and lawmakers continue seeking the right balance, decreasing youth appeal and limiting potential health dangers must remain top priorities. Public education around the uncertain risks, addressing misleading marketing practices, and preventing non-smokers from ever starting vaping could help curb risks while still allowing e-cigarettes as a reduced risk option for committed quitters. An evidence-based approach is vital to navigating this complex public health issue.
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