Smoking is the number one preventable cause of death worldwide. It is for this reason that smoking cessation tools - methods for quitting smoking - are used, and these can be products that replace the nicotine you would normally get from cigarette smoking (known as Nicotine Replacement Therapy or NRT), to nature based interventions that have shown promising effects on personal well-being.
A new tool that has become available in the fight against smoking is e-cigarettes. The word ‘e-cigarette’ is used as an umbrella term for all vaping devices, but also refers to what is known as a Cig-a-like is a small and easy to use electronic cigarette that is popular for adult smokers looking to quit smoking a "cig-a-like’ device; a specific style of vape device that is modelled to look like a cigarette. These devices all deliver nicotine in a fashion similar to regular cigarettes, satisfying the nicotine addiction with an action close to smoking, tapping into the habitual aspect of the addiction.
HOW DO E-CIGARETTES WORK?
E-Cigarette devices all function in the same way, just with a variety of materials, sizes and customisation options. The principle is that a battery is used to heat a coil, which in turn heats up the e-liquid in the device’s tank - this could be the refill on cig-a-like or vape pod systems. The liquid is heated into an aerosol, which is then inhaled by the user.
Some devices like vape pens have a built-in liquid tank, and the big devices known as a Vape Mod usually have a detachable one that can be changed. These big devices often have changeable batteries, require regular maintenance and changing of parts that deteriorate with use over time - like the coil and wicking material. The cig-a-like and vape pod systems just have a battery and a refill, as the wicking material and coil are contained within the refill.
MISCONCEPTIONS ABOUT E-CIGARETTES
Since e-cigarettes have become available, there hasn’t been international consensus on their validity due to a variety of factors. One such important factor is the regulation of the e-liquids.
In the UK, we have strict regulation on nicotine products - how they are packaged, limits on strengths, amounts, and what they can contain. The US regulation works quite differently, and has updated in recent years due to the cases of EVALI - e-cigarette and vaping associated lung injury - and the appeal of flavours to young adults apparently resulting in the youth being encouraged to vape.
Due to the highly addictive nature of nicotine, and the impact that nicotine has on brain development, we can understand the importance of discouraging the youth to start vaping, but the law in the US means that a young person would have to break the law to obtain vaping gear and liquids, where limited flavours may result in vapers that were happy now returning to cigarettes.
Their answer to the EVALI problem was to ban all flavoured e-liquids, leaving only tobacco flavours; and as of January 2020, began enforcing this ban, applying it to all flavours except tobacco and menthol.
These instances of EVALI were used by the media all over the world as proof that e-cigarette use is as harmful as smoking. What the media failed to do, was include any details on the differing levels of regulation when these lung injuries occurred. One recurring injury, known as ‘popcorn lung’, was caused by the chemical diacetyl - a chemical that caused lung injuries in the popcorn factories where it was used as flavouring, hence ‘popcorn lung’. This injury was cited as a risk of e-cigarettes, which is egregious here in the UK where diacetyl is banned from being included in e-liquids.
Other lung injuries and deaths from vaping in the US are related to other components being added to e-liquids. Some vapers in the US are mixing chemicals like THC (tetrahydrocannabinol), the psychoactive compound in cannabis, into their liquids - when they do this, other chemicals are needed to either thin or thicken the mixture to the appropriate viscosity, and often vitamin E acetate is used. According to the Centre for Disease Control and Prevention, vitamin E acetate has been found in samples of lung fluid in patients with EVALI across the US.
In the UK, we have seen injury from vape devices that have short circuited because it was carried in the same pocket as other metal objects, like loose change or keys. This resulted in the device heating up and exploding, causing third degree burns. Therefore, awareness regarding the transportation and storage of e-cigarettes is the issue here. The number of EVALI cases seen here in the UK is still incredibly low, and the examples seen have been from former smokers where damage has already occurred, and instances of vaping homemade THC oil.
WHAT IS E-JUICE AND WHAT DOES IT CONTAIN?
E-liquid, also known as e-juice or vape juice, is the medium used by e-cigarettes to deliver nicotine into the lungs. It is a mixture of vegetable glycerine (VG), propylene glycol (PG), nicotine and flavourings.
Vegetable Glycerine is normally made from soybean, coconut or palm oil, and is used by the food, pharmaceutical and cosmetics industries.
Propylene Glycol is a synthetic food additive that retains moisture and improves texture and flavour; great at carrying flavours.
Nicotine is the addictive substance found in tobacco.
Flavouring - Natural and synthetic food grade flavourings such as vanillin.
Remember that there is variation in the regulation of e-liquids between countries, so liquids made in some countries will be subject to a higher level of standards, as well as including chemicals that may be prohibited elsewhere. If in doubt - buy UK made!
WHAT IS IN E-CIGARETTE VAPOUR?
E-Cigarette vapour - or more accurately, e-cigarette aerosol - is the gaseous mixture created by heating e-liquid. The contents of the aerosol vary depending on the ingredients of the liquid, but also the power of the battery and the nature of the ‘puffs’ on the device.
In E-Cigarette liquid there are only 4 ingredients, all of which have been shown to be safe on their own (apart from nicotine, which is needed to make the e-cigarette work).
Naturally, you will find vegetable glycerine, propylene glycol and nicotine in the aerosol from e-cigarettes, but the variety of flavourings and their chemical make-up leads to variations in the chemicals formed by the heating process.
A 2014 study published in the Annals of the American Thoracic Society examined the contents of e-cigarette aerosol from twelve brands of e-liquid and compared the contents with tobacco cigarettes. A comparison of the toxic chemicals revealed that levels of formaldehyde found in e-cigarette aerosol is approximately ten times lower than the levels found in cigarettes.
Acetaldehyde levels in e-cigarette aerosol are approximately 100 to 450 times smaller than the levels in traditional cigarettes, and acrolein levels are 15 to 30 times smaller. Other harmful chemicals such as nitrosamines and nitrosonornicotine were present in the electronic cigarette aerosol but again at much lower levels - the nitrosamine content in cigarettes is about 380 times that found in e-cigarette aerosol, and the nitrosonornicotine level is around 40 times higher in cigarette smoke. Seeing those numbers helps us understand how Public Health England concluded that e-cigarettes are "at least 95% less harmful than traditional cigarettes"!
Another study, also conducted in 2014, examined the levels of acetaldehyde and hydroquinone in exhaled e-cigarette aerosol from two e-cigarettes of a named brand - one tobacco and one menthol flavour - and compared it with exhaled cigarette smoke (Marlboro Gold brand). The results showed that of all the subjects that were used to measure the cigarette smoke, only one reading had levels too low to accurately quantify the amount of acetaldehyde. The majority of readings on the subjects used to measure the acetaldehyde in exhaled e-cigarette aerosol were too low to quantify - and in the instances that quantities were high enough to be measured, the amount found is always a number of times smaller than the volume found in cigarette smoke.
The same study confirmed that over 99.9% of the mass of the exhaled e-cigarette aerosol is water and glycerine, and cites that approximately 85% of environmental tobacco smoke aerosol is due to the passive burning of the cigarette - something that isn’t present in e-cigarettes. The study also cites investigations where machine generated e-cigarette aerosol has been examined in closed spaces, and they indicate that exposure to the constituents in e-cigarette aerosol would not exceed background levels - and that is without being exhaled from a pair of lungs, that would decrease the levels of those constituents.
This evidence tells us that ‘second-hand’ e-cigarette aerosol can’t really be considered as harmful, like second-hand smoke from cigarettes. The analysis of the flavourings and other chemicals in the e-liquid shows us that the levels of harmful particles are negligible when compared to cigarette smoke and, as one study suggested, are consistent with background levels. It is therefore a logical step to infer that switching from cigarettes to vaping will reduce risk of heart and lung disease due to the massive reduction in toxins and elimination of carbon monoxide (due to no combustion) and tar.
It is important to note that there are other factors that can play a role in the contents of your e-liquid aerosol. For example, the state of the coil is likely to affect the content of heavy metals in your e-liquid - an old, deteriorating coil will leech particles, so if you use a sub ohm device, make sure you always have spare coils on you. Clean your device regularly, particularly where it is in contact with e-liquid, to prevent contamination!
WHAT IS IN THE VAPOUR PRODUCED BY E-CIGARETTES CONCLUSION
With all the misinformation surrounding e-cigarettes and their safety, I hope this article has provided enough information for you to see that there are specific instances where vaping particular ingredients can be harmful, but these instances are being used to tarnish the well regulated markets of the world, like here in the UK. Otherwise, the significantly reduced volumes of harmful particles indicate that e-cigarette aerosol contains a fraction of the harmful stuff found in cigarette smoke.
Any long term cigarette users who want to stop smoking would do well to investigate vaping as a means of quitting tobacco products - the health effects of e cigarettes are substantially reduced compared to smoking traditional cigarettes, and studies have shown e-cigarettes could be up to twice as effective as other forms nicotine replacement therapy when it comes to quitting cigarettes!
So if you are still smoking cigarettes but want to try using an e-cigarette to help you quit smoking, check out some of our most popular electronic cigarette and vape Starter Kit deals!
So if you are still smoking cigarettes but want to try using an e-cigarette to help you quit smoking, check out some of our most popular electronic cigarette and vape Starter Kit deals!
