Electronic cigarette and smoking

Every discussion about the health risks of e-cigarettes should start with the comparison with smoking. E-cigarettes are designed to reduce the harm of cigarette substitutes, it is important to weigh e-cigarettes and smoking, because the vast majority of e-cigarette users are smokers or smokers.

A paper written by 15 former presidents of the nicotine and tobacco research association concluded that long-term smokers were misled about the relative risks of e-cigarettes and smoking.

“We believe that the potential life-saving benefits of e-cigarettes to adult smokers are as noteworthy as the risks to adolescents,” the scientists wrote “Millions of middle-aged and elderly smokers are at high risk of recent illness and death. Quitting smoking can reduce the risk.”

“Although there is evidence that e-cigarettes are currently increasing the smoking cessation rate,” they added, “if the public health community pays serious attention to the potential of e-cigarettes to help adult smokers, the impact may be greater. Smokers will receive accurate information about the relative risks of e-cigarettes and smoking, and the potential impact on smokers is taken into account in the design of policies. That did not happen.”

Is electronic cigarette harmful to your lungs?

Smoking causes well-known damage to the lungs. Long term inhalation of burning tobacco can lead to lung cancer and esophageal cancer, as well as various fatal lung diseases, such as emphysema, chronic bronchitis and chronic obstructive pulmonary disease (COPD).

Cigarette smoke attacks the lungs in many ways. It contains thousands of chemicals, more than 70 of which are known carcinogens. It also contains particulate matter – burned tobacco, tobacco residues and paper scraps – which can go deep into the lungs and be buried in tissues, and may lead to cancer and chronic obstructive pulmonary disease.

But what about e-cigarettes? E-cigarettes do not produce known carcinogens sufficient to be considered a real risk, and it does not contain solid particles such as smoke.

In fact, the most dangerous thing when burning tobacco basically does not exist in e-cigarettes. Since e-cigarettes do not burn, there is no tar or carbon monoxide – the two main dangers of smoking. Electronic smoke uses the heat of metal coils to turn electronic liquids into inhalable aerosols. It looks like smoke, but it’s not. In other words, e-cigarettes are not without potential risks to lung health.

There are some problems in the components of electronic cigarette oil: propylene glycol, vegetable glycerin and flavoring agent. Over the years, no serious human studies have been conducted on the effects of daily inhalation of PG or VG, although animal studies of PG inhalation have not triggered any danger signals. PG has been found to cause slight irritation to the respiratory tract, but it is not important in itself.

Is the taste harmful to your lungs?

Electronic cigarette oil flavoring agent is a possible source of danger, which has not been fully studied. Most flavorings are mixtures of many compounds, and some flavorings may have worse effects on lung health than others. Until recently, these flavorings were strictly used in products that were eaten rather than inhaled. The focus of toxicological research is to show that flavoring agents can be eaten safely. This is an area where e-cigarette science needs to catch up.

There have been many news reports about the discovery of diketones (such as diacetyl) in some electronic liquids. When these flavoring chemicals are inhaled in large quantities (as in the case of popcorn factory workers), they are believed to cause a fatal disease called popcorn lung. Not all electronic liquids contain diketones, but a 2014 study by cardiologist Konstantinos farsalinos concluded that diacetyl and acetopropionyl are “avoidable risks”. Later, many manufacturers redesigned their products and eliminated diketones. Others began to release tests showing the content of diketones in their products.

Diketone is also found in cigarettes, which is 100-750 times the content of any electronic cigarette product. However, although smoking can damage the lungs in other ways, it has nothing to do with popcorn lungs. Considering the much higher content of diketones in cigarette smoke, the relatively small content of diketones in e-cigarettes is unlikely to pose a threat. This is not to say that diketone inhalation is safe, but considering the small amount of electronic liquid, the safer choice between electronic cigarette and smoking is clear.

Is electronic cigarette harmful to your oral health?

Smoking can cause and cause various oral health problems. Of course, it is well known that smokers have a high risk of oral cancer, throat cancer and esophageal cancer. But cigarettes can also cause tooth and periodontal disease, including gum (GUM) disease. Cigarette smoke will change the bacterial ecology (microbiome) in the mouth and make the existing periodontal problems worse.

There is not much information about the medical side effects of e-cigarettes on oral health. A recent literature review in the Journal of oral pathology and medicine summarized the current situation of science and pointed out that “the evidence is insufficient”. However, the author summarizes some interesting findings.

The authors describe a small study that showed that e-cigarette users may increase the prevalence of nicotine stomatitis (curiously, nicotine has nothing to do with nicotine), which is an oral injury caused by heat. This is a secondary situation, which is usually solved by itself after eliminating the heat source (usually the pipe).

A small pilot study examined the oral microbiome of 10 e-cigarette users, 10 smokers and 10 non-e-cigarette / smokers. The authors found that the bacterial characteristics of e-cigarette users were similar to those of the control group without e-cigarette / smoking, but the oral bacterial characteristics of the smoking group were very different. The researchers concluded that steam did not change the microbiome. Similarly, this study is too small to draw broad conclusions from it. This review covers other small studies, but questions their relevance based on size and lack of appropriate controls.

Finally, there is the problem that the exploding e-cigarette will damage the mouth of e-cigarette users. Although it is true that a very small number of e-cigarette users have had catastrophic accidents leading to severe facial and oral tears and tooth fractures, this is more about the safety of e-cigarette batteries. Most of the injuries caused by the explosion of equipment in the mouth are caused by the mechanical modules used by inexperienced e-cigarette users. Using modern monitoring equipment and high-quality batteries, it is almost impossible for the atomizer to enter the user’s teeth.

Can smoking Electronic Cigarettes cause cancer?

Cancer forms when toxins destroy the DNA of cells and cause cells to grow and reproduce out of control. Tumors can remain localized, or cancer can spread, or even metastasize from one organ to another (metastasis). Most people know that smoking can lead to lung cancer. Lung cancer kills more Americans than any other type of cancer, and most (but not all) lung cancer victims are smokers or former smokers.

Smoking can also lead to many other types of cancer, because cancer can be formed not only through direct contact with smoke particles, but also through smoke by-products in blood and organs. According to the Centers for Disease Control and Prevention (CDC), smoking can cause cancer in almost any part of the body.

Carcinogens have been found in e-cigarettes, but their levels indicate that the risk of cancer is very low. According to a 2017 study in the Journal of tobacco control, the cancer risk of e-cigarettes is equivalent to that of drugs such as nicotine gum or patches – less than 1% of that of smoking. According to this study, the only e-cigarette by-product that poses a real risk is the carbonyl compounds produced by the overheating of e-cigarette equipment (as described in the formaldehyde section below).

Other researchers have reached similar conclusions. A study published in the journal mutation research in 2016 tested the ability of electronic cigarette steam and cigarette smoke to cause bacterial cell mutations. Smoke causes mutation (mutation) and is also toxic to bacteria, while steam has no mutation or toxicity.

Nicotine itself – whether cigarettes or electronic cigarettes, or other nicotine products – has not been shown to cause cancer. Long term studies of nicotine replacement therapy (NRT) and snuff users in Sweden have shown that there is no demonstrable link between nicotine and cancer, despite unconfirmed concerns that nicotine may be a “tumor promoter” that encourages the expansion of established tumors.

In 2016, the Royal College of physicians’ report on e-cigarettes said, “strong evidence from five-year lung health research shows that long-term use of nicotine is safe for human body, in which participants are actively encouraged to use NRT for several months and many continue to use NRT for a much longer time, indicating that there is no association between continuous use of NRT and the occurrence of cancer (lung cancer, gastrointestinal tract or any cancer) or cardiovascular disease.”

Does electronic cigarette have formaldehyde?

What is formaldehyde? The U.S. Environmental Protection Agency (EPA) defines formaldehyde as “a colorless flammable gas with a strong smell at room temperature. Exposure to formaldehyde may have adverse effects on health.”

Researchers at Portland State University reported in 2015 that steam products produce high levels of formaldehyde – even more than cigarettes. What they did not explain was that their experiment used unrealistic high-pressure settings and smoking machines to produce steam that humans cannot breathe in.

In fact, you can do a similar experiment. Put the bread in the toaster until the toaster smokes and the bread turns black by carbon. Does the result cause cancer? Yes, but since no one can eat it, the danger is strictly assumed. Similarly, the toxic aldehydes produced by burning dry wicks and atomizers are not really dangerous, because they cannot be inhaled repeatedly. Vapers called this effect dry hitting or dry pumping, which they tried to avoid.

In a 2017 study, Dr. Konstantinos farsalinos replicated the experiment of Portland and showed that the steam generated by deliberately overheating the atomizer was unacceptable to human users. “The high level of formaldehyde emissions reported in previous studies is caused by unrealistic use conditions, which will bring unpleasant dry puff taste to e-cigarette users, so it can be avoided,” the author wrote about the Portland experiment.

In 2018, farsalinos and gene Gillman conducted a systematic evaluation and analyzed 32 research evidences on carbonyl compounds such as formaldehyde, acetaldehyde and acrolein found in e-cigarette steam. The authors found that almost all high levels of carbonyl compounds (such as formaldehyde) produced during the study were caused by poor methods that led to “dry spray conditions”. They proposed standards for future research and defined appropriate parameters for e-cigarette experiments, including standardized suction methods, the use of current generation atomizers and realistic power settings, as well as the appropriate pg/vg ratio of test equipment.

The author also explained that we inhale 1 mg of formaldehyde from the air in our home every day. On average, people who use 5 ml of electronic cigarette oil in modern atomizers every day will increase their formaldehyde intake by only 0.083 mg. This is less than 9% higher than the normal exposure level, which may not be significant.

Smoking kills people, but what about e-cigarettes?

Cigarettes cause serious damage to the body, almost hurting users from head to toe. These hazards have proved beyond doubt. But there is little evidence that e-cigarettes have a similar effect on health – or any health problem, for that matter, unless you calculate nicotine dependence. But nicotine does not directly cause any terrible harm of smoking.

The British Department of public health made it clear in its survey results: the respected British agency said that e-cigarettes were at least 95% safer than smoking. Phe researchers understand that only studying the harm of e-cigarettes is only half of the theme, because e-cigarettes mainly exist as a substitute for smoking. The potential risk of smoking e-cigarettes is very low, and it must be compared with the proven risk of smoking.

Compared with smoking, the risk of smoking e-cigarettes to users is much lower.