The use of e-cigarettes is on the rise, particularly among high school students, and, given that the use of these devices is a relatively new phenomenon, we felt it important to provide students and parents with some relevant background information.
Electronic cigarettes are battery-operated devices that heat a liquid to produce a vapour that is inhaled. The fluid usually contains propylene glycol, glycerol, nicotine and added flavouring(s). The devices are designed to deliver the aerosol directly to the lungs. Some resemble conventional cigarettes, while more recently developed devices look like everyday items such as pens or USB memory sticks. The appeal of these flavoured e-cigarettes to adolescents has led to their rapid uptake around the world.
The Australian National Health and Medical Research Council (NHMRC) is concerned that e-cigarettes have ‘renormalised’ smoking. A worryingly recent study has also found that e-cigarette users were three times more likely than non-e-cigarette users to subsequently become tobacco smokers.
While the damaging impact of smoking tobacco is well known, the short and long-term health effects of e-cigarettes are still being researched.
SAFETY OF E-CIGARETTES
Although the compositions of the e-cigarette liquids vary, they all contain a range of different solvents and flavouring agents which have the potential to increase the risk of developing cardiovascular, cancer and respiratory diseases.
When overheated, the solvents propylene glycol and glycerine can produce dangerous levels of the carcinogens formaldehyde and acetaldehyde.
The vapour can also contain:
- Heavy metals such as aluminium, arsenic, chromium, copper, lead, nickel and tin, all of which cause adverse health effects.
- Particulates at levels that have the potential to cause adverse health effects for both the user and for bystanders. The World Health Organisation has warned that exposure to any level of particulate matter may be harmful and that levels of exposure should be minimised.
- Flavourings normally approved for use in food production e.g. cherry, cinnamon, vanilla and popcorn flavours which, when inhaled directly into the lungs, can be toxic and have been demonstrated to have a range of different deleterious effects.
The NHMRC has found that users of e-cigarettes typically experience a low rate of adverse effects in the short-term, with mouth and throat irritation the most commonly reported symptoms. The most common symptoms reported by those passively exposed to e-cigarettes included respiratory difficulties, eye irritation, headache, nausea and sore throat or throat irritation.
More serious adverse events have also been reported, with over 200 incidents in the US and UK alone of e-cigarettes overheating, catching fire or exploding, leading to disfigurement and life-threatening injury. The rising popularity of e-cigarette use internationally has also corresponded with an increasing number of reported nicotine poisonings due to skin exposure to or ingestion of e-liquids.
The newest and most popular vaping product is the JUUL, which resembles a USB memory stick. This device now accounts for three quarters of the market share in the United States and every JUUL product contains a large dose of nicotine. Many lawmakers and public health officials in the US have criticised the company’s marketing practices, believing them to have targeted teens through social media influencers and their promotion of fruity pod flavours, which are now only sold online.
VAPING AND THE LAW
IN NEW SOUTH WALES
- E-cigarettes that do not contain nicotine are legal for use by adults. The sale and use of e-liquid nicotine is against the NSW Poisons and Therapeutic Goods Regulation 2008.
- The sale of e-cigarettes or e-cigarette accessories to a person under the age of 18 is illegal. NSW Public Health (Tobacco) Act 2008. It is also illegal to use an e-cigarette in a car with a child under the age of 16.
- Note: E-cigarettes have also often been found to be labelled incorrectly. Despite claims to the contrary, many do contain nicotine. Tests conducted by NSW Health in 2013 showed that 70 percent of the samples contained high levels of nicotine, even though the label did not state nicotine as an ingredient.
Nicotine is known to be very addictive and can impact on brain development in teenagers, affecting memory, concentration, learning, self-control, attention and mood.
“While smokers build up a tolerance to nicotine, people exposed to nicotine for the first time may experience mild symptoms of nicotine poisoning.”
NSW Health Fact Sheet: Are electronic cigarettes and e-liquids safe?