This post was written by Heather Willison, MSN, FNP-C, PPG – Allergy, Asthma & Immunology.
Called many different names, including e-cigs, vape pens, e-hookahs, mods, vapes, Juuls (named for the brand) or ENDS (electronic nicotine delivery systems), e-cigarettes are battery-operated devices that simulate tobacco smoking.
E-cigarettes were initially introduced in the United States in 2006 to help people stop smoking cigarettes. Since that time, e-cigs have evolved from cigarette look-a-likes to vape pens, and more recently pod-based systems. The introduction of the discreet, sleek-looking pod-based systems in 2015 led to a rapid rise in the use of e-cigarettes by adolescents, with an estimated 30% of teens in 2019 reporting use of e-cigs in the prior month. This has created controversy, both due to the potential for harmful negative effects related to e-cig use, but also because teens who have never smoked cigarettes before are now hooked on nicotine.
Devices
As a non-smoker, I was amazed by the many varieties of e-cigs that are available for purchase. E-cig devices may be open or closed systems, as well as tank or pod mods.
An open system is where the device has a refillable reservoir for e-liquids. This allows for the system to be opened and the e-liquid to be customized (nicotine content or flavors). Closed systems use pre-filled cartridges that are disposable. The preference amongst teens seems to be a closed system, as the vapor cloud is much smaller, thus less noticeable.
Tank mods have an electronic control box that allows for more customization. This makes tank mods a preferred choice for those trying to stop smoking. Pod mods are the newest option, and seem to be the preference for teens and young adults due to their lower cost, discreet designs and less obvious vape cloud. JUUL is a common pod mod brand and has hooked many teens, not only due to the nicotine they contain, but also due to the appealing flavors. They are also easily concealed from parents who are not savvy to e-cig devices, as they are similar in appearance to USB drives.
Risks
Various studies have determined that the negative health effects of e-cigs are similar to that of their traditional cigarette counterparts. It’s thought that these negative effects are not only due to the highly addictive nicotine content, but also the flavoring additives, and the propylene glycol and vegetable glycerin (components found in the e-liquid).
The airways of e-cig users compared to nonsmokers and traditional cigarette smokers have been shown to be more susceptible to infection, with airway tissue being severely damaged in some cases. In fact, even when e-cigs don’t contain nicotine, there is evidence that the e-liquid components (propylene glycol and vegetable glycerin) and flavoring additives can result in irreversible airway damage.
Studies have shown, and it has been my experience, that patients with asthma report increased coughing, shortness of breath, wheezing and/or chest tightness when using e-cigs. Asthma becomes more difficult to control, resulting in missed days of school or work, as well as a decrease in quality of life. In addition to being linked to chronic lung disease and asthma, e-cigs have also been associated with cardiovascular disease.
Ready to quit?
E-cigs are not approved by the FDA as an aid to assist people in their endeavors to quit smoking, and there is limited evidence showing that e-cigs are even helpful in doing so.
Freedom from Smoking is an American Lung Association course that is offered by Parkview free of charge. The course strives to assist people in achieving freedom from nicotine dependence. Please contact the Parkview Center for Healthy Living at 260-266-6500 for more information.
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