Maybe less harmful – but not harmless: Use of e-cigarettes carries health risks

An e-cigarette, also called a vape pen, for vaping -- inhaling the vapor -- of the liquid nicotine within.

An e-cigarette, also called a vape pen, for vaping — inhaling the vapor — of the liquid nicotine solution within.


A pharmacist in China in 2007 developed the first of what scientists call an electronic nicotine delivery system — what’s now known as an electronic cigarette or e-cig.

Seeking to kick his own smoking habit, the pharmacist designed the device as a substitute for combustible tobacco products, explains Lee Livermore, public education coordinator for the Upstate New York Poison Center.

Ten years later, it’s not clear whether e-cigs are a better choice than regular cigarettes. But the use of e-cigs has soared, especially among American youth who may be attracted by the multitude of sweet flavorings and a new generational take on the old rebellious act of smoking. E-cig devices today come in a variety of styles. Some look like cigarettes or pipes. Others are disguised as asthma inhalers or thumb drives.

One of the most popular devices among youth is a brand called Juul, which is powered by a USB charger to provide an “intensely satisfying vapor.” The Boston Globe referred to ‘juuling’ as the most widespread phenomenon you’ve never heard of. Livermore suggests parents learn more about this trend because it’s showing up in junior and senior high schools throughout Central New York.

Both conventional and electronic cigarettes contain nicotine, plus other chemicals. Even e-cig liquid labeled “nicotine-free” has been found to contain the highly addictive substance, Livermore says. E-cigs typically contain a smaller amount of nicotine, but vaping (inhaling) habits may mean a person ingests a larger overall quantity of nicotine.

Some users carry their e-cig devices on lanyards around their necks, so it’s convenient to vape mindlessly and continually without scheduling any sort of smoking break, says Livermore. “If you’re using it more frequently and at higher and deeper rates, then you’re actually getting a higher level of nicotine into your system,” he says.

Some users put drugs other than nicotine into their e-cigs. Any chemical that can be converted into an oil or a liquid may be used; some devices are designed to burn finely ground plant material.

E-cigs don’t typically have the stink of tobacco cigarettes. Livermore says that disguises how harmful the products can be. As for the dangers of breathing in the secondhand vapor of an e-cig, he says studies are ongoing.

A report from the National Academies of Sciences, Engineering and Medicine analyzed the evidence available on vaping. It indicated that e-cigs may help adult smokers transition off of tobacco cigarettes, just as the pharmacist from China intended, but that the devices also may entice younger smokers to transition to tobacco cigarettes.

Livermore has studied the report’s findings. Depending on how it’s used, an e-cig may be less harmful than a conventional cigarette. “However, it by no means is harmless or safer,” he says. “You’re still consuming chemicals into the human body.”

The Upstate New York Poison Center is receiving an increased number of inquiries from school districts throughout Central New York concerned about the student vaping trend. The center provides public education. To learn more, call 315-464-5375.

What the research says

— Nicotine intake among experienced adult e-cigarette users can be comparable to that from conventional cigarettes.

— Exposure to toxic substances other than nicotine from e-cigarettes is significantly lower than from conventional cigarettes.

— Completely switching from conventional cigarettes to e-cigarettes results in reduced short-term adverse health outcomes in several organ systems.

— E-cigarette use by youth and young adults increases their risk of ever using conventional cigarettes.

— E-cigarette use increases airborne concentrations of particulate matter and nicotine in indoor environments.

— Adolescents who use e-cigarettes have increased coughing and sneezing and increased asthma exacerbations.

— Drinking or injecting e-liquids can be fatal.

Source: National Academies of Sciences, Engineering and Medicine study sponsored by the U.S. Food and Drug Administration.

Upstate Health magazine spring 2018 cover

HealthLink on Air logoThis article appears in the spring 2018 issue of Upstate Health magazine. For a podcast/radio interview with Upstate New York Poison Center staffers Livermore and nurse Michele Caliva about e-cigarettes and vaping, click here.

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