E-Cigarettes

Originally created as a cessation to combustible tobacco cigarettes, e-cigarettes are an up and rising way of portraying a healthy alternative to smoking. However, while being portrayed as a healthy substitute e-cigarette devices are designed to deliver the same highly addictive nicotine that is found in tobacco cigarettes. E-cigarettes primarily include a battery, or some type of electronic circuit that delivers vaporized nicotine through the heating of a nicotine containing solution, often called e-liquids, to the body that produce smoke visible smoke called vapor that can be inhaled and exhaled. When the device is triggered, the heating element turns on and aerosolizes a solution, sending nicotine aerosol into the lungs.

Hildick-Smith et al. (2015) report that, the growth of e-cigarettes among the adolescent population has become so rapid that it has surpassed that of conventional cigarettes in 2014 (p. 1). Despite their sudden growth little is
known about the health risks posed by them, especially in the susceptible adolescent population. These products may potentiate nicotine addiction and have been found to contain numerous harmful chemicals. The e-cigarette has rapidly gained popularity becoming a multi billion-dollar industry in the United States. The e-cigarette epidemic has raised many questions regarding long-term health concerns. E-cigarette potential to renormalize cigarette use appeals to nonsmokers especially amongst adolescents, and their possible health risks as a result of usage are the three main public health concerns revolving around e-cigarettes.

E-cigarettes are highly customizable, allowing users to increase nicotine uptake as extremely large levels sometimes ten times the amount of normal usage (Hildick-Smith et al., 2015, p.
2). Carcinogens and chemicals such as nicotine, formaldehyde, and diacetyl have been found in e-cigarettes that have been proven to be of harm to human health. For example, diacetyl has been showed to cause acute-onset bronchiolitis obliterans, which is a severe and irreversible obstructive lung disease (Rowell and Tarran, 2015, p. 8). Chemists have found various levels of chemical metals in vapor including chromium, nickel, tin, silver and aluminum when the heating elements of e-cigarettes are operated at high voltage. These chemical findings have also been related to findings in combustible cigarette usage. E-cigarettes also may potentially contain harmful compounds that are not found in tobacco products, such as propylene glycol. Propylene glycol allows for the formation of a visible vapor and is known to be a respiratory
irritant.

Adolescents may be susceptible to nicotine addiction after being exposed to e-cigarettes as well as possibly promoting transitioning of non-smokers to combustible tobacco cigarette usage. Nicotine has its biggest effects on the developing brain, harming its development in adolescence (Rigotti, 2015, p. 673). Flavorings known as e-liquids are largely unrecognizable potentials of health concerns, and as of recent jurisdiction, ingredients had not been mandated by the FDA permitting companies and corporations to not properly indicate the ingredients (Barrington-Trimis, Samet, McConnell, 2014, p. 2493). However, the FDA does not have any authorization of advertisement restrictions. Unlike cigarettes where advertisement bans are in place not allowing them to market their products on television, there is no such thing when it comes to e-cigarettes which have expanded advertising expenditures from $6.4 million in 2011 to $18.3 million in 2012 (Hildick-Smith, 2015, p. 5).

The available data surrounding e-cigarettes shows that e-cigarette use is undeniably associated with the increase use of combustible tobacco initiation during early adolescence (Leventhal et al., 2015, p. 706). Questions that have not been answered due to lack of research and information include: What are the risks of e-cigarettes, are they truly a cessation to combustible cigarettes, do e-cigarettes help smokers quit, and what are the effects of e-cigarettes on the human body?