E-cigarettes: A Win or a Loss for Public Health?

There have been raging debates on whether e-cigarettes are a win or a loss for public health. On one side, there are those who think e-cigs could push traditional cigarettes out of the market, hence saving lives by assisting smokers to kick away the habit. Nevertheless, there are those who feel e-cigs may make it harder to quit smoking, and act as a gateway to smoking, more so among the youth. This endless debate is grounded on three main issues: if it is true e-cigs are safe, whether they promote or undermine efforts to stop smoking, and if they act as a gateway to ordinary cigarettes—especially for the youth—by exposing them to nicotine.

Fewer toxins are not necessarily safer

Since e-cigs do not produce carbon monoxide, tar, and other carcinogens, their users and others deem them to be safer products to supply nicotine. Studies have shown that e-cigs emit fewer poisonous substances like carbon monoxide and hydrogen cyanide—some of the over 7000 chemicals found in tobacco smoke. As such, they may be better than some smoking cessation aids for reducing tobacco consumption and minimizing the chances of getting lung cancer.

Nevertheless, there are other concerns about using e-cigs in addition to preventing cancer. Some studies have shown that the aerosols emitted by e-cigs may contain ultra-fine particles linked with cardiovascular diseases, as they affect the functioning of blood vessels. Additionally, the ultra-fine particles bring about inflammation in the lungs, raising chances of respiratory infections and asthma.

Overall, e-cigs may be less harmful than the traditional cigarettes, but they have not been in the market for long enough, mean extensive research has not been done on them. Also, the widespread claim that they act as a pathway to realizing the ultimate public health goal—to assist people to quit smoking—is still in contention and requires more research.

E-cigs do not always help people stop smoking

Among the reasons for supporting e-cigs is that they can act as quitting aids in the same way as lozenges and nicotine patches, both of which have been approved as smoking cessation tools by the US Food and Drug Administration. Studies conducted on the use of e-cigs as quitting aids show that smokers who did not use e-cigs to help them stop smoking had a 28% lower chance of quitting than those who used them. In reality, a good number of e-cig users take them up with the intention to help kick away smoking.

However, others use them to get their nicotine dose where smoking is prohibited. According to two researchers, Glantz and David Bareham of Lincolnshire Community Health Services, UK, most adults who use e-cigs continue to smoke ordinary cigarettes. They are referred to as dual users. The researchers indicated in the 2018 Annual Review of Public Health that in 2014, 93% of e-cig users who continued to smoke cigarettes were in the US, 83% in France, and 60% in the UK. Such dual users tend to use e-cigs because they are discreet and thus convenient for smoking-restricted areas. This may increase their smoking habits and aggravate their addiction.

Smokers who intend to reduce their nicotine intake can use e-cigs as a quitting aid, but those who have no intention to give up smoking can worsen their nicotine addiction with e-cigs. The mere taking up of e-cigs cannot help sort out the addiction problem. It is therefore crucial to be intentional about using e-cigs as a smoking cessation tool if at all you are to be successful in giving up smoking. While you’re at it, ensure you get quality e-cigs and vaping supplies from a reliable manufacturer who you can reach at https://epuffer.com/.

E-cigarettes as a gateway to conventional cigarettes

Many critics of e-cigs, most of whom are conventional cigarette manufacturers, argue that e-cig manufacturers push them to the youth through aggressive marketing. The attractive packaging and e-liquids in many flavors, even bubblegum and cinnamon red hot, make youngsters want to try them. One researcher says that young people experiment with e-cig devices and think that e-liquids are just flavored water without any nicotine or ensuing health risks. However, once they get addicted, it becomes hard to quit. Some researchers from the University of South California observed that 40.4% of high school students who vape have also smoked. Conversely, only 10.5% of the high school students who have smoked have never vaped.

However, another researcher, Abrams, thinks e-cigs are not so much to blame for smoking among the youth. He argues the youth generally have a risk-taking behavior and will tend to experiment with many things—cigarettes, marijuana, e-cigs, and alcohol. Therefore, the notion of e-cigs being a gateway to conventional cigarettes disappears. He notes it is vital to watch out for youths smoking. Two more studies—Monitoring the Future Study (ongoing for over 40 years) and the National Youth Tobacco Survey—both show that smoking among the youth has been on the decline over the years. This shows positive change, and that if vaping is a gateway to smoking, it is not affecting many young people. However, Abrams notes that the argument of the gateway effect is a valid concern and feels there should be concerted efforts to prevent the youth from getting e-cigs.

Final thoughts

The conflicting views on the impact of e-cigs on public health seem to be far from over, and will continue until scientists have more data put together over time. There are differing opinions on the regulation of e-cigs to adults. Some feel that they should be taxed in the same way as conventional cigarettes to deter their use, and that public health education should be done to make people aware of the dangers of dual use and the gateway effect. Other people, however, feel that the nicotine products should be taxed in proportion to their harm, so traditional cigarettes should be taxed more heavily than e-cigs to encourage smokers to switch to the latter.

All the same, most public health researchers agree on a few things, such as the prohibition of e-cig use where smoking is also prohibited, and the prohibition on selling e-cigs to minors. Several laws have also been enacted to prevent minors from accessing e-cigs. However, there is still so much controversy in e-cigs marketing, and only data from studies that show marketing e-cigs to the youth is harmful will help settle the issue.

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