Many smokers have considered quitting, and in fact, nearly 70% of tobacco users state their intention to quit.
Quitting smoking is not just a personal choice but also a decision that positively impacts overall health. Smoking is considered harmful to almost every organ in the body, including the heart – a vital organ of the circulatory system.
According to statistics, approximately one-third of heart disease deaths are linked to smoking behavior or passive exposure to secondhand smoke.
In the process of seeking alternatives, many people turn to e-cigarettes, hoping they will be a stepping stone to gradually reduce nicotine dependence.
E-cigarettes, including both disposable and reusable types, are often promoted as a less harmful option compared to traditional cigarettes.
Dr. Michael Blaha, Director of Clinical Research at the Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University, has presented analyses based on clinical research and empirical evidence to clarify the health aspects related to e-cigarettes.
Less Toxic Does Not Mean Safe
E-cigarettes work by heating a solution containing nicotine, often extracted from tobacco, along with flavorings and many other chemical compounds, to create an aerosol that users inhale.
Unlike traditional cigarette smoke, which contains over 7,000 chemical substances, many of which are proven to be harmful, e-cigarette aerosol is believed to have fewer harmful components.
However, according to Dr. Michael Blaha, this does not mean e-cigarettes are safe.
“While the exact composition of all substances present in e-cigarette aerosol has not been fully determined, users are still exposed to compounds that pose potential health risks, especially to the respiratory system,” he emphasized.
A clear illustration of this risk is the outbreak of acute lung injury associated with e-cigarettes in the United States in 2019-2020.
As of February 2020, the U.S. Centers for Disease Control and Prevention (CDC) had recorded 2,807 cases of acute lung injury (named EVALI) and 68 deaths.
CDC analysis showed that the majority of EVALI patients used e-cigarette products containing THC – the active ingredient in cannabis – and many cases were linked to the use of unregulated or modified e-liquids.
Vitamin E acetate, a thickening agent often added to illicit THC-containing e-cigarette products, was found in lung fluid samples from all EVALI patients tested.
Notably, a study published by Johns Hopkins University in October 2021 revealed that e-cigarettes contain thousands of chemical compounds, most of which remain unidentified.
The research team discovered several concerning components, such as caffeine, a pesticide, three compounds never before reported in e-cigarettes, and two flavorings that could cause respiratory irritation or have potential toxic effects.
These findings raise questions about the true safety of e-cigarettes, especially when product components remain largely unknown and are not uniformly regulated.
Not a Recognized Quitting Method
Nicotine is the main component in both traditional and e-cigarettes. It is a highly addictive substance. It stimulates the brain, creating cravings and causing users to experience withdrawal symptoms when trying to quit.
Physiologically, nicotine constricts blood vessels, increases blood pressure, promotes adrenaline production, and accelerates heart rate. These changes increase the risk of cardiovascular damage, especially in long-term users.
Dr. Michael Blaha warns: “People need to understand that e-cigarettes can be dangerous to health. New data shows that using e-cigarettes in combination with smoking is a cause of chronic lung disease, asthma, and cardiovascular disease.”
Both e-cigarettes and traditional cigarettes deliver nicotine. Studies show that the level of dependence nicotine creates can be comparable to heroin or cocaine.
According to Dr. Michael Blaha, many e-cigarette users tend to consume higher doses of nicotine compared to regular cigarettes. As a result, the body receives a larger amount of nicotine without clear control.
Another issue being raised is the link between e-cigarettes and subsequent smoking behavior.
Although promoted as a smoking cessation aid, e-cigarettes have never been approved by the U.S. Food and Drug Administration for this role. Current scientific evidence shows that the effectiveness of e-cigarettes in helping users quit nicotine is very limited.
A recent study indicated that the majority of individuals intending to use e-cigarettes to quit smoking ultimately continued to use both traditional and e-cigarettes. This dual-use situation makes quitting efforts more complex and prolonged.
The Younger Generation and a New Wave of Nicotine Addiction
In recent years, e-cigarettes have surpassed traditional cigarettes to become the most popular nicotine product among young people. Particularly, disposable devices account for a significantly higher usage rate.
According to the 2021 National Youth Tobacco Survey, over 2 million middle and high school students in the United States had used e-cigarettes, with nearly 85% choosing flavored products.
Dr. Michael Blaha points out three factors that make e-cigarettes attractive to adolescents: “Many teenagers believe e-cigarettes are less harmful than traditional cigarettes. The low cost is also a common reason. Additionally, e-cigarettes do not produce smoke and have less odor, making it easier to evade adults and reducing feelings of stigma,” he explained.
Blaha warns about the increasing trend of adolescents initiating nicotine use through e-cigarettes.
He considers the most concerning aspect to be that individuals who would otherwise never have smoked, especially young people, are now developing a nicotine habit.
Although the rate of e-cigarette use among adolescents decreased slightly since 2020, partly due to the impact of the COVID-19 pandemic and increased parental supervision, this trend remains difficult to control.
Blaha notes that survey data may not fully reflect reality. Adolescents often change their usage habits quickly and may not consider devices like puff bars (a type of disposable e-cigarette) to be a form of e-cigarette.
The CDC’s report for the same period stated that the use of disposable e-cigarettes increased by 1,000% among high school students and 400% among middle school students compared to 2019.
