ENDS a gateway to other nicotine products: Experts, Health News, ET HealthWorld
By Nisha KumariNew Delhi: The emergence of e-cigarettes, the most popular form of electronic nicotine delivery system (ENDS) is a disruptive change in the prevention of tobacco globally. The toxicological profile and the impact of nicotine are critical especially concerning teens and adolescents. Calling nicotine addiction as the strongest addiction in the entire world, experts believe that the use of nicotine in any form can have long-lasting effects. A report by the Asia Pacific Journal of Cancer Prevention on September 2022 titled Adolescents and E-cigarettes in India: A Qualitative Study of Perceptions and Practices observed that the use of e-cigarettes in India is most common among adolescents and around 4 per cent of adolescents aged 15-24 years were reportedly aware of e-cigarettes according to the Global Adult Tobacco Survey (GATS)-2 conducted by Tata Institute of Social Sciences (TISS), Mumbai and Ministry of Health and Family Welfare, Government of India, 2016-2017. Speaking to ETHealthworld, on World No Tobacco Day, experts inform that the availability of vaping devices, various e-liquid flavours, and the belief that they're safer than traditional cigarettes appeals to a spectrum of people, especially teenagers.Are e-cigarettes alternatives to traditional cigarettes?The consumption of e-cigarettes has challenged tobacco control globally as it is thought that it does not contain nicotine and hence can be used as an alternative to traditional cigarettes. Dr Kamlesh Pandey, Consultant Chest Physician, Wockhardt Hospitals Mira Road, said, Traditional cigarettes have around 7000 chemicals, so different vaping companies promoted the idea that e-cigarettes don't have all these chemicals, and it can also be used by someone who wants to quit smoking.E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, and other tobacco products, flavouring, and other chemicals that help to make the aerosol. So when one smokes e-cigarettes, they also smoke all these products in an aerosolised form.Although the long-term health effects of vaping are still under investigation, they cannot be cleared as harmless at present. But the levels of risk associated with using these products come from a variety of other factors, like some of them relating to the type of products used and their characteristics, how frequently one uses them, and how the products are delivered. Voicing his opinion on this Dr Shubham Jain, Consultant Surgical Oncology, HCMCT Manipal Hospital, Dwarka, said, The effectiveness of such products depends on their ability to heat the solutions, and since there is considerable variability in quality and standards, it may affect the delivery of nicotine and other constituents and may contribute to the formation of toxicants in the emissions. Users behaviour, such as length of puffs, depth of inhalation, and frequency of use, may also affect how vapours are consumed by the user. It has also been observed that a few metals like nickel and cadmium are used in e-cigarettes. But toxicity is not the only factor that should be considered. Factors like the potential for abusing or manipulating a product, used by children who otherwise would not have used cigarettes and experimentation of different other chemicals that are not natural and presumably might damage the functioning of the lungs. E-cigarette lung injuries outbreaksTo date, evidence on the use of electronic nicotine delivery systems (ENDS) and their association with lung injuries is unclear, and also because vaping is a recent phenomenon, many of its side effects are still unclear but it has been associated with an outbreak of lung injury. According to Dr Deepak Sarin, Vice Chairman, Head & Neck Onco Surgery, Head and Neck Oncology, Cancer Institute, Medanta Gurugram, said, The thing with e-cigarettes and vaping is that it's a relatively recent phenomenon. And many of the side effects of harmful chemicals take years or even decades to manifest. So we may not know the harmful effects till 10 years. Some of these will just damage the lung, while some may be cancer-causing. The high nicotine content in some solutions may be addictive and particularly harmful to adolescent brain development. Certain vaping products are also reported to be associated with breathing difficulties, causing respiratory distress and even death in some cases. It can have adverse effects during pregnancy and may contribute to cardiovascular diseases too.E-cigarette or vaping-use-associated lung injury (EVALI) is another serious inflammatory condition that has been identified recently and has received significant attention. Its pathophysiology is similar to chemical pneumonitis (a condition in which the foreign particles cause inflammation of the lungs or cause breathing problems due to the inhalation of chemical fumes or breathing in or choking on certain chemicals) and it causes significant morbidity and mortality, particularly if it goes unrecognised. A gateway to induce non-smokersIn addition to the unknown health effects of e-cigarettes, experts believe that vaping might serve as an introductory product for teens and adults who then go on to use other nicotine products, that includes cigarettes, ganja, and beedis, which are known to cause cancer and premature deaths. Adding to this, Dr Jain said, The popularity of such ENDS amongst the youth is leading to genuine concerns about a new generation becoming addicted to nicotine or the acceptance of flavoured habit-forming substances. This possibly acts as a gateway to initiate nicotine abuse, amongst non-smokers. Once addicted, these ENDS-users, may switch to traditional tobacco products, which may appear as cheaper alternatives. Also, such social acceptance, may then in turn renormalise the attractiveness of smoking, undermining the public efforts so far to fight the tobacco pandemic.Flavours on the other hand have been found effective and are considered as one of the main reasons why teens initially try and continue to use e-cigarettes. Dr Kushal Chidgupkar, Pulmonologist, Global Hospitals Parel, said, Flavours are also nicotine that will go to machine switching. So rather than being used for stepping down from cigarettes, it started being used as a setup for cigarettes. Also, the appeal to flavours differs by age among e-cigarette users.Experts voice out that the use of e-cigarettes in place of traditional cigarettes and the notion of safety is a myth. Although the long-term health effects associated with it are under investigation, e-cigarettes has been associated with lung injuries, and it often acts as an introductory product for non-smokers.
Wednesday, May 31, 2023 at 11:44 am