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Smoking in disguise: Electronic smoking devices labeled ‘healthy’ can be misleading

Vaping and using e-cigarettes have become very popular in recent years, but users should be aware of known risks and potential dangers. Electronic nicotine delivery systems use noncombustible tobacco products and typically contain nicotine, flavorings, and other chemicals. (DoD file photo) Vaping and using e-cigarettes have become very popular in recent years, but users should be aware of known risks and potential dangers. Electronic nicotine delivery systems use noncombustible tobacco products and typically contain nicotine, flavorings, and other chemicals. (DoD file photo)

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FALLS CHURCH, Va. — Cigarette smoking has been around since the ninth century. Today, many people are using battery-powered devices designed to mimic the habit while delivering fewer toxins. Experts, however, warn that regarding these devices as “natural” or “healthy” can be misleading.

“Many people think e-cigarettes are safe and without any sort of harm, because they’re not a conventional cigarette,” said Army Lt. Col. Sally DelVecchio, chief of Pulmonary Critical Care Service at Fort Belvoir Community Hospital in Northern Virginia. “While there may be fewer toxins in e-cigarettes, people should still be aware that there can be harmful toxins in the product liquid.”

Electronic nicotine delivery systems use noncombustible tobacco products and typically contain nicotine, flavorings, and other chemicals. They’re known as e-cigarettes, vaporizers, vape pens, hookah pens, and e-pipes. These devices can mimic traditional cigarettes and pipes, or they can look like everyday objects, such as pens or USB memory sticks.

In 2016, the Office of the U.S. Surgeon General released the first comprehensive report by a federal agency on e-cigarette use among older children and young adults. It said more than a quarter of students grades 6-12, and more than a third of young adults, have tried e-cigarettes, which is now the most common form of tobacco used by middle school and high school students in the United States.

In e-cigarettes, nicotine is delivered through a liquid called e-juice, which turns into vapor when using the devices. DelVecchio said the liquid can come in various flavors, which is attractive for the young population.

Regina Watson, health promotion program manager for the Air Force Medical Support Agency, warned that there are misconceptions about what’s in these products and the harm they can do. Some people may believe that e-cigarettes don’t contain nicotine, because they don’t have combustible tobacco, which is found in traditional cigarettes. But e-cigarettes are a nicotine product, Watson said.

“In some cases, it might have more [nicotine] than regular cigarettes, but it’s difficult to know, because it’s largely unregulated,” she said.

According to the Centers for Disease Control and Prevention, e-cigarette aerosol can include nicotine, cancer-causing chemicals, ultrafine particles, and heavy metals such as nickel, tin, and lead. It can also include flavorings like diacetyl, which is a chemical linked to serious lung disease.

E-cigarettes also increase the possibility of negatively affecting brain development and respiratory health, the OSG said. Nicotine affects the development of the brain’s reward system, which includes brain circuits that affect attention and learning. Other risks include mood disorders and permanent problems with impulse control.

DelVecchio warned that while more research needs to be done on the long-term health effects of e-cigarettes and vaping, bronchiolitis obliterans has been linked to these products. This disease occurs when e-cigarette use triggers an immune system response, causing inflammation in the lungs. It’s unknown whether the inflammation is long-term or if any additional damage disappears over time, DelVecchio said.

“I believe more and more places are starting to acknowledge that vaping and e-cigarettes are potentially just as harmful as secondhand smoke,” she said.

More than 460 different e-cigarette brands are available, according to the National Institute on Drug Abuse. Watson warned that many vaping products are not FDA-approved, since the contents, including chemicals and substances in flavoring, aren’t fully known, making the safety level difficult to determine.

According to NIDA, about 66 percent of teenagers who use e-cigarettes believe their products only contain flavoring, while nearly 14 percent report not knowing what’s in them, and only roughly 13 percent believe they contain nicotine. Although some e-cigarette brands are FDA-approved, other vaping products and e-cigarettes are not regulated. Long-term data on the safety of all of these products is not available, since they are still relatively new, DelVecchio said.

Research shows e-cigarette use among youth can lead to traditional tobacco use, which is known to cause disease and premature death, said Watson.

Additional information on e-cigarettes can be found through the Centers for Disease Control and Prevention and National Institutes of Health. Resources for quitting smoking can be found through the Department of Defense’s UCanQuit2 campaign.

“Even though you may not feel like you’re smoking with an e-cigarette, you can be putting more harm in your body than you realize,” said Watson. “It’s important to stay informed and do your research.”

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