A Deeper Looking Into E-Cigarettes
Written by Hoi Ying Chan, a fourth year McMaster work-study student with the Student Wellness Centre.
E-cigarettes, also known as “e-cigs,” “vapes,” and “e-hookahs”, have become increasingly popular among young people. According to a survey conducted by the Government of Canada, E-cigarette prevalence rates have doubled among students from 2016-17 to 2018-19. The most recent data suggests that 29.3% of young adults aged 20 to 24, and 22.8% of teenagers aged 15 to 19, have tried an e-cigarette (Canada.ca).
What are e-cigarettes?
E-cigarettes are smoking devices that consist of a battery, a heating element, and a cartridge (tank that holds the e-liquid). They produce an aerosol by heating the liquid- usually containing nicotine, flavorings, and other chemicals-, which the user then inhales (CDC).
What is in e-cigarette aerosol?
- Ultrafine particles that can be inhaled deep into the lungs
- Ultrafine particles are retained longer in the lungs and cause more pulmonary inflammation, compared to fine particles.
- Ultrafine particles can cause systemic inflammation, endothelial dysfunction, and coagulation changes that predispose individuals to ischemic cardiovascular disease and hypertension. They are also linked to diabetes and cancer. (Schraufnagel, D.E., The health effects of ultrafine particles)
- Flavoring such as diacetyl, a chemical linked to a serious lung disease
- Volatile organic compounds
- Cancer-causing chemicals (CDC)
- Carcinogens (e.g., formaldehyde, acetaldehyde, and acrolein) and toxic heavy metals (e.g., nickel, lead, and cadmium)
To date, it is unclear whether e-cigarettes’ aerosol is less harmful to bystanders, compared to cigarettes’ smoke.
Are e-cigarettes safer than conventional cigarettes?
Yes—but they are still not harmless. E-cigarettes are safer than combustible tobacco (such as cigarettes and cigars) because they contain fewer toxic chemicals (CDC).
However, even though e-cigarettes generally contain fewer toxic chemicals, the nicotine content is much higher than combustible cigarettes. Some nicotine pods like the Juul pod contain as much nicotine as one pack of cigarettes (Baylor College of Medicine).
Can e-cigarettes be used for tobacco cessation?
To date, evidence is insufficient to recommend e-cigarettes for smoking cessation. However, multiple studies have found that most adults who use e-cigarettes for smoking cessation become dual users: they do not stop smoking cigarettes and are instead continuing to use both products (Kim et al., 2020; Martinez et al., 2021; Famiglietti et al., 2021).
E-cigarettes Use & Mental Health:
E-cigarettes are often used as a coping strategy by individuals suffering from depression, anxiety, or other mental health conditions. However, this may be counterproductive as research has shown that nicotine can exacerbate existing mental health conditions.
Specifically, the nicotine in e-cigarettes interrupts the cerebral dopamine pathway leading to an increase in depressive symptoms. Therefore, this behaviour creates a vicious cycle, in which the existing mental health conditions could be worsened.
Meanwhile, nicotine also increases the users’ sensitivity to stress and alters the coping mechanism in their brains. These changes lead to an increased dose-response relationship: the users’ depressive symptoms increase as their nicotine exposure increases (Baylor College of Medicine).
If I want to quit using e-cigarettes, what are some resources I can use?
Smokers’ Helpline offers online, phone, and text cessation supports for everyone who would like to quit smoking. The 24/7, free, and confidential services are available in English and French and over 100 languages. Access by visiting https://www.smokershelpline.ca/ or by texting iQuit to 123456.
Telehealth Ontario Smoking Cessation Program:
Telehealth offers bilingual smoking cessation support from a Quit Care Coach between 10 am and 10 pm daily. Translation services are available in 300 languages. Call 1-866-797-0000.
STOP on the Net (SOTN):
An online program open to people age 18+ across Ontario. This program provides 8 weeks of treatment including nicotine patches and gum or lozenges, delivered to your address. Enroll in the STOP program.
ReferencesAddictions, Alcohol, Cannabis, & Substances