The American Lung Association defines an electronic cigarette (aka e-cigar, JUUL or vape pen) as a device which uses a battery to heat up a ‘special liquid’ into an aerosol or vaporiser that users inhale. It is just like tobacco smoking. However, instead of a regular cigarette, an electronic device filled with ‘juice’ is used.
The ‘e-juice’ in the cartridge usually contains nicotine (which is extracted from tobacco), propylene glycol, flavouring and other chemicals.
Studies have found that e-cigarettes claiming to be nicotine-free contain trace amounts of nicotine.
According to the Centre for Diseases Control and Prevention, when the liquid heats up, more toxic chemicals are formed.
E-cigars come in different shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid.
The CDC says e-cigarettes produce an aerosol by heating a liquid that usually contains nicotine — the addictive drug in regular cigarettes, cigars, and other tobacco products — flavourings, and other chemicals that help to make the aerosol.
Users inhale this aerosol into their lungs.
Bystanders can also breathe in this aerosol when the user exhales into the air.
Some e-cigarettes are made to look like regular cigarettes, cigars, or pipes. Some resemble pens, USB sticks, and other everyday items.
Larger devices such as tank systems, or “mods,” do not resemble other tobacco products.
Using an e-cigarette is sometimes called “vaping.” E-cigarettes, over the years, have been used to deliver marijuana and other drugs.
There has been considerable argument among scientists over the dangers of electronic cigarettes for many years.
The first school of thought argues that it can be a ‘healthier’ alternative to tobacco smoking and can help to cure smoking addictions as it tastes almost like tobacco.
However, the second school avers that it is just as addictive as tobacco and should not be used as a substitute. For the second school, being a ‘healthier’ option to tobacco does not take away from the device not being totally healthy.
In Nigeria, health practitioners believe there has been a spike in the use of electronic cigarettes.
According to the Tobacco Control Laws Legislation by Country, there is no regulation in Nigeria on the sale of e-cigarettes. Therefore, the sale of e-cigar is allowed.
There is also no law addressing the use of e-cigarettes in public places, indoors, workplaces and public transport.
“There is no law addressing ingredients or additives in e-cigarettes; therefore, there are no restrictions on the use of ingredients or additives in e-cigarettes.”
“There is also no law addressing health warnings on e-cigarette product packaging; therefore, health warnings on e-cigarette packaging are not required.”
“There is no law addressing nicotine concentration levels in e-cigarettes; therefore, there is no prescribed maximum nicotine concentration.”
“There is no law addressing manufacturer/importer disclosure and/or notification requirements; therefore, no manufacturer/importer disclosure and/or notification is required,” the website stated.
Despite obvious health risks, as many health professionals confirmed that nicotine exposure can be harmful to adolescent and young adult brain development, the device is left unregulated.
The National Library of Medicine, in a publication in 2021, titled, ‘Electronic cigarette use among adolescents and young adults in Nigeria: prevalence, associated factors and patterns of use’ stressed that electronic cigars, “if used without supervision, may have damaging effects on the physical and mental health of users”.
“Therefore, there is a need to determine the patterns of use, especially among adolescents and young adults. This study aims to assess the prevalence and factors associated with electronic cigarette use, as well as the relationship between their use and anxiety among adolescents and young adults in Lagos, Nigeria,” the resource added.
An online cross-sectional study among participants aged between 15 and 35 years was carried out by a group of scientists in Nigeria in 2021.
The survey had three sections: sociodemographic information, the pattern of e-cigarette use, and a seven-item Generalised Anxiety Disorder scale.
Bivariate and multivariable logistic regression analysis was used to identify factors associated with e-cigarette use.
Older age and being male were independently associated with higher odds of e-cigarette use.
Findings suggested a higher likelihood of e-cigarette use among alcohol consumers, poly-tobacco or substance users and individuals with friends who used e-cigarettes.
“Health providers and policymakers in Nigeria might consider preventive measures aimed at young adults with the identified risk factors, as well as close monitoring of trends in e-cigarette use in the coming years,” the survey posited.
In January 2006, Nigeria became a party to the World Health Organisation Framework Convention on Tobacco Control and began developing supporting policies aligned with the FCTC articles.
Currently, the prevalence of tobacco use, according to research, is estimated at 5.6 per cent among individuals above 15 years.
“The lack of policies regulating e-cigarettes can potentially allow the tobacco industry to freely market these products, encouraging unintended effects that can be compounded by their inherent novelty, flavours, and addictive nicotine content,” the researchers added.
A review of e-cigarette products at a major online retail store in Lagos indicated the presence of second to fourth-generation devices at prices ranging from N7,500 ($16.29) to N70,000 ($151.35).
These prices suggest e-cigarettes are more expensive than combustible cigarettes (a pack -N500).
Nonetheless, they remain available and affordable for a significant proportion of the population in Lagos, especially those of middle to upper socioeconomic status.
The CDC, further raising health concerns, stated that e-cigarettes contain ‘harmful and potentially harmful substances, including nicotine, heavy metals like lead, volatile organic compounds, and cancer-causing agents’.
A health researcher, Mrs Ndube Nwachukwu, in an interview with our correspondent, said e-cigarettes were still fairly new and scientists were still learning about their long-term health effects.
However, she noted that most of the ‘chemicals’ in the cigar were ‘highly addictive’.
“Nicotine is highly addictive. It is toxic to developing fetuses. Nicotine can harm adolescent and young adult brain development, which continues into the early to mid-20s. It is a health danger for pregnant adults and their developing babies.”
“Besides nicotine, e-cigarette aerosols can contain substances that harm the body. This includes cancer-causing chemicals and tiny particles that reach deep into lungs. However, e-cigarette aerosol generally contains fewer harmful chemicals than smoke from burned tobacco products,” she added.
The CDC, corroborating Nwachukwu’s claim, also noted that e-cigarettes could cause unintended injuries.
“Defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious injuries. Most explosions happened when the e-cigarette batteries were being charged.”
“In addition, acute nicotine exposure can be toxic. Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes,” the CDC added.
An Ogun State-based internal medicine specialist, Dr Olusina Ajidahun, in an interview with our correspondent, said the risks of e-cigarettes and e-smoking were almost the same as normal smoking.
He said, “The aerosols still contain nicotine and even though e-cigarettes are less harmful than normal smoking, they’re also very harmful.”
“Aerosols contain a mixture of over 7000 chemicals and some of them are very dangerous. Some particles in these aerosols are proven to cause lung cancer. Nicotine which is also found in these devices is very addictive.”
“The only difference between e-smoking and normal smoking is that e-cigarettes contain some of these chemicals in a lesser quantity. Now, can we say they’re healthier than normal tobacco? No. A lot of people think when they’re vaping, they feel they’re not taking too much nicotine.”
“E-cigarettes are not approved for nicotine substitution and more research is ongoing with e-cigarettes. They’re equally dangerous and should not be encouraged.”
“If anyone is addicted to smoking, there are other approved methods of substitution like nicotine gums, lozenges, nicotine patches and others, not e-cigarettes.”
He also added that vaping could expose users to a series of chest infections and lung cancer.
According to him, e-cigars could affect the way the body cleared out toxins.
“There is something called mucociliary apparatus, which consists of three functional compartments — the cilia, a protective mucus layer, and an airway surface liquid layer — which work in concert to remove inhaled particles from the lung,” Ajidahun added.
E-smoking can, according to the medical practitioner, increase users’ chances of chest infections.
“In users, most especially pregnant women, nicotine is harmful to the foetus. Nicotine is also harmful to children and can irritate their eyes and lungs.”
“Age plays a huge factor and different conditions. Children, adolescents and pregnant women should do away with smoking because of their immunity and what it can expose them to.”
“I’m not sure if there’s any regulation when it comes to e-smoking devices. People order them online and they can be found in open display at stores too.”
“As a medical practitioner, I’ll not advise anyone to vape. A lot of people want to vape because they feel it’s classy and it increases their social status.”
“There’s a lot of addiction to smoking, and I’d advise anyone to see a therapist for nicotine substitution advice.”
“Also, there are smoking programmes one can check into to seek help. People do not know how bad vaping can be because currently there are still more studies on e-smoking; with time, people will know more about the side effects,” he added.
An Akwa Ibom State-based medical practitioner, Dr Uyon Robert, noted that e-cigarette was dangerous to the lungs “as aerosols are thicker molecules as compared to thinner molecules of traditional cigarettes”.
“This causes larger granules and long-term damage to the lungs as compared to traditional cigarettes whose damage can resolve with time,” he added.
@ Punch Newspaper