E-cigarette or NOT ?

E-cigarettes are high on the media agenda at the moment. I have never been a fan of smoking, so the introduction of e-cigarettes already had my alarm bells ringing. In the UK sales have soared by 340% in one year, with the industry worth rising from an estimated £44 million (2012) to £193 million (2013). It is advertised as a safer alternative to tobacco smoking, but is it really?Earlier this year my fears were realised when my patient’s ongoing ear inflammation and symptoms of pain and congestion were immediately relieved when we eliminated the use of e-cigarettes.

E-cigarette or ‘Vaping’ is the inhalation of a mixture of carrier substances; propylene glycol (an alcohol) and glycerine (produced from fats and oils), added with nicotine and flavourings through an electronic vapouriser. Scientists are still divided on its safety. One camp believes that vaping is a safer alternative to tobacco smoking, while others are sceptical of its longer-term use. The finger has been firmly pointed at the many ‘flavours’ and ‘carrier substances’ that cause physiological effects. The inhaled gaseous mixture also deposits in our lungs and undergo changes. A study found propylene glycol to cause upper airway irritation (probably what happened to my patient). Vaping also releases volatile organic compounds and (ultra) fine particles into the atmosphere therefore for the rest of us increasing the risk of passive vaping. In one case the toxic element chromium and four times more nickle was found when compared to traditional tobacco. A BBC investigation found that a VIP butterscotch flavour refill contained a chemical diacetyl which, although safe to eat is not safe for inhalation and has been linked to a serious lung condition called ‘Popcorn worker’s lung’.  A heavy smoker from Gateshead died of lipoid pneumonia after he started vaping. His doctor and wife link his death to the use of e-cigarettes.

It took a long time for us to realise the health risks of smoking tobacco. Doctors used to recommend smoking to aid the nerves. How long will it take for us to realise that e-cigarettes are not safe? The rise in popularity amongst young smokers is worrying as they are drawn towards its image as a ‘safer’ alternative to smoking, consequently making it a potentially major public health issue. One young person I spoke to considered it safe because it was ‘Just some vegetable oil and flavourings’. Somehow I never thought that regularly spraying your lungs with layers of vegetable fat was OK! There is talk of e-cigarettes undergoing stricter regulation, and for its sale to be made illegal to the under 18s, while the WHO has called for stronger scientific evidence on its safety and advised on banning its use indoors. Personally, I feel both of these cannot come soon enough as we need to establish a few facts before it is too late and lives are lost.

If we theorise that e-cigarettes are (eventually) found to be unsafe, then I guess the question is aside from nicotine patches, gums and herbal cigarettes is there a safe and effective alternative to giving up smoking. Complementary therapies such as acupuncture, hypnotherapy, yoga, meditation, relaxation and breathing techniques and  have been used by many with varying results. I have set this task for my next blog where I will explore what other types of alternatives there may be available and how effective they may be.


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