ECigarettes The Untold Truth Presented by Mageshree Naidoo

E-Cigarettes: The Untold Truth Presented by Mageshree Naidoo Environmental Health Practitioner: City of Tshwane

Smoking an E-Cigarette

Why did I choose this topic?

Nicotine in any form is addictive

Contents • • What is an e-cigarette? History of e-cigarettes What devices are available? How does an e-cigarette work? What do e-cigarette users exhale? How to dispose of e-cigarette cartridges? What are the adverse effects? What should our response be?

What is an e-cigarette?

History of E-Cigarettes • Herbert A. Gilbert patented a “smokeless, non-tobacco cigarette” in 1963.

History (Cont…) • The invention of the modern electronic cigarette can be traced to Chinese pharmacist Hon Lik.

E-Cigarette Devices Currently Available

Components of E-Cigarettes

How does an e-cigarette work?

What do the fluids contain? Fluids may contain: • Nicotine • Humectants: propylene glycol (or vegetable glycerin) for vapour production • Water • Metal particles • Flavourings

Variety of Flavours

“Harmless” Vapour • E-cigarette fluid and vapour contains toxic metals and nanoparticles • Vapour contains tobacco-related toxins and chemicals o Formaldehyde o Acrolein o Acetaldehyde o Volatile Organic Compounds o NNN and NNK

What do e-cigarette users exhale? • • • Passive vaping. This chemical aerosol is not “just” water vapour. Studies so far show it contains: o nicotine o propylene glycol o fine & ultrafine (UF) particles o low levels of toxins known to cause cancer o nanoparticles of chromium, nickel, tin o volatile organic compounds (VOCs)

Cancer-causing Chemicals in E-Cigarette Vapour • • • Benzene Cadmium Isoprene Lead Nickel Formaldehyde Acetaldehyde Toluene N-Nitrosonornicotine Nicotine

Nicotine - a POISON! • • • Large amounts of nicotine are lethal Is also an insecticide and toxicant Increases insulin resistance Is immunosuppressive Directly stimulates pulmonary mucus secretion Cases of poisoning

How to dispose of e-cigarette cartridges? • Remove filler material • Wash it in running water • Wrap the filler in a scrap of biodegradable material before disposal • Wash the plastic cartridge under running water • Plug it with the original plug • Dispose of it as you would any other plastic waste

Exploding E-cigarettes

What are the adverse effects? • • Pneumonia Congestive heart failure Disorientation Seizure Low blood pressure Chest pain Second degree burns to face

What are the adverse effects? Cont… • • • Loss of vision Possible infant death from choking on e-cigarettes Physically ill Poisoning Gene mutations in lung cells similar to those found in smokers’ lungs. Cancer

Look Familiar?

Didn’t we already fight this battle with big tobacco companies?

The FDA Warns • • E-cigarettes can increase nicotine addiction among young people May lead children to try other tobacco products The products may contain ingredients that are known to be toxic to humans. Conducted a preliminary analysis on some samples of electronic cigarettes and components from two leading brands.

FDA 2009 Study Revealed • Diethylene glycol was detected in one cartridge at approximately 1%. • Certain tobacco-specific nitrosamines which are human carcinogens were detected in half of the samples tested. • Tobacco-specific impurities suspected of being harmful to humans. • The electronic cigarette cartridges that were labeled as containing no nicotine had low levels of nicotine present in all cartridges tested, except one.

FDA Study Cont… • Three different electronic cigarette cartridges with the same label were tested and each cartridge emitted a markedly different amount of nicotine with each puff. • The nicotine levels per puff ranged from 26. 8 to 43. 2 mcg nicotine/100 m. L puff. • One high-nicotine cartridge delivered twice as much nicotine to users when the vapour from that electronic cigarette brand was inhaled.

Further Studies • A Japanese-commissioned study revealed that the e-cigarette contains 10 times the level of carcinogens, including formaldehyde and acetaldehyde.

Statistics

Youth E-Cigarette Use Increases

Ways in which the Youth are Exposed to E-Cigarettes

Celebrity Advertising • 23 million likes on Facebook • 10 million followers on Twitter • 5 million followers on Instagram

Cons No health warnings. No instructions. Leakages from cartridges. Prolonged consumption of e-cigarettes might lead to lung disorders. • Questions about quality and safety. • •

World Health Organization • “Has banned the sale of e-cigarettes to young children and women of reproductive age, e-cigarette advertising, public indoor use, and on claims that they aid smoking cessation. ”

What should our response be? • • • Keeping the price of nicotine products high. Cigarette advertising restrictions to electronic cigarettes Restricting nicotine devices’ marketing. Restrict marketing of e-cigarettes on social networking sites. Reinforcing a tobacco/nicotine-free norm.

What should our response be? Cont… • • • Include e-cigarettes in tobacco free policies. Regulate e-cigarettes like other nicotine products. Prohibit cessation and health claims. Require manufacturers to test for safety. Nicotine free school campuses. Mass media campaigns to reduce initiation.

What should our response be? Cont… • Children’s perceptions of how many people are smoking is a major factor in whether they decide to smoke. • Prohibit the sale of e-cigarettes to people < than 18 years. • Prohibit use of e-cigarettes indoors and in workplaces. • Take notes from the US. • Stop using celebrities in advertising e-cigarettes.

Stop Celebrity Advertising

So…are you still wondering?

Now You Decide… • E-cigarettes may be less dangerous than tobacco, but given that tobacco kills 50% of its users, what would not be safer? ” Health E News

References & Acknowledgements • • • Centre for Tobacco Control Research and Education ETF Daily News Health E News SAMJ Smoking Cessation Leadership Centre The Wall Street Journal Tri- County Mental Health Services UK Centre for Tobacco Control Studies UNISA News and Media University of Washington

THANK YOU