Typically e-cigarettes have three integrated components:
- a reservoir or cartridge containing solution,
- a heating element (atomizer) which vaporizes the solution, and
- a battery (at varying sizes and capacities)
When activated, the heating element produces a vapor from a solution containing the humectant carrier (e.g., vegetable glycerine), nicotine, flavorings, and other ingredients.
HEALTH & SAFETY
- Nicotine is derived from tobacco and has psychoactive and physiological effects. Nicotine can be harmful to those with cardiovascular diseases and diabetes or other chronic medical illnesses. Nicotine is a potent poison when mishandled, ingested or absorbed through the skin. It is known to cause birth defects during pregnancy and affects the developing brain so should not be used by youth.
- Nicotine is an addictive substance, but its level of addictiveness can vary depending on its mode of delivery. For example, in cigarettes, nicotine is highly addictive. On the other hand, FDA-approved NRTs are minimally addictive and can be used long term. Studies suggest that the current generation of e-cigarettes on the market are less addictive than combustible cigarettes and closer in profile to NRTs. [9,57]
- User experience and e-cigarette product selection may influence nicotine delivery from e-cigarettes. Several studies indicate that e-cigarettes, under certain conditions, can deliver nicotine reliably and effectively.[5,58-64] Some e-cigarette brands may yield little or minimal nicotine delivery due to design and/or mislabeling of the nicotine amount.[3,8,10,65] Some e-cigarette solutions and vapors contain nicotine doses that are not consistent with manufacturer specifications.[9-11,65-67]
- Health effects associated with exposure to e-cigarette vapor are not fully studied, but available data suggest that e-cigarette vapor is less harmful than cigarette smoke.[68-72] However, e-cigarette vapor is not water vapor.
- E-cigarettes and e-liquid vary in quality and vapor constituents.
- In contrast to combustible products, existing studies of e-cigarettes report that e-cigarette vapor produces no carbon monoxide and fewer chemicals.[64,69,73] The chemicals that are present are at lower levels of toxicity than in smoke from combustible tobacco products like cigarettes, cigars, pipes, or hookah.
- Potentially harmful constituents have been identified (typically 1-3 orders of magnitude lower than in cigarettes) in some e-cigarette liquid and vapor, including nitrosamines, heavy metals, and carbonyls. [57,64,65,68,69,72,74,75]
- Some e-cigarettes/e-liquid contain propylene glycol, which has not been studied for long-term safety via inhalation.[57,64,65]
- Mainstream vapor from e-cigarettes contains measurable levels of nicotine. Some studies also show that e-cigarette vapor when exhaled by the user emits low levels of nicotine and particulate matter into the air. [64,69,70,72] There is concern with exposing bystanders, including youth and pregnant women, to nicotine in the air, even at low levels.
- Studies demonstrate e-cigarettes do not produce the same acute adverse health effects observed with conventional cigarette smoking (e.g. eye, nose, and throat irritation, coughing and bronchitis, inflammation of tissues in the mouth, nose, and throat, bronchitis, increased heart rate and blood pressure).[5,76]
- Common adverse effects associated with e-cigarette use include minor complaints or irritation relating to the mouth, eyes, and upper respiratory system.
- Nicotine is a potent poison and can cause death if not properly stored and handled. Small ingestions could be deadly. With an estimated median lethal dose between 1 and 13 mg per kilogram of body weight, 1 teaspoon (5 ml) of a 1.8% nicotine solution could be lethal to a 90-kg person.
- The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014. More than half of these calls involved young children 5 years old and under. A serious poisoning of a 10 month old infant occurred.80
- Poisoning related to the nicotine in e-cigarette liquid can occur by ingestion, inhalation, or absorption through the skin or eyes. The most common adverse health effects mentioned in e-cigarette calls were vomiting, nausea, and eye irritation.
Legacy – Tobacco Fact Sheet http://www.legacyforhealth.org/content/download/582/6926/version/6/file/LEG-FactSheet-Topical-E-Cigarettes-May2014.pdf
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