Vaping
Q) What is Vaping?
A) Vaping is the recreational act of inhaling and exhaling smoke generated from 'electronic (e) cigarettes'. These e-cigarettes are battery operated devices that heat and vaporize a liquid mixture containing nicotine, flavors and other chemicals to produce smoke.
Q) Why are we worried?
A) Vaping is fast catching up across the world. As e-cigarettes do not generate tar compounds that happen to be the main carcinogenic agents produced by burning tobacco, and because these devices contain nicotine - the main stimulant in tobacco products - producing the same desirable mental effects of a traditional cigarette for consumers, they are being touted as an healthy alternative by many lay people.
Q) What is the truth?
A) Nicotine is one of the most addictive substances known to us - more than alcohol, cannabis or cocaine. It is true that nicotine by itself doesn't lead to significant harmful effects on our body, but owing to its strong addiction potential and presence of high doses of it in vaping products, use of e-cigarettes often acts as a 'gateway' for trying traditional cigarettes and also to multiple drugs use. In addition, a host of short- and long-term negative health effects have been documented with the use of e-cigarettes.
Q) What are the negative health consequences of vaping and what causes them?
A) Several studies have found vaping to cause more intense inflammation of airways as compared to traditional cigarettes, leading to conditions such as constrictive bronchiolitis, asthma, lipoid pneumonias and also gene dysregulations (a precursor mechanism for cancer causation). Effects on cardiovascular system have also been consistently documented ranging from abnormal heart rhythms, rise in blood pressure, and to even clogged coronary arteries and heart attacks. These effects are due largely to the use of flavoring agents and presence of Volatile Organic Compounds (VPCs) chemicals in e-cigarettes. Also, as e-cigarettes are sold in unregulated markets in most countries, manufacturers tend to add many other chemicals to enhance the experience for consumers, making them even more harmful.
Q) Are e-cigarettes available in India?
A) Government of India banned e-cigarettes in September 2019 through 'The Prohibition of Electronic Cigarettes Act, 2019'. But as per many reports, they are still widely available at paan shops and even on e-commerce sites.
Q) What are the approved methods for smoking cessation?
A) The approved treatments for smoking cessation are: Nicotine Replacement Therapy (NRT), the use of medications such as bupropion, varenicline, clonidine, and Cognitive Behavioral Therapy (CBT).
In NRT, a controlled dose of nicotine is delivered via transdermal patches, chewing gums, lozenges, or nasal sprays, usually over a period of 12 weeks, to wean off from addiction. NRT is a well-studied and effective therapy with minimal side effects. Successful quit rates range from 50 to 70%. Medications can be used as stand alone in selected patients, or as additive treatment with NRT.
CBT is a structured program offered by psychologists that aims at correcting habit forming thought patterns and any underlying anxiety or depressive disorders leading to addictions. CBT also helps in dealing with any withdrawal symptoms and is integrated into most smoking cessation programs for aiding in successful quitting.
Q) Are herbal cigarettes approved for smoking cessation?
A) There is no evidence supporting the use of herbal cigarettes as smoking cessation therapies. On the contrary, even herbal cigarettes have been shown to generate tar compounds on burning, and are best avoided.
References:
1. https://www.who.int/news-room/questions-and-answers/item/tobacco-e-cigarettes
2. The global prevalence of E-cigarettes in youth: A comprehensive systematic review and meta-analysis. https://doi.org/10.1016/j.puhip.2024.100506
3. Hamann SL, Kungskulniti N, Charoenca N, Kasemsup V, Ruangkanchanasetr S, Jongkhajornpong P. Electronic Cigarette Harms: Aggregate Evidence Shows Damage to Biological Systems. Int J Environ Res Public Health. 2023 Sep 22;20(19):6808. doi: 10.3390/ijerph20196808. PMID: 37835078; PMCID: PMC10572885.https://doi.org/10.3390/ijerph20196808
6. Tobacco Addiction. https://www.nejm.org/doi/pdf/10.1056/NEJMcp2032393
7. Agnihotri, Archna1,; Sood, Poonam2; Kaur, Antervir3. Herbal Smoke: Next Hurricane on Horizon. Indian Journal of Public Health 65(1):p 76-81, Jan–Mar 2021. | DOI: 10.4103/ijph.IJPH_707_20
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