Why is it so hard to quit smoking?

Is it as addictive as conventional cigarettes? Does it cause cancer? Is it capable of calming the smoker’s anxiety? Eight years after the worldwide expansion of electronic cigarettes, there are still many doubts about this new form of smoking.

1. Is it less harmful than conventional tobacco?

Experts speculate that it could produce less toxicity than conventional cigarettes, but there are no studies to prove it. The long-term effects of electronic cigarette use are not known. At high temperatures, propylene glycol decomposes and can produce propylene oxide, which is probably carcinogenic. The glycerol produces acrolein, although in less proportion than the traditional cigarette. Propylene glycol and glycerol produce carcinogens such as formaldehyde and acetaldehyde. Traces of carcinogens typical of classic tobacco have also been found, such as nitrosamines, metals, phenolic compounds, and volatile organics. The nickel levels detected are higher than those found in classic tobacco.

Electronic cigarettes that include nicotine increase heart rate and blood levels of cotinine. This varies depending on the smoker’s experience and the inhalation technique. There may be a risk of nicotine poisoning if taken orally when handling the cartridge, so it is dangerous to leave an electronic cigarette within the reach of children.

2. What effects does it have on the lungs?

Electronic cigarette causes alterations in lung function. The acute changes found in respiratory function, such as bronchoconstriction, are less than those produced by the conventional cigarette. There is some study showing that it causes asthma in children, as well as irritation in the eyes, throat, and airways. There are no long-term safety data. This new way of smoking also causes lipoid pneumonia; isolated cases have been described in large consumers, related to the deposit of glycerol in the lung.

3. Disadvantages

The main disadvantage of the electronic cigarette is that its long-term effects are not known. The effect of conventional tobacco is known: cancer, ischemic heart disease, Chronic Obstructive Pulmonary Disease (COPD), chronic bronchitis, emphysema, etc.

4. To which diseases are electronic cigarettes related?

There are no known long-term effects, mainly due to the lack of independent studies. Electronic cigars were introduced to the Chinese market in 2003 and their use has increased worldwide since 2010. In recent years, health authorities and health professionals are beginning to see its use as a real public health problem. In the short term, some cases of lipoid pneumonia have been described.

5. Consequences for a passive smoker of electronic cigarettes

It is estimated that the effect is less than that associated with a conventional cigarette. Elevations of cotinine in the blood have been detected in non-vipers exposed to electronic cigarettes. It has also been demonstrated the presence of volatile substances of 2.5 microns in diameter that can be deposited in the lungs of passive smokers of electronic cigarettes.

6. Is the electronic cigarette as addictive as the traditional one?

If they do not have nicotine, electronic cigarettes do not produce physical addiction. The risk of getting hooked depends on whether it is used to replace tobacco, to reduce tobacco use, or simply for recreational purposes by people who have never smoked. But it is important to know that electronic cigarettes can maintain the psychological addiction to nicotine.

The addiction has a physical component, of short duration, and a psychological one, longer lasting in time. The electronic cigarette makes it difficult to break the behavior with the cigarette, given the similarity with the conventional cigarette.

For the above reason, it is considered that, even if they helped to reduce physical abstinence, electronic cigarettes would limit smoking cessation. This is why many consumers chronicle their use or combine it with the traditional cigarette, making voluntary access to conventional pharmacological help difficult and with a false sense of security that they suffer less harm from consuming fewer cigarettes.

Finally, the effect on future smokers is pernicious, as it relaxes the prevention of smoking behavior and harms what has been achieved so far in anti-smoking campaigns. The electronic cigarette could increase the consumption of tobacco in young people and “normalize” the consumption of tobacco.

7. Can it be helpful to quit smoking?

Some experts believe it can, but they call for it to be considered a health product and for controlled research in this field to continue. Experts continue to advise traditional pharmacological methods. If a patient opts for the electronic cigarette, he should be informed about the state of science at this time, its efficacy, and its safety.