A pulmonologist explains the differences between e-cigarettes, vapes, and pod systems, and the potential harm they cause.

Contents:

• Where did the idea come from that electronic cigarettes are less dangerous
• How electronic cigarettes affect the body
• Why electronic cigarettes became popular and what did this lead to
• What is EVALI
• What is included in liquids for vaping systems
• The first symptoms of developing lesions in the body

Where did the idea that e-cigarettes are less dangerous come from?

Smoking is considered one of the most serious threats to health. The World Health Organization reports that almost 50% of smokers die due to the consequences of this harmful habit. Every year, 1.7 million people die from smoking-related diseases, even without being smokers, but only from exposure to secondhand smoke. This underscores the importance of combating smoking and protecting the health of both smokers and those around them.

Alternative smoking devices, such as e-cigarettes and heated tobacco systems, began to appear in Russia and European countries around 2008. These devices work by heating tobacco or a special liquid, which eliminates the combustion process. Manufacturers of such devices claim that their use is associated with fewer health risks compared to traditional cigarettes. However, it is important to remember that despite the potential benefits, these alternatives may also have their own risks and health consequences.

Despite their relatively recent popularity, e-cigarettes are raising serious concerns in the medical community. The World Health Organization (WHO) warns that these devices may be harmful to the lungs, although the data on them is not yet as extensive as on traditional tobacco. E-cigarettes contain nicotine, which is addictive, and there is also a risk that their use may lead to switching to regular cigarettes. Research is ongoing, and it is important to consider the potential risks associated with e-cigarette use.

According to VTsIOM, since the introduction of the anti-tobacco law in Russia 10 years ago, which bans cigarette advertising and smoking in public places, the number of smokers in Russia has decreased by 11%. At the same time, the popularity of electronic devices is growing: in 2023, one in six smokers preferred them. Interestingly, survey results show that many people do not give up traditional cigarettes completely, but use electronic devices as a supplement. This highlights the changing habits of smokers and the need for further study of the impact of anti-smoking measures on smoking choice.

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Stroke is an acute disturbance of blood flow to the brain that can lead to serious consequences, including disability and even death. There are two main types of stroke: ischemic, caused by a blood clot that blocks blood flow, and hemorrhagic, caused by a ruptured blood vessel and bleeding in the brain.

Stroke can be recognized by several key symptoms. These include sudden weakness or numbness in the face, arm, or leg, especially on one side of the body. Speech problems are common: the person may slur their speech or be unable to pronounce words. Also note any sudden deterioration in vision, dizziness, and loss of coordination. If you notice these symptoms in yourself or a loved one, you should seek medical attention immediately.

Recognizing a stroke early and calling an ambulance can significantly increase the chances of a successful recovery and minimize the consequences. Educating the public about the main signs of stroke is an important step in preventing and treating this dangerous condition.

How e-cigarettes affect the body

E-cigarette users do not inhale burnt tars, as these devices do not burn, but rather heat. However, e-cigarettes contain the same amounts of nicotine as traditional tobacco products. Doctors strongly recommend not to neglect the harm associated with nicotine consumption, as it can negatively affect health.

• inflammatory reactions in the lungs;
• irritation of the alveoli and exacerbation of asthma;
• increased resistance to antibiotics of some bacteria, such as Staphylococcus aureus, which can be acquired through airborne droplets;
• decreased immunity and, accordingly, increased susceptibility to viruses;
• narrowing of the arteries, which can lead to a heart attack;
• changes in the prefrontal cortex of the brain and, as a result, problems with cognitive functions - this is especially dangerous in childhood and adolescence, because these changes are irreversible [6];
• effect on the hormonal system, which is also especially dangerous for children and adolescents, mental problems and addiction.

Smoking leads to many negative consequences, including poor health and an increased risk of serious diseases. The main consequences of smoking include cardiovascular disease, lung disease, cancer of various localizations, and decreased immunity. Smoking also negatively affects the condition of the skin, teeth, and overall appearance. In addition, smokers are more likely to experience problems with reproductive function and an increased risk of complications during pregnancy. It is important to remember that quitting smoking can significantly improve the quality of life and reduce health risks.

• chronic obstructive pulmonary disease (COPD);
• lung cancer, mucous membranes of the upper respiratory tract or oral cavity;
• progressive atherosclerosis, leading to amputation of the lower limbs, strokes, and heart attacks.

Patients suffering from chronic obstructive pulmonary disease (COPD) often say: "There is no point in quitting smoking, the disease cannot be cured anyway." However, it is important to think about the quality of life. Smoking leads to a slow and painful death, accompanied by shortness of breath, as our lungs are designed for clean air. While animals instinctively avoid smoke, humans, on the contrary, voluntarily inhale it, causing harm to themselves. Quitting smoking can significantly improve quality of life and slow the progression of the disease.

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Scientists have not yet conducted long-term studies on the harm of electronic devices, as they are relatively new. Experts can only speculate about the health impact of these devices over years of use, based on limited data. For example, research suggests that regular e-cigarette use can cause acute lung and airway inflammation, emphysema, DNA damage, and cell death. These findings highlight the need for further research to better understand the long-term health effects of e-cigarette use.

Why E-Cigarettes Have Become Popular and What Have They Led to

With the advent of e-cigarette systems, doctors believed that switching from traditional cigarettes to e-cigarettes could be the first step toward quitting smoking. This belief has contributed to the popularity of e-cigarettes and other similar devices. Research shows that many smokers view e-cigarettes as an alternative that can help reduce the harm associated with smoking. However, it is important to remember that e-cigarettes are not completely safe and may contain nicotine and other harmful substances.

Over time, two alarming trends have become noticeable:

• smokers still return to regular cigarettes;
• the main consumers of e-cigarettes have become young people who had not smoked before.

In 2014, 8.8% of e-cigarette users reported that they first tried them before the age of 14, and by 2018, this figure had increased to 28.6%. Smoking during adolescence is especially dangerous, since the human bronchopulmonary system is formed before the age of 17. Starting to smoke at 10-12 years old can lead to serious and irreversible health consequences.

Studies of the effects of e-cigarette smoking on adolescents show that young people experience bronchial constriction, inflammation, and decreased respiratory function, similar to those associated with traditional smoking. These changes can lead to chronic obstructive pulmonary disease (COPD), which is untreatable. Even if a young person decides to quit smoking, the level of lung obstruction remains the same. It is important to note that in adult smokers, the disease develops over 15-20 years, while in young people this process occurs much faster.

What is EVALI

By 2020, the US Centers for Disease Control and Prevention had registered more than 2,500 cases of acute lung injury in severe forms associated with e-cigarette smoking and vaping. As a result, the term EVALI was coined - e-cigarette and vaping-associated lung injury. This disease is also known as vaper's disease. EVALI causes serious health concerns and requires attention from both healthcare professionals and e-cigarette users.

Diagnosing EVALI is a complex task, since comprehensive tests have not yet been developed. Symptoms of EVALI are similar to those of other pathologies, such as bacterial and bilateral pneumonia, cardiovascular and oncological diseases. The main symptoms include fever, sudden weight loss, lack of oxygen, shortness of breath, chest pain, tachycardia, gastrointestinal lesions and inflammatory processes. Currently, there is no single treatment protocol for EVALI, which complicates the therapy and care of patients with this disease.

What is included in liquids for vaping systems?

Vapes, or vaping systems, do not contain tobacco and are often devoid of nicotine. Some users claim that vape liquids are beneficial due to the vitamins they contain. However, these liquids actually contain a vitamin-like substance, namely vitamin E acetate. Research has linked this component to the development of EVALI, a condition that can lead to severe inflammation in the lungs and even necrosis. It's important to understand that despite marketing claims of safety, vaping can pose health risks and should be approached with caution. Vapes are used primarily for flavor and visual effect. Smoking them is not prohibited in some public places, which means smokers often don't realize how much time they spend with the device. It's important to note that vaping produces an aerosol containing harmful components. This product contains no beneficial substances. Vape liquids contain two main components: propylene glycol and vegetable glycerin. These substances are responsible for the formation of a thick cloud of vapor, making vaping popular among young people. Propylene glycol has excellent vapor production and flavor properties, while vegetable glycerin provides a thicker texture and sweetness. The combination of these ingredients creates a unique experience, attracting more and more vapers.

Propylene glycol negatively impacts the cells of the small respiratory tract. When heated, glycerin reacts with propylene glycol to release formaldehyde, a Group I carcinogen. Increasing glycerin concentrations leads to increased formation of toxic substances, which poses a serious health risk.

Vape liquids contain medium-chain triglycerides, which are esters of glycerol and fatty acids. According to preliminary studies, these components may have a toxic effect on the body. Flavorings added for flavor can increase inflammation, release harmful substances, and, when evaporated, form free radicals that damage cells. These factors highlight the importance of understanding the potential risks associated with vaping and its health impacts.

In 2014, a study conducted in Germany analyzed the composition of 28 e-liquids from seven manufacturers of electronic systems and vapes. The study found ethylene glycol in all samples, which, compared to traditionally used glycerin and propylene glycol, has a higher toxic load. Additionally, other potentially hazardous substances were found in a number of e-liquids and aerosols.

• heavy metals (lead, arsenic, chromium), as well as tin, nickel, manganese;
• nitrosamines, carbonyl compounds, metals, volatile organic compounds and phenolic compounds;
• cannabinoid oils;
• coumarin and acetamide, which are hazardous to health;
• in some samples, the same levels of formaldehyde were released in the last third of smoking as in regular cigarettes - it affects the central nervous system.

Other studies conducted in vaping systems found 31 harmful chemical compounds. Among them is acrolein, which irritates the mucous membranes of the eyes. Acrolein is used in the production of acrylic paints and was also used as a poison gas during World War I. Various vaping systems include mini-hookahs, mechanical mods, box mods, and the popular pod systems. Pod systems, or simply pods, are compact e-cigarettes with a cartridge that use salt nicotine. This type of nicotine is combined with synthetic acids, providing rapid satisfaction for nicotine addiction. Unlike other systems, pods do not create large clouds of vapor; their primary purpose is to satisfy nicotine cravings. However, due to their compact size and variety of flavors, users often consume larger amounts of nicotine, which can contribute to greater addiction compared to traditional smoking.

First Symptoms of Developing Damage to the Body

When vaping electronic devices, just like traditional cigarettes, a person can experience a variety of sensations. These feelings can range from relaxation and pleasure to mild dizziness and dry mouth. It's important to note that individual reactions to vaping may vary depending on the liquid composition, the wattage of the device, and the overall health of the smoker. Some users report an improvement in mood, while others may experience unpleasant symptoms. It is important to understand that vaping can also carry certain health risks, and everyone should carefully approach the selection and use of e-cigarettes. Headaches, dizziness, dry mouth, salivation, and tearfulness. The body's initial reaction to the toxins and chemical components of the aerosol may manifest as a cough. Regular exposure to these substances can lead to chronic diseases. Smokers often become accustomed to coughing and ignore it for many years. However, this symptom may indicate bronchitis or inflammatory processes in the upper and lower respiratory tract, which can become chronic. It's important to recognize that ignoring these signs can lead to serious health consequences.

Constant inflammation of the bronchi leads to their narrowing and the development of shortness of breath, which significantly limits daily activities and reduces quality of life. Simple tasks such as walking and dressing become difficult, and the ability to travel is also reduced. Airway health requires attention to prevent further complications and improve quality of life.

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