Public Health Implications of E-Cigarettes

Vaping and e-cigarettes are threatening to set back advances made on reducing the consumption of nicotine, warns WHO. Policy makers are already responding the threat with regulations and prohibition of such devices.

Unlike popular belief, vaping does have numerous health consequences as its popularity comes from the high amount of nicotine available in vaping liquids, coupled with the added flavors they contain. Electronic nicotine delivery systems are battery-operated devices used to generate an aerosol that when inhaled simulates the effects of a regular cigarette. Vaping liquids typically contain nicotine, flavorings and other chemicals often present in conventional cigarettes. Depending on the brand, the vapor produced by e-cigarettes may contain toxic substances and cancerogenic compounds such as acrylaldehyde, formaldehyde, acetone and other carbonyls in lesser or equal magnitude to cigarette smoke, warns WHO. The vapor also carries ultrafine particles that can affect health.

Nicotine is highly addictive. Exposure to nicotine in children and adolescents can have long-lasting, damaging effects on brain development and there is risk of nicotine addiction. A CDC study found that 99 percent of the e-cigarettes sold in the US contain nicotine but most of them do not disclose it. And while the health effects of nicotine are widely known, according to NCBI, much remains unknown about the specific health effects of nicotine when delivered as an aerosol in comparison to combusted smoke. Moreover, NCBI explains that many of the flavoring constituents have been thoroughly evaluated for safety when included in food, but their effects when they enter the bloodstream through the lungs are less well known. Similarly, much remains unknown about the effects of inhaling aerosolized humectants.

E-cigarettes are widely used by teenagers and young adults. In Mexico, 938,000 teenagers had tried an e-cigarette and 160,000 use them regularly, according to the Ministry of Health.

Public Health Implications

The prevalence of e-cigarettes is becoming a public health problem. In 2019, US News reported that there had been over 2,050 confirmed and probable cases of severe lung disease and 39 deaths the US, some of the patients were in their teens. During this same period, former US President Donald Trump announced plans to ban flavored vaping products in an effort to stem this growing problem.

In Mexico, the Ministry of Health has recognized vaping and e-cigarette smoking as a public health concern. Consequently, the government released a presidential decree prohibiting the import of such devices to “comply with the international commitments and the fundamental right to the protection of the health of every person, provided for in the fourth article of the Constitution, and to prevent irreversible damage to the population, particularly young people.”

Moreover, the commercialization of electronic cigarettes has been prohibited in Mexico since May 2008, however, COFEPRIS stated that "a harmonization was required in the regulatory framework in order to prevent illegal trade practices from being carried out," therefore, the import ban. Despite of these efforts, several online and retail shops still sell these products.