The US Food and Drug Administration (FDA) recently approved the marketing of an electronic cigarette (e-cig) brand called Vuse (RJ Reynolds Vapor Company, US) to help aid in smoking cessation for adult smokers.
It was believed that the consumption of traditional cigarettes and their harmful effects would be reduced given the availability of newer e-cigarettes.
However, adolescent use of tobacco and nicotine products rather increased with the availability of the same e-cigarettes, and the FDA-approved market boom only worsened this problem.
Although the FDA underlines the importance of marketing e-cigarettes as a possible solution for adult traditional smoking, its consequences on adolescents’ health raise many concerns, which we narrated in this review article.
Introduction & Background
Electronic cigarettes (e-cigs) have been sold legally in the United States for more than a decade, but they have remained unregulated as there has not been a clear consensus surrounding the health benefits and detrimental effects of vaping. On October 12, 2021, the US Food and Drug Administration (FDA) declared for the first time the approval of the marketing of e-cigs produced by RJ Reynolds Vapor Company, US [1]. The FDA’s main goal was that by authorizing e-cigs, addicted adult smokers would be compelled to use them, therefore reducing traditional cigarette consumption. Although this was a very optimistic approach to the ongoing increase of tobacco-based products, some researchers are skeptical about its effects. As young adults began consuming e-cigs with flavors, researchers were concerned that there would be severe health consequences with the approval. However, the FDA insisted that the marketing of e-cigs would be necessary for the protection of public and human health [1].
The first e-cigarette (e-cig) was patented in 2003 as a device to aid in smoking cessation and as an alternative for nicotine delivery [2]. E-cig use has grown exponentially since its inception, especially in North America [3]. Although e-cig vapor (the cloud of aerosols released by e-cigarettes) is said to be less toxic than conventional tobacco smoke, it still contains toxins due to its nicotine content, additional flavor additives, and metallic contaminants [4].
There is a standard method of e-cig delivery. Vapor is created in the e-cig through heating a solution utilized to produce the nicotine aerosol (also called e-liquid), which is inhaled by the user [5]. The e-liquid is housed in a cartridge, similar to a traditional cigarette filter, and contains an atomization chamber [6]. Depending on the brand or type of device carrier, the e-liquid contains compounds such as nicotine, propylene glycol (with or without glycerol), flavoring, and water [5,6]. The second part of the e-cig, analogous to the white paper wrapping of a traditional cigarette, contains the electronics, including the controller and battery. Users can alter many of the products of e-cigs, and there are engineering differences between brands (Table 1, Figure 1) [5,7-9], thereby altering the amount of nicotine and other chemicals delivered to the user. Though e-cigs have been on the market for decades, there is little information about their toxicity due to the lack of quality control [5]. The absorption of nicotine and other compounds in e-cigs occurs through the respiratory tract, similar to traditional cigarette smokers, and may have similar toxicokinetic properties [6]. Although, the data needed to confirm this assumption is not available at this time.
Mikael Mir et al. – Cureus – 2022-05-22.
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