Vapers and electronic cigarettes, a new public health challenge

The age at which children first come into contact with tobacco is 10 years; with these products, it is 12 years. In addition to nicotine, their aerosols contain volatile organic compounds, heavy metals, ultrafine particles, flavorings, and dyes.

Vapers and electronic cigarettes, a new public health challenge
The new challenge for public health, vapers and electronic cigarettes. Photo by Claudia Ramírez / Unsplash

There are approximately 1.1 billion tobacco consumers in the world; in Mexico, close to 15 million adults smoke and six percent of adolescents. Every year eight million people die from this cause; one every four seconds. To this situation, we must now also add vapers and electronic cigarettes.

Ana Beatriz Moreno Coutiño and Guadalupe Ponciano Rodríguez, academics from UNAM's Schools of Psychology and Medicine, respectively, agreed that when it has not yet been possible to solve the problem of tobacco consumption, we have this new public health problem caused by tobacco companies that have not only an enormous influence but also the capacity to diversify their products.

In the remote media conference, Moreno Coutiño warned that the vape and e-cigarette campaigns have been aimed at adolescents, a vulnerable and attractive population for this market. The issue is particularly serious since, according to a survey by the National Commission against Addictions (2022), 975 thousand people in the Mexican population between 12 and 65 years of age use vapes or electronic cigarettes, and five million have used them at some time.

The expert mentioned that the age of first contact of children with tobacco is 10 years old; with electronic cigarettes, the pattern is similar and from 12 years old they start using them, which contain nicotine and other substances -such as cannabinoids-, besides being easily accessible, because they are available in street stalls, in vending machines located in shopping malls and even in food delivery platforms. In other words, they arrive at your doorstep, even though they are illegal in Mexico.

Ana Moreno also estimated that the cost is low: from 180 to 270 pesos, which allows a minor to obtain it quite easily; with the variety of flavors, sweet and perfumed smell, as well as diverse shapes, including pen or USB memory, consumers do not perceive the danger involved in its use.

The "vapor" that comes out of an e-cigarette is an aerosol containing substances such as propylene glycol and vegetable glycerin, which increase respiratory tract irritation; but also, formaldehyde, a cancer-causing substance that can be formed if the so-called e-liquid is overheated.

We are facing an unethical industry that includes new substances to know the impact they have on the market; they are chemicals that emulate the activity of cannabinoids, and those who consume them are testing chemicals that "look like", they are "guinea pigs of very cheap products that come mainly from China", she said.

A few days ago, Mexico's Federal Commission for the Protection of Public Health (COFEPRIS) issued a maximum health alert in the country, to make the problem more visible and make people more informed about these products, since "the inhalation of an excipient is frequently found in vaping devices, called vitamin E acetate, constitutes a high health risk related to acute respiratory diseases and even death".

Moreno Coutiño mentioned that emotional dysregulation is the main factor associated with "hooked vaping," that is, those who experience anxiety, depression, and stress, or lack pleasurable and stimulating activities or personal challenges, and those who have an absence of emotional support figures. Therefore, one way to prevent the problem is to engage in sports, artistic and intellectual activities, or hobbies; to have guardians present to provide accompaniment and supervision; and to serve others, among other actions.

Guadalupe Ponciano Rodríguez, attached to the FM's Department of Public Health and coordinator of the Tobacco Research and Prevention Program, said that the industry's new products are divided into electronic systems for nicotine administration (electronic cigarettes, vapes, pods); similar systems without nicotine; and alternatives for nicotine consumption, such as hybrid cigarettes.

A cigarette has one milligram of nicotine; pods up to 60 milligrams, that is, the equivalent of three packs. People do not know how much nicotine they are putting into their bodies. Meanwhile, aerosols also contain volatile organic compounds, heavy metals, ultrafine particles, flavorings, and colorants, in other words, a large number of toxic substances that are harmful to health and pollute the environment.

There is scientific evidence that electronic nicotine delivery systems affect the respiratory, cardiovascular and reproductive systems, as well as the oral cavity; they cause damage during pregnancy, such as an increased risk of congenital malformations. There are also a large number of associated tumors.

Aerosols affect all levels of the respiratory system, from the nasal and bronchial epithelium to the fundamental part which is the alveoli. Lung tissue tears, breaks, and loses its structure; "who breathes fat (vitamin E acetate) through the respiratory tract? No one would. There is also evidence that this aerosol, plus nicotine, solvents, and flavorings affect the cardiovascular system, increasing the risk of heart attack and lung tumors, among other risks, she said.

Related news: Mexico bans e-cigarette sales