Introduction
As governments around the globe attempt to tackle the problem of tobacco use in their respective countries, new generations of tobacco products appear to replace the less available ones. The efforts to extend the tobacco market and flood it with electronic cigarettes (e-cigarettes, ECs) has already led to the emergence of a global vaping problem. Although public health policies are adapting to the changing paradigm of tobacco consumption, they seem to lag behind the fast-growing market.
Main body
The problem appears to be especially grave in the United States, where the age of starting smoking continues to shrink. E-cigarettes (that also include vapes) are defined as “battery-powered devices that provide nicotine and other additives to the user in the form of an aerosol” (Cullen et al., 2018, para 1). While e-cigarettes first entered the US market in 2007, by 2014, they became the most used tobacco product among US youth and later on boosted the spread among middle school students by five times (Cullen et al., 2018). It is widely believed by many that transitioning from smoking to vaping is a healthier alternative for adults, but it does not imply that vapes are to be utilized by adolescents.
The reasons for concern also stem from the fact that the long-term effects of vaping are understudied. Besides, it is not clear what potentially harmful substances e-cigarettes or vapes contain (“New Jersey Department of Health,” n.d.). With cases of poisoning by swallowing, absorbing, or breathing e-cigarette liquid remaining widespread and fires and explosions caused by defective devices resulting in injuries, a more balanced course of action is necessary (“New Jersey Department of Health,” n.d.). As the problem of traditional smoking appears to have found a solution, new risks for the public health system continue to emerge.
There is no consensus reached among scholars or medical practitioners on the severity of the situation, as some believe the pervasive substitution of smoking with vaping is a win for the public health sector. According to Ronald Seifer (2019), the devastating effects of tobacco have little to do with nicotine and are instead caused by the byproducts in tobacco smoke. There is no substantial research on the harmful effects of e-cigarettes byproducts, so it is only the issue of the nicotine that remains disturbing (Seifer, 2019). Thus, the behavioral change is a positive achievement that should not be disregarded or nullified by misinformation about vaping presented to teens by their parents.
Still, the supporters of the positive effect of the spread of vaping are in the minority group for now. The multiple research findings suggest that e-cigarettes’ byproducts prove to be extremely harmful to one’s health. Electronic cigarettes function by heating the nicotine-containing liquid and transforming it into the aerosol, therefore producing heat-induced degradation compounds (Hobson, Arndt, & Barenklau, 2020). These compounds “show traces of heavy metals, tobacco-specific N-nitrosamines, and diacetyl,” meaning that their negative health impact cannot be ignored (Hobson et al., 2020, p. 27). The growing evidence suggests that e-cigarettes cause pulmonary toxicity, alter airflow, and interfere with lung development (Hobson et al., 2020). The latter appears to be the most concerning in regards to adolescent users – who happen to be the most exposed to the ECs age group. The fact that e-cigarettes are flavored and have various designing options available only increases their appeal for the younger population.
Besides pulmonary effects, researchers discovered that ECs affect the cardiovascular system. It is documented that nicotine has a negative impact on the development of cardiovascular disease, so the claim that e-cigarettes are healthier than their traditional tobacco counterparts does not stand the argument (Hobson et al., 2020). The list of health-related issues goes on to the effects of embryonic development, with the evidence showing that e-cigarette smoke prevents sufficient maturation of embryo’s cardiac system (Hobson et al., 2020). Moreover, it increases the incidence of heart and lung defects, which is especially concerning for young females, who enter the age of childbearing with large-scale health problems. The existing data suggest that for New Jersey, the gap between adolescent male and female EC smokers is declining steadily, showing a 1.5% gap in 2018 (“New Jersey Department of Health,” n.d.). The negative consequences for future generations seem to be clear, but ECs remain socially acceptable with their negative health impact widely negated. Even if this situation changes over time with more statistics, the damage might be found irreversible.
Another concerning side of the issue is that nicotine influences adolescent brain development. Scientists are still in the process of figuring out the scope to which teenage brains are exposed to harmful effects of nicotine, as it is virtually impossible to measure those in a short time period (Hamilton, 2019). Thus, some conclusions are already made; for instance, nicotine exposure increases the chances of attention and memory disorders, hyperactivity, impulse control issues, drug abuse, and more (Hamilton, 2019). Besides, new products, designed with the purpose of increasing levels of nicotine delivered to the brain, are continuously flooding the market, making it impossible for the research to keep up the pace.
There are law enforcement regulations aimed at ECs distribution introduced in the state of New Jersey. For instance, smoking e-cigarettes is prohibited in the same spaces tobacco smoking is banned; besides, the sale of e-cigarettes to citizens under age 21 is illicit (E-cigarette regulations – New Jersey, n.d.). Moreover, ECs advertising is prohibited on all public transportation in the state (E-cigarette regulations – New Jersey, n.d.). Still, these measures appear insufficient for tackling the existing problem. The contribution of significant importance to solve the vaping problem was made in late January when the Governor signed the bill imposing a permanent ban on flavored vape products (Faughnan, 2020). This legislation made New Jersey the first state in the nation to prohibit vapor products, thus, advancing its efforts to put an end to the vaping epidemic.
While legislative efforts in New Jersey rank high in comparison to the national average, the reality of ECs use by adolescents is still concerning. Electronic cigarettes are more than two times more widespread among high school students than adults (Truth Initiative, 2019). Another negative aspect of the existing situation is that most often, the use of electronic cigarettes does not imply giving up smoking conventional tobacco products, on the contrary, they are combined (Hobson, Arndt, & Barenklau, 2020). Thus, the increased popularity if e-cigarettes did not help the government reach tobacco use reductions; in contrast, it benefited fast-adapting companies. They managed to create a new niche in the smoking market and increased their revenues at the expense of public health.
However, the problem is not single-faceted, as there are two sides on the spectrum of ECs use attitudes in academia and among medical workers. There is no doubt that there is not enough information about the long-term dangers of e-cigarettes. As they only entered the market in the late 2000s, the prediction of the impact they have on particular aspects of human health requires more trials and data. Still, it is already clear that the byproducts of electronic cigarettes and heat-induced degradation compounds are harmful to one’s health (Hobson et al., 2020). Besides, the impact on the brain development of adolescents is proved to be negative, as well as the fact that ECs cause pulmonary toxicity and alter airflow (Hobson et al., 2020). Nevertheless, some researchers believe that substitution of smoking with EC products is a public health sector victory of our time, stating that the devastating effects are caused primarily by the byproducts in the tobacco smoke (Seifer, 2019). While this opinion has evidential grounds, it appears to root in the fact that the impact of electronic cigarettes is understudied, so the full picture of the health implications they have is to be drawn.
Conclusion
All in all, the debate on what the pervasive popularization of ECs means for the public health sector is still heated. There are strong arguments in support of the tobacco substitution by nicotine-containing e-cigarettes, as those seem to be less harmful to human health. Nonetheless, there are even stronger arguments against it, as the full impact of e-cigarettes degradation compounds is yet to be studied. With scientists and hospital statistics having proven the adverse effects on pulmonary, reproductive, and brain development systems, the processes of legislative reinforcement taking place in New Jersey appear to be called for and objective.
References
Cullen, K. A., Ambrose, B. K., Gentzke, A. S., Apelberg, B. J., Jamal, A., & King, B. A. (2018). Use of electronic cigarettes and any tobacco product among middle and high school students – United States, 2011-2018. Morbidity and Mortality Weekly Report.
E-cigarette regulations – New Jersey (n.d.). Web.
Faughnan, S. A. (2020). Flavored vape products now banned in NJ. Web.
Hamilton, J. (2019). How vaping nicotine can affect a teenage brain. Web.
Hobson, A., Arndt, K., & Barenklau, S. (2020). Vaping: Anesthesia Considerations for Patients Using Electronic Cigarettes. American Association of Nurse Anesthetists, 88(1), 27-34.
New Jersey Department of Health. (n.d.) Web.
Seifer, R. (2019). The dramatic increase in teen vaping is the largest public health success story in our lifetime. The Brown University and Adolescent Behavior Letter.
Truth Initiative. Tobacco use in New Jersey 2019. Web.