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Madrid, May 27, 2021- On the occasion of World No Tobacco Day, Dr. Allan Sam, head of the Pulmonology Service at MD Anderson Cancer Center Madrid, states that "the use of electronic cigarettes as a means by which to stop smoking is a mistake with serious consequences for one’s health” and points out that most vaping devices contain more nicotine than normal tobacco, thus generating more addiction and dependence when users try to stop.

"They are not a solution and the long-term effects they have on one’s health are not yet known," says the specialist, who acknowledges that electronic cigarettes were originally invented as an aid to stop smoking. "They came into being as a substitute that simulated smoking again, but by adding a higher nicotine load than normal cigarettes, they are actually more addictive," he warns. These e-cigarettes are also known as vapers, as they produce a water vapor that is reminiscent of traditional tobacco smoke.

In accordance with the National Plan on Drugs of the Ministry of Health, Consumer Affairs and Social Welfare, “electronic cigarettes, denominated as Electronic Nicotine Delivery Systems (ENDS) (Law 28/2005 and Royal Decree 579/2017), are included in the category of products related to tobacco. Carcinogenic substances have been found in e-cigarette liquids and vapor, so the health risks associated with the use or exposure to vapor cannot be excluded ”1. For these reasons, the Ministry of Health does not recommend the use of electronic cigarettes as a strategy to stop smoking.

Dr. Sam points out that the problem with tobacco lies in the addiction caused by nicotine. "Nicotine is a stimulant (it is not one of the substances associated with the combustion of tobacco which are carcinogenic). Tobacco is considered a drug because it causes withdrawal syndrome and that is directly related to nicotine. Because it is addictive, smokers cannot stop consuming tobacco”. “Closed system vapers, which are approved mainly in Europe, come with sealed cartridges and have higher concentrations of nicotine, therefore causing more addiction than the traditional cigarette. The higher the nicotine load, the greater the dependence created”.

The specialist also warns that vaping has become fashionable among the adolescent population and there are rates of smoking or vaping that are almost comparable to smoking rates at an early age, especially between 16 and 20 years of age. In Spain, practically half of students aged 14 to 18 have used electronic cigarettes at some point (48.4%), with more boys using vapers than girls, regardless of age. This proportion shows that the use of vapers has more than doubled in two years2.

"The proliferation of vaping on social networks at the hands of youth influencers, in addition to the attractive flavors added to this type of products, are partly responsible for this increase among young users," says the specialist. In fact, in Europe such devices are already beginning to be regulated, and flavors have been banned in closed, or sealed vapers, although they are allowed in devices with refillable containers, or pods.

Serious health effects and greater concern during the pandemic

The long-term effects on the health are unknown. "However, the fact that the mixture used to generate this water vapor contains formaldehyde, a carcinogen, leads us to think that long-term vaping may cause cancer of some kind, oropharyngeal or even lung", says Dr. Sam.

Furthermore, some studies have already detected health issues for users. "In tissue samples obtained from certain vapers, non-cancerous changes such as dysplasia (the presence of abnormal cells) are observed throughout the respiratory system and, in some cases, quite serious lung diseases in young people who are frequent users of vapers, even requiring lung transplants in those who mixed cannabis oil with their regular vape”, warns Dr. Sam.

According to the ‘Report on electronic cigarettes: current situation, available evidence and regulation (2020)’ of the Ministry of Health, Consumer Affairs and Social Welfare, in the short term, adverse physiological effects have been found in the respiratory tract similar to those associated with tobacco smoke and carcinogens have been found in e-cigarette fluids and emissions2.

The advice of MD Anderson Madrid pulmonologist, Dr. Sam, is clear: “Do not smoke, do not vape and do not heat tobacco. Vaping can never be a substitute. Just heating glycerin and forming formaldehyde causes substances that are not benign to enter the body and which, in the long term, are most likely going to cause very serious problems".

Regarding the risk of contagion by COVID-19 with these devices, as it is an aerosol and vaporizer, the rate of virus that a person can exhale in the vapor produced by the vaper, and that may be inhaled by the people around the user, is higher than for normal exhalation. The 2020 report of the Ministry of Health, Consumer Affairs and Social Welfare on Electronic Cigarettes2 states that “the consumption of electronic cigarettes is related to inflammation of the respiratory tract and, therefore, complicates the prognosis of any disease with symptoms related to the respiratory system, as is COVID-19”.

1 Plan Nacional Sobre Drogas: Consultado el 11/05/2021

2 Informe sobre los cigarrillos electrónicos: situación actual, evidencia disponible y regulación. Ministerio de Sanidad, Consumo y Bienestar Social  (2020). consultado el 11/05/2021