The world is always fascinated by new discovery and novelty. One such item is the electronic cigarettes. Since medical science has shown that there are around 4000 (not 400) toxic agents in cigarettes and proven beyond reasonable doubt that cigarette smoking ravages the human body, maims, and kills, researchers and resourceful venture capitalists tried to find a “healthier” alternative to smoking tobacco. Hence, electronic cigarette, or “e-cig,” appeared from behind a smoke screen.

But are people jumping out of a frying pan on to the fire when they quit smoking real cigarettes and switch to smoking electronic cigarettes, the so-called “miracle cigarette?

Here are some facts about tobacco and its use:

New research revealed that tobacco smoke causes genetic damage within minutes of inhalation of cigarette smoke, not years. The adverse effects are almost instantaneous as the smoke gets into the lungs. This new finding corrects the old notion that smoking took years to initiate damages to the body.

According to the study in Chemical Research in Toxicology there are toxic chemicals in tobacco that cause damage in DNA linked to cancer development among smokers. Lung cancer due to smoking kills more than 3,000 lives every single day around the world. There are almost 20 other cancers caused by tobacco use.

Secondhand smoke (involuntary or passive smoking) has been found to cause physical and mental aberrations among children. There are about 4000 toxic chemical agents in cigarettes. These helpless victims of parents or family members who smoke can suffer recurrent respiratory tract infections and psychological disturbances as they are regularly inhale secondhand smoke in their environment.

Children exposed to the toxic substances from secondhand smoke are more prone to develop hyperactivity, bad behavior (conduct disorder), and other mental health disorders.

At least 250 Filipinos die each day, yes, each day, or about 90,000 a year, from smoking-related illnesses, cardiovascular, pulmonary, metabolic diseases, and cancers, especially lung cancers. In Malaysia about 10,000, and Vietnam at least 40,000, die annually from tobacco-related conditions. Indonesia’s death toll is the worst: 400,000 a year.

The official global tobacco youth survey has revealed that the “smoking prevalence among Filipino youth had jumped from 15 percent in 2003 to 21.6 percent in 2007,” and extrapolated to go even higher.

Use of tobacco is a form of slow-suicide. The damages to the DNA among smokers lead to cardiopulmonary diseases, like high blood pressure, heart, attack, stroke, and increase the risks for diabetes, Alzheimer’s, and many forms of cancer.

Who invented e-cigarette?

Herbert Gilbert patented in 1963 “a smokeless non-tobacco cigarette”. His device worked by “replacing burning tobacco and paper with heated, moist, flavored air.” It failed commercially and the fume died out. Then, in 2003 a Chinese pharmacist, Hon Lik, patented the first nicotine-based e-cig, which today is an internationally successful venture.

How does it work?

Rechargeable lithium battery powers the e-cig, and it does not need a match. Inside the stick is a miniature electronic devise and an atomizer (which vaporizes the liquid nicotine and turning it into an aerosol mist, with a filter. Taking a puff triggers it. It also provides a sense of nicotine high as in smoking regular cigarette. The vapor even looks like the regular smoke.

Are there toxic chemicals in e-cig?

While e-cig does not contain harmful tar, it contains other dangerous agent like acrolein, formaldehyde, and diethylene glycol, a toxic chemical used in anti-freeze. The investigation is ongoing. The secondhand vapors from e-cig could also be as bad and dangerous as regular secondhand smoke. There are countries where the sales and marketing of e-cig are banned. Starting in 2010, the US FDA has issued a number of warning letters about this.

How popular is e-cig?

Groping for a healthier substitute, the ignorant and gullible smokers have welcomed the e-cig with “open mouth and lungs.” Gorbes.com has reported that the manufacturers were making between $250 million to half a billion dollars annually, a small portion of the $100 billion US tobacco market. About 2.7 percent of the US adults had tried e-cig by 2010, an increase from the 0.6 a year before, a hint of the trend this booming business. About 700,000 Americans have shifted to e-cig. There are about 150 brands of electronic cigarettes.

What are the claims about e-cig?

Creators, manufacturers, promoters claim that e-cig is a “healthier and cheaper” alternative to the use regular cigarettes. Here are the others: No tar, tobacco, carbon monoxide, or ash; average consumer can expect to save over $1,000 each year; smokers  won’t “smell” like a smoker any longer; different flavors are available and no more second-hand smoke, no cancer from its use.  These are huge claims!

While the less essential claims could be true, the facts are now becoming evident that e-cigarettes are as harmful, if not more than smoking cigarettes. Then there is the misconception that it is a healthier option, which is not true but which encourages smokers to use it more  often because of the confidence factor. Cheaper, yes; healthier and not as deadly, no. And this includes its harmful secondhand effects to people around the smoker of e-cig.

The September issue of the French magazine ’60 Million Consumers’ stated that electronic cigarettes may be as harmful as normal tobacco, and its 10 studies showed that these e-cigs “may emit potentially carcinogenic compounds.” In 3 models, “the levels of the carcinogenic compound formaldehyde come close to those of a conventional cigarette. They also contained potentially toxic molecules and metals.”

The US attorney general from 41 states “urged the Food and Drug Administration this week to promptly issue promised regulations that would govern the sale of electronic cigarettes— including sales to minors—as concerns about the products mount among health officials.”

Any possible useful role for e-cig?

It is my opinion that since e-cig is here, let’s put it to good use. I propose the idea that electronic cigarettes could be use as a “bridge” to quitting smoking. For one thing, it is cheaper, and so far, science has found bout half  dozen toxic agents in e-cig compared to about 4000 in regular cigarettes. But the caveat and goal must be “only as a bridge to permanent smoke cessation, within the shortest possible time.”

What could happen to those using e-cigs?

If the smokers of electronic cigarettes continue using them, they may experience the same medical fate as regular cigarette smokers, and the adverse effects of the secondhand “e-vapor” might be evident then. There are even suspicions that the harmful effects of e-cig might even be worse. Only time will tell.

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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]

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