Tar Wars – A New Hope

Tar Wars – A New Hope

Previously published in 2016

In light of a recent incidence of an exploding electronic cigarette that injured the mouth and face of a teenage boy in Alberta, I looked into what other potential dangers and possible benefits there were to these devices.

Note: this article is by no means an exhaustive look at all the pros and cons of using electronic cigarettes.  Please do your research if you are considering taking this up as a new habit.

Electronic cigarettes (e-cigarettes) are devices that produce an aerosol that is inhaled. This aerosol is sometimes referred to as a vapour, hence; using e-cigarettes has been called “vaping”.  This aerosol is a solution of diluents, flavourings and nicotine that is drawn through an atomiser, heated to 200°C and then inhaled from the device by the user.

These devices imitate traditional cigarettes but have been touted as a tool to help people quit smoking because they contain less nicotine than traditional cigarettes.

So is this really true?  

A Cochrane Collaboration Systematic review published in December 2014 concluded that: Nicotine containing e-cigarettes increased the chances of quitting long term compared to e-cigarettes without nicotine.

Using an e-cigarette with nicotine helped more smokers reduce the amount they smoked by at least half, compared to using an e-cigarette without nicotine or a nicotine patch.  It is important to note that while this study shows promising results, there were participants who did not reduce their cigarette use at all.

E-cigarettes do not produce smoke therefore the adverse effects of secondhand smoke are negligible.  Non-smokers can be exposed to the nicotine produced in the vapours but nicotine is not carcinogenic so there is very little risk to passive-vaping.

What are the potential oral health side effects?

Some of the most common reported side effects of e-cigarettes are mouth and throat dryness and irritation but it is not known which component is the culprit.  It is likely chemicals in the flavourings such as menthol and tobacco, in which case, avoiding such flavours will help reduce these symptoms.

Toxins have been found in e-cigarettes in several studies including diethylene glycol (used in anti-freeze), lead, nickel and chromium. These are found in much lower levels than in burnt tobacco smoke.  The role of diethylene glycol in causing cancers in humans (via this method of delivery) is not well known at this time.

There are also studies being undertaken to measure the harmful effects of heated carcinogens coming into close contact with the tissues of the mouth but no convincing results have been made available.  

I think you are starting to catch the general idea here – there is very little concrete scientific research showing harmful side effects of using e-cigarettes.  For now, it is up to the reader to decide whether this is from lack of quality research or if this truly is a therapeutic innovation.  

Since I published this article in 2016, I’ve noticed many vape shops opening in Edmonton.  The easy availability of e-cigarettes to everyone, including children and young adults, can be concerning because there is very little known about their long term health effects.

But they explode?!

E-cigarettes use lithium-ion batteries like the ones in cell phones.  The one difference is while cell phone chargers can be quite universal, e-cigarette chargers are not.  A lot of the cases of exploding e-cigarettes are caused by the device overheating because smokers use  incompatible chargers, overcharging the devices, or substituting in parts.  

I would advise that anything that gets heated to 200°C and put in your mouth should be treated with respect.  E-cigarette users are cautioned to follow the manufacture instructions that come with kits and stick to well-known brands of e-cigarettes.

Polosa R, Morjaria JB, Caponnetto P, et al. Effectiveness and tolerability of electronic cigarette in real-life: a 24-month prospective observational study. Intern Emerg Med Published Online First: 20 July 2013. doi:10.1007/s11739-013-0977-z

McRobbie H. E-cigarette briefing. National Center for Smoking Cessation and Training (NCSCT). 2014.

Jensen RP, Luo W, Pankow JF, et al. Hidden Formaldehyde in E-Cigarette Aerosols. New England Journal of Medicine 2015;372:392–4. doi:10.1056/NEJMc1413069