E-cigarettes are a relatively newer tobacco product that has penetrated the US markets in the last decade.  In January 2018, after reviewing over 800 studies on e-cigarettes, the National Academies of Science, Engineering and Medicine concluded that using e-cigarettes causes health risks and that e-cigarettes emit several potentially toxic substances, including formaldehyde, acrolein and acetaldehyde which cause lung disease and heart disease. Acrolein is an herbicide used to kill weeds and can cause acute lung injury, COPD, asthma and even lung cancer.  They also concluded that youth using e-cigarettes are at increased risk for cough, wheezing and asthma exacerbations.  

According to the US Surgeon General, besides nicotine, e-cigarettes contain harmful ingredients including ultrafine particles that can be inhaled deep into the lungs, volatile organic compounds and heavy metals, such as nickel, tin and lead.  The two primary ingredients found in e-cigarettes, propylene glycol and vegetable glycerin, are toxic to cells. 

According to the American Cancer Society, the chemicals found in e-cigarette flavouring, including diacetyl and acetoin, have been linked to a serious lung disease called bronchiolitis obliterans, also known as popcorn lungs.  A study showed that the e-liquid found in vapes was cytotoxic to human pulmonary fibroblasts, lung epithelial cells and embryonic stem cells.  Cell cultures treated with e-cigarette liquids showed increased levels of oxidative stress, increased DNA damage, reduced cell proliferation and overall increased carcinogenic risk.

The secondhand smoke associated with e-cigarettes is also very toxic.  In 2016, the Surgeon General reported that the second-hand emissions from e-cigarettes contains “nicotine, ultrafine particles, flavours (such as diacetyl, a chemical linked to serious lung disease), volatile organic compounds (such as benzene which is found in car exhaust), and heavy metals such as nickel, tin and lead.”  Volatile organic compounds (VOCs) have been shown to cause eye, nose and throat irritation, headaches, nausea and can even damage the liver and kidneys.

• Avoid smoking and, if smoking, consider quitting (refer to smoking cessation options).

• Distance yourself from secondhand smoke.

• If you are a former e-cigarette smoker, consider supporting your respiratory and cardiovascular systems in addition to supporting the detoxification of the heavy metals from cigarette smoke.

• Avoid moving into homes that were smoked inside. 

• Educate others on dangers of smoking.