California Department of Public Health Releases e-Cigarette Advisory

The director of the California Department of Public Health (CDPH) has released a Health Advisory report on the toxicity of electronic cigarettes (e-cigarettes). Dr. Ron Chapman warns that e-cigarettes are just as addictive as regular cigarettes and contain many harmful chemicals. Although many of the warnings are directed toward discouraging teens and young adults from using e-cigarettes and ensuring children are not given access to them, he also encourages adults to consider the ill effects and discontinue the use of all cigarettes.

How they Work

E-cigarettes contain a battery, some of which can even be charged with a USB cord connected to a computer. An atomizer is usually activated by taking a drag off of the e-cigarette, which heats the liquid containing nicotine and other chemicals in a cartridge, and the heated liquid forms an aerosol (or vapor, hence the term “vaping” instead of smoking) that is inhaled. The device produces a cloud of scented vapor. Options for flavored cartridges range from mint, to fruity, to tobacco.

The types of e-cigarettes vary. Disposable models are designed as a single unit to be discarded when the juice is used or the battery dies. Other models have removable cartridges and rechargeable batteries, and an atomizer triggered by a button. The earlier devices were designed to look like traditional cigarettes, but newer models differ in appearance and users have more control over the types of batteries and materials in the device.

Health Concerns

The California Health Advisory addresses several health concerns. Although e-cigarettes are considered to emit lower levels of carcinogens than traditional cigarettes, the aerosol still contains ten or more chemicals that California considers dangerous due to a risk of cancer, birth defects, or other reproductive issues. Secondhand aerosol contains a level of nicotine comparable to traditional secondhand smoke.

Although e-cigarettes do not contain tobacco, Dr. Chapman warns of the harms of nicotine, particularly to maternal and fetal health during pregnancy. Using an e-cigarette seems quite different from traditional smoking, but the Health Advisory cites studies that have shown that using these nicotine-containing devices for five minutes causes similar irritation and inflammation on lungs and blood vessels.

Children and Teens

The California Department of Public Health is particularly concerned about the effects of e-cigarettes on children and young adults. Since available flavors include bubble gum and chocolate, children may be drawn to the liquids in e-cigarettes. Cartridges and bottles of liquid are generally not child safe, and the liquid is potentially lethal if ingested by a child. In California in 2012, the Poison Control Center received seven calls related to children five and under exposed to e-cigarette liquid. That number increased to 154 calls in 2014. Children are not the only ones to inappropriately use e-cigarette liquid, as total calls for all ages in 2014 neared 250.

A survey of over 40,000 youth across the country revealed that twice as many 8th and 10th graders use e-cigarettes than traditional cigarettes. Another survey revealed that over 250,000 students use e-cigarettes but have never used traditional cigarettes. Law enforcement and school officials are also concerned that the use of marijuana is going undetected, as the devices can be used for that purpose and some may resemble a ballpoint pen. Although California banned the sale of e-cigarettes to minors in 2010, underage use is still on the rise. California officials are concerned that teenagers and young adults who would not be drawn to tobacco are swayed to start using e-cigarettes by marketing and product design.

Legislation

California Senator Mark Leno introduced legislation last week that would subject e-cigarettes to the same regulations that govern tobacco cigarettes. If passed, these devices would be banned in public places including hospitals, bars and schools. A total of 122 cities and counties in the state have bans in place. Additionally, the Bay Area Rapid Transit (BART) board will vote next week on a possible e-cigarette public transit ban. Other states have passed comprehensive bans, although a similar state-wide bill was defeated in California last year.