The Dangers of Electronic Cigarettes: A Call for Regulation

In recent years, electronic cigarettes have gained a lot of attention online, causing many people to have doubts about their safety. Despite Brazil's ban on the production and sale of electronic cigarettes since 2009, their usage has significantly increased in recent years due to their easy availability on both websites and physical storefronts.

Brazil is known as a global model for tobacco control public policy. Policies implemented over the years from 1989 to 2019 have reduced tobacco consumption among those aged 18 and over by about 60%. Some of these policies prevented children and adolescents from accessing tobacco products, thus preventing them from smoking. However, unlike all efforts to reduce smoking through public health, a new smoking trend emerged: electronic cigarettes. This includes a nicotine release device, whose first prototype was created in Pennsylvania in 1963, but it was never commercialized. In 2003, electronic cigarettes were created in China and spread around the world a decade later after a major tobacco industry company acquired a patent for them.

Many young people are drawn to the various formats, designs, and flavors of electronic cigarettes, making up a significant proportion of e-cigarette users. Research shows that in Brazil, one in five young people aged 18-24 have already used e-cigarettes. Additionally, 80% of those who use e-cigarettes are between the ages of 18 and 34. However, studies indicate that apart from nicotine, the aerosol may also contain other irritants and toxic substances such as formaldehyde, acrolein, diethylene glycol, acetaldehyde, benzene, and low doses of carcinogens. Tests on cells, tissues, and small animals exposed to liquids from different brands of e-cigarettes indicate that they are toxic to neurological, respiratory, and cardiovascular cells and may have adverse effects and cause birth defects during critical stages of fetal development.

The safety of electronic nicotine delivery systems has not been scientifically proven. In fact, the amount of nicotine dispensed by different e-cigarette devices can vary greatly, exposing consumers to much higher doses of the substance than traditional cigarettes. Reports have linked multiple incidents of severe burns, dismemberment and even death to explosions of e-cigarette batteries, dependent on the device's position at the time of detonation.

Although there is a lack of research evaluating the long-term consequences of inhaled substances from these devices, it is well-known that in the short-term, they may trigger or exacerbate symptoms of previously existing conditions such as coughing, asthma, chronic obstructive pulmonary disease (COPD), and hypertension. Additionally, in 2019, a series of severe cases of lung illness related to the use of electronic cigarettes, known as EVALI, was reported in the United States. By 2020, these cases resulted in over 2,800 hospitalizations, with many in intensive care units, and 68 deaths. The majority of cases were in young people, with one patient requiring a lung transplant.

Although the tobacco industry has attempted to convey the idea that e-cigarettes can aid in quitting smoking, this is not a good strategy. E-cigarette use operates through the same mechanism as traditional cigarettes, providing the brain with a nicotine rush. This explains why over 80% of those who use e-cigarettes to quit smoking still rely on nicotine (and e-cigarettes) after a year of follow-up. Scientifically proven and effective behavioral and pharmacological therapies are available to help quit smoking.

Since 2009, the use of electronic cigarettes has been prohibited in Brazil and will continue to be banned. However, children and teenagers are still able to obtain them, and the rate of experimentation is increasing daily. It is time to acknowledge that electronic cigarettes are not just vaporizers and to implement monitoring and restrictions on their sales.

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