Since its appearance in China in 2003 patented by the pharmacist Hon Lik, electronic cigarettes (EC) have broken into the world market. The number of consumers of this product, known as “vapers”, is multiplied day by day and the sales of the companies that sell them increase from year to year.
The use of the EC is not exempt from all kinds of controversy, not only among consumers of this product, but also among different groups of healthcare professionals.
A group of experts in smoking of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), consisting of members of the Smoking Area and members of the Integrated Smoking Research Program of this scientific society, review different aspects of this new device for Nicotine inhalation. The EC is a device that works by means of a battery and that releases a vapor – which may contain nicotine – that can be inhaled by the user.
The CE consists basically of 3 elements: the battery, the atomizer and the cartridge. These 3 elements are assembled with each other and form a device that looks like a cigarette. The cartridge is loaded with liquid that can contain different substances: propylene glycol, glycerin and, occasionally, nicotine. When the subject “vapes” and the battery goes into operation, the atomizer heats up, the liquid is poured inside and becomes vapor.
This vapor is the one that is inhaled by the consumer. From 2009 until now, the design of these devices has been sophisticated, but in essence it remains the same, although its external appearance has changed, becoming more attractive and exhibiting different shapes and colors.
The battery has a longer life and the cartridge can be charged with a liquid that is sold separately and that is stored in small containers. These liquids may have different doses of nicotine. It is noteworthy that at present there are numerous CE patents. In Europe up to 19 can be found, of which 14 are in the United Kingdom.
The CE cartridge is filled with liquid. This liquid is an essential part of the EC. In 95% the liquid contains propylene glycol and vegetable glycerin, which are responsible for producing steam. The liquid of almost all CE marks also contains nicotine in different concentrations, ranging from 0 to 36mg / ml Flavors are other components of the liquid. There are many types of flavorings: tobacco, mint, cinnamon, fruit, etc. In addition, some additives are added to reduce the irritative action on the oropharynx.
The ECs are used mainly by smokers who want to quit, or by smokers who want to reduce tobacco use, or by ex-smokers. However, some surveys have shown that a small number of non-smokers also use these products. Recent Eurobarometer data shows that 7% of smokers from 27 European countries have used EC on occasion: 5% used them once or twice, 1% use them occasionally and 1% use them regularly.
Data from the International Tobacco Control Four-Country Survey show that 7.6% of smokers in those countries have used EC on occasion, and that 2.9% of them were regular “vapers” at the time of being surveyed. As far as we know, in Spain there are no reliable studies from representative surveys that show data on the prevalence of EC consumption.
Probably the most vivid data on EC consumption is provided by the Smoking Toolkit Study. This study is a survey that is carried out in England on a monthly basis via the internet. Data on EC consumption are available since the second quarter of 2011. The figures show that at the present time (third quarter of 2013) 16% of English smokers have consumed EC on some occasion and that 10% of They do it on a regular basis. Note that in the second quarter of 2011 they only consumed EC on a regular basis or had 2% tried it.
The most representative data on consumption in young people come from 2 studies. One of them is a study conducted in Poland on a sample of 13,250 subjects between 15 and 24year old. 20% of them had tested the EC on occasion and up to 7% had done so in the last month. A relevant fact was that 3.2% of those who had used it were non-smokers. This figure is close to 4.9% that Sutfin et al.
get in their study in schoolchildren. According to data from the Global Youth Tobacco Survey (GYTS), in 2012 in Hungary 13% of children between 13 and 15years of age they had tested the EC in the last month and, what is worrisome, the use of this type of devices reached 4.7% of young non-smokers. This is a fact that should make us think that, sometimes, the use of CE can be a gateway to the consumption of manufactured cigarettes.