Mahnoor Yousif Shaikh  ( 5th Year MBBS Student, Dow University of Health Sciences, Karachi, Pakistan )
Choudhary Ahmed Hasan  ( 4th Year MBBS Student, Dow University of Health Sciences, Karachi, Pakistan. )
Fariha Hasan  ( 5th Year MBBS Student, Dow University of Health Sciences, Karachi, Pakistan. )
Munira Jamali  ( 5th Year MBBS Student, Dow University of Health Sciences, Karachi, Pakistan. )

DOI: https://doi.org/10.5455/JPMA.64207

 

Madam, use of e-cigarettes has risen recently, especially among the youth. It is now considered a socially accepted harmless form of tobacco smoking. The usage patterns are not only limited to developed countries but is rampant within Pakistani communities as well. However, the side effects are dangerously fatal. E-cigarettes or vapes were initially started in the United States to replace traditional cigarette smoking as an aid to reduce addiction. But substantial research gaps exist in proving the effectiveness and potency of e-cigarette as quit smoking aids.^1,2

The first vaping related death was reported in the United States by the Centre for Disease Control (CDC) on the 23rd of August 2019, followed by 193 cases of lung damage, linked to vaping reported across 22 different states. Investigations revealed fatal lung injury secondary to vaping as cause of death. The emergence of symptoms in patients with severe lung damage has no consistent pattern, many report a slow onset of the symptoms that include difficulty in breathing, shortness of breath or chest pain. Few reportedly had diarrhoea, vomiting and fatigue as well.³ E-cigarettes contain dangerously high levels of nicotine which need to be regulated in order to prevent an overdose, a fact most youngsters do not know.⁴ Furthermore, vaping devices are used to smoke cannabis, loose Tetrahydrocannabinol (THC) oilas well, not just nicotine.⁵ In a study E-cigarettes vapors were found to increase adherence of pneumococcal bacteria to airway cells and sharing amongst users increased infection transmission.⁶ These events have prompted the CDC to alert physicians to look out for the symptoms and rule out vaping in patients presenting with respiratory illness. Unfortunately, in Pakistan where the state of healthcare is abysmal, there is no awareness regarding the ill-effects of vaping devices.

Addressing the lack of concern shown by healthcare professionals towards the consequences of vaping is crucial. A popular youth activity, it is widely available across the nation and is marketed as a 'cool' cultural norm.Educating our physicians is imperative so they in turn can educate patients and not promote vaping as a replacement amongst addicted smokers. Along with widespread awareness campaigns in educational institutions where most of the vaping youth can be educated towards the harmful side effects, as well as involving mass media for nationwide awareness is essential. Lastly, the government needs to ban the distribution and selling of e-cigarettes.

 

Disclaimer: None to declare.

Conflict of Interest: None to declare.

Funding Disclosure: None to declare.

 

References

 

1.      Manzoli L, Flacco ME, Ferrante M, La Vecchia C, Siliquini R, Ricciardi W  et al. Cohort study of electronic cigarette use: effectiveness and safety at 24 months. Tob Control. 2017; 26:284-92.

2.      Tomashefski A. The perceived effects of electronic cigarettes on health by adult users: A state of the science systematic literature review. J Am Assoc Nurse Pr. 2016; 28:510-5.

3.      Vaping: CDC investigation continues after patient dies from severe lung injuries BMJ 2019; 366:l5320. 

4.      Willett JG, Bennett M, Hair EC  et al. Recognition, use and perceptions of JUUL among youth and young adults. Tob Control. 2019; 28:115-6.

5.      Kowitt SD, Osman A, Meernik C et al. Vaping cannabis among adolescents: prevalence and associations with tobacco use from a cross-sectional study in the USA. BMJ Open. 2019; 9.

6.      Miyashita L, Suri R, Dearing E, Mudway I, Dove RE, Neill DR, Van Zyl-Smit R, Kadioglu A GJ. E-cigarette vapour enhances pneumococcal adherence to airway epithelial cells. Eur Respir Journal 2018; 1(51):2.