Vaping as opposed to cigarettes?

JustBeachyNurse, LPN · Jul 1, 2014

Propylene glycol = a component of antifreeze. Not exactly non toxic solvent.

I think the bigger issue is the other substances being mixed in the vapor solutions ( oxycodone, cocaine, heroin, liquid marijuana oil ( forget the technical name but it's concentrated and potent), etc).

I find the vapors toxic smelling and irritating especially some of the synthetic candy & fruit flavors/scents.

la_chica_suerte85, BSN, RN · Jul 1, 2014

I think that it's a better alternative but not the best idea. I'll never forget something our H&P assessment instructor told us about those: "I'm just waiting to see what fungal infection from hell ends up coming out one of those." :)

A lot of people in my cohort do it and they get kind of miffed when our instructors start going over the detriments of cigarette smoking and start getting all huffy about their vaping. Sheesh...touchy. As others have said, it is possible to get the fluid without nicotine in it -- some people just do it for the flavor and the habit having been smokers prior. I'm mixed on it. I'm still thinking about the fungal infection possibilities.

panic36 · Jul 1, 2014

I'm not even going to bother with a rebuttal because it wouldn't make a difference. As for the nursing program, I'd hope that the person that I was in an academic debate would actually have some substantiating evidence to back up their claim, and not repeating the same thing many websites already state with little or no research involved.

The fact of the matter is there is no supporting evidence that ecigs are worse or better for you. If you go based on the ingredients of what is provided in the ejuice, and you trust your manufacture (the one I use for ejuice is a local business owner, and I trust him hell of a lot more than I trust Phillip Morris) then you would most likely come to the assumption that they are probably better than traditional cigarettes. This is because unlike cigarettes it does not contain the 4,000 chemicals, with 69 of them that are known to actually cause cancer.

But yes, your answer is right. Telling people that there has not been enough research, nor evidence to support either claim of them being better or worse and at this point anyone who does is simply expressing an opinion.

Carpediem1012, BSN, RN · Jul 1, 2014

I do appreciate what you are saying panic36-and also that it has helped you quit smoking. That's absolutely worth something! :)

mommycruz3 · Jul 2, 2014

It way better than smoking. No tar, no smell, no cancer. It does contain nicotine IF YOU WANT IT TO. It is a way better alternative.

Karou · Jul 3, 2014

When a patient asks me if e-cigs are better than cigarettes, I always tell them that there is not enough research available for me to say yes/no, but if they are interested in quitting smoking that I will provide them with information and advise them to speak to their physician about it. Our hospital policy is that they are not allowed and I inform my patients of this.

I really am interested to see what research starts saying about them and their long term effects. Personally, with what I understand about them now, I am for it.

I have never smoked/used any nicotine product and never intend to. Both of my parents have smoked for 30+ years. My father has quit more times than I can count. My mother has been a 2 pack/day smoker for at least 15 years. Both smoke in the house, always have. I can't stand the smell of smoke and how it clings to everything, stains white yellow, ect...

My mother got diagnosed with breast cancer in December and to make a very long story short, both her and my dad decided to quit smoking. My dad bought an e-cig and did really well with only that for a few months. My mother tried... She got down to less than 1/2 a pack a day with e-cig. I was so proud of her. She has tried the patch, gums, antidepressants, ect... This was the first thing that helped her. Her pulmonologist initially discouraged her from using it because she did require the high nicotine dose, but then changed his mind and decided that of it helps her cut back and eventually quit, that he approves. I think the problem is that a lot of people never quit.

We know so much about the dangers of smoking cigarettes, does anyone believe the e-cigs can actually be more harmful? I see it as the lesser of two evils. At least people are trying to quit smoking cigarettes, I think that should count for something.

As for people using them for recreational drug use- these people would be using those drugs e-cig or not. Addicts will always find ways to get high.

I have wondered about increased risk for fungal infections. As long as someone is aware of that risk, then I believe it's buyer beware. A fungal infection will harm the user but unlike secondhand smoke, won't harm those around you. I worry about people accidentally taking in more nicotine than with cigarettes, I do see this as a real and dangerous risk. I would like to see it more regulated by the FDA, I think it would add legitimacy and safety.

Anyway... That's just my two cents.

Glycerine82, LPN · Jul 7, 2014

Propylene glycol = a component of antifreeze. Not exactly non toxic solvent.
I think the bigger issue is the other substances being mixed in the vapor solutions ( oxycodone, cocaine, heroin, liquid marijuana oil ( forget the technical name but it's concentrated and potent), etc).
I find the vapors toxic smelling and irritating especially some of the synthetic candy & fruit flavors/scents.

Propylene glycol is used as an additive in foods, is recognized by the FDA as "generally safe", and is in anti-freeze to make it less toxic. Just saying.

Not to mention that the ingredients in cigarettes are way more harmful. I just can't see discouraging someone from switching to vaping if it helps them quit smoking and they discuss it with their doc.

JustBeachyNurse, LPN · Jul 7, 2014

Propylene glycol is used as an additive in foods, is recognized by the FDA as "generally safe", and is in anti-freeze to make it less toxic. Just saying.
Not to mention that the ingredients in cigarettes are way more harmful. I just can't see discouraging someone from switching to vaping if it helps them quit smoking and they discuss it with their doc.

Let me clarify, if this was an issue for my patient population ( I work complex pedi so Id hope not) my response would be the jury is out and discuss with their physician risk vs benefit.

I think it's likely better than smoking in many ways but the other concerns are non intended substances (narcotics , etc) being used in lieu of the flavored I liquid nicotine. Or teens/young adults who never smoked starting vaping because it's en vogue.

mrsboots87 · Jul 7, 2014

There is not enough research available for me to make a solid conclusion, but from what I do know I would vote they are the lesser of two evils. I find some of the arguments abiut children drinking the liquid and dying, and that it will make young people start smoking to be very flawed. The liquids have a nice smoking flavor. Have you ever tasted the stuff? I have unintentionally and i can tell you that monkey cream flavor tastes anything but delightful in liquid form. It is just like any other toxic household substance, or even cigarettes themself. If a child gets their hands on it amd are interested, they will try it. There are plenty of repirts of chuldren drinking hand sanitizer, windex, eating pills, eating cmgigarette butts, you name it. I don't see anyone here gung ho on banning window cleaner. For kids startimg smoking because its "cool" - at least there are non nicotine versions, so the liquid won't become addictive to them. They can just occasionally smoke. And honestly, even if it did lead to smoking, those are probably the type of kids who would have started on regular cigs anyway. And lastly, banning because they can be used for drugs. Well we better not sell rolling paper intended for tobacco because they are used for joints. Same for the flavored cigar papers. No more glass vials because crack heads and meth usuers might heat bubble the tip to smoke out of them. while were at it, lets ban staplers because opiate users might use one to smash a oill for snorting. My point is that drug users will just use other things to do their drugs. Vaporizors aren't going to somehow change people into becaoming drug users just because the chambers can be altered.

Im not saying these are great amd everyome should hop on board. Without personally knowing the liquid makers, there is currently no way to know how they are making the ejuices and could be outting god knows what in them. There are plenty of good vendor, but without regukation, there is no real way to know whats in them and buyers shoukd beware. I would also like more info on side effects. Im sure the vapor in the lungs probably has an affect as well ad what little ingredients are in them. But when i start to practice in the real nursing world, and a patient asked abot them i woukd say not enough research has been done to advise definitively, but that they seem to at least be a better option than traditional smoking for both the smoker and the peiple around them.

seconddegreebsn · Jul 7, 2014

Article on vaping in last month's JAMA: JAMA Network | JAMA | E-Cigarettes, Vaping, and Youth

"Preliminary evidence demonstrates the potential of e-cigarettes to reduce harm by weaning smokers from combustible tobacco, but the benefits appear minimal. At the same time, evidence of harm is emerging. More powerful e-cigarettes, commonly known as tank systems, heat nicotine liquid hot enough to produce cancer-causing carcinogens, such as formaldehyde and acetaldehyde, in their vapor.3 Further, in a study of human bronchial cells that contained some mutations found in smokers at risk of lung cancer, scientists found a pattern of gene expression in cells grown in a medium exposed to e-cigarette vapor that was similar to the pattern found in cells grown in a medium exposed to combustible tobacco smoke.4 In addition, the virulence of drug-resistant bacteria can be increased by e-cigarette vapors and affect the ability of cells to destroy bacteria.5The Centers for Disease Control and Prevention reported an increase in calls to poison control centers after unintentional exposure of children to e-liquid, including oral ingestion, eye contact, and inhalation exposure.6 Public reports commonly associated with e-cigarettes include trouble breathing, headache, cough, dizziness, sore throat, nose bleeds, chest pain, heart palpitations,7 and allergic reactions such as itchiness and lip swelling. The conundrum is how to regulate e-cigarettes given scientific uncertainty about the nature and extent of harms."

Soooo, I'm just gonna side with no - this is not something appropriate for a hospital or for my patients.

mrsboots87 · Jul 7, 2014

Article on vaping in last month's JAMA: JAMA Network | JAMA | E-Cigarettes, Vaping, and Youth
"Preliminary evidence demonstrates the potential of e-cigarettes to reduce harm by weaning smokers from combustible tobacco, but the benefits appear minimal. At the same time, evidence of harm is emerging. More powerful e-cigarettes, commonly known as tank systems, heat nicotine liquid hot enough to produce cancer-causing carcinogens, such as formaldehyde and acetaldehyde, in their vapor.3 Further, in a study of human bronchial cells that contained some mutations found in smokers at risk of lung cancer, scientists found a pattern of gene expression in cells grown in a medium exposed to e-cigarette vapor that was similar to the pattern found in cells grown in a medium exposed to combustible tobacco smoke.4 In addition, the virulence of drug-resistant bacteria can be increased by e-cigarette vapors and affect the ability of cells to destroy bacteria.5The Centers for Disease Control and Prevention reported an increase in calls to poison control centers after unintentional exposure of children to e-liquid, including oral ingestion, eye contact, and inhalation exposure.6 Public reports commonly associated with e-cigarettes include trouble breathing, headache, cough, dizziness, sore throat, nose bleeds, chest pain, heart palpitations,7 and allergic reactions such as itchiness and lip swelling. The conundrum is how to regulate e-cigarettes given scientific uncertainty about the nature and extent of harms."
Soooo, I'm just gonna side with no - this is not something appropriate for a hospital or for my patients.

My only question is what in the e-liquid is heating to become carcinogens? I ask because since there are MANY recipes with varying ingredients, it is possible that while some ejuice has these toxic chemical, some may not. And how is this worse than the already known carcinogens found in regular cigarettes. Again, I am not saying these are great because I just don't know, but I would like a definitive answer to how they are worse. As far as IN a hospital, definitely not appropriate. It is still not fully understood how the exhaled vapor can affect surrounding people as well as other things that make it inappropriate for indoor use. Especially in a medical facility. Hopefully some better research comes out with more specifics as to what is good/bad about e-cigs and vaporizers. I have seen a lot of good they have done for people, but it is still unclear of what they are doing internally to the friends and family I have that use them.

seconddegreebsn · Jul 7, 2014

My only question is what in the e-liquid is heating to become carcinogens? I ask because since there are MANY recipes with varying ingredients, it is possible that while some ejuice has these toxic chemical, some may not. And how is this worse than the already known carcinogens found in regular cigarettes. Again, I am not saying these are great because I just don't know, but I would like a definitive answer to how they are worse. As far as IN a hospital, definitely not appropriate. It is still not fully understood how the exhaled vapor can affect surrounding people as well as other things that make it inappropriate for indoor use. Especially in a medical facility. Hopefully some better research comes out with more specifics as to what is good/bad about e-cigs and vaporizers. I have seen a lot of good they have done for people, but it is still unclear of what they are doing internally to the friends and family I have that use them.

There's more articles on PubMed about the chemicals released by ecigs and what they do to indoor air and your lungs. Small body of research since they're so new, but here's more articles that I can't link to since my access is thru PubMed.

Comparative effects between electronic and cigarette smoke in human keratinocytes and epithelial lung cells - Toxicology in Vitro, volume 28, issue 5
, August 2014, Pages 999–1005.

Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers. Int J Hyg Environ Health. 2014 Jul;217(6):628-37. doi: 10.1016/j.ijheh.2013.11.003. Epub 2013 Dec 6.
Chemical hazards present in liquids and vapors of electronic cigarettes.
Arch Toxicol. 2014 Jul;88(7):1295-308. doi: 10.1007/s00204-014-1294-7. Epub 2014 Jun 11.

I know there are some longitudinal studies with results forthcoming, curious to see what they find....