“The e-Cigarette Craze”

By Bakani M. Ncube

According to the American Food and Drug Administration, the FDA, e-cigarettes are battery-operated devices designed to look like and to be used in the same manner as conventional cigarettes. They are sold online and in many shopping malls. The devices generally contain cartridges filled with nicotine, flavour, and other chemicals and work by turning nicotine, which is highly addictive, and other chemicals into a vapour that is inhaled by the user. Unlike the conventional cigarette, electronic cigarettes don’t contain tobacco, so vaping (a term used to describe smoking/use of e-cigs) is not a form of tobacco use. The main component of e-cigarettes is the e-liquid contained in cartridges. The e-liquid is created by nicotine extraction from tobacco which is mixed with a base (usually propylene glycol), and may also include flavourings, colourings and other chemicals. There are nearly 500 different brands of e-cigarettes and around 7,700 flavours.

E-cigarettes can expose users to several potentially harmful chemicals, including nicotine, carbonyl compounds and volatile organic compounds. Nicotine is an addictive substance, and almost all e-cigarettes contain nicotine. Even some products that claim not to have any nicotine in them may still contain it. Initial FDA lab tests conducted in 2009 found that cartridges labelled as nicotine-free had traceable levels of nicotine. A 2014 study found little consistency in the amount of nicotine delivered by e-cigarettes of the same brand and strength. The newer e-cigarettes, especially “tank” styles, with higher voltage also deliver a greater concentration of nicotine and the more nicotine used, the greater the potential for addiction.

Nicotine has a negative impact on adolescent brain development. Human brain development continues far longer than was previously realized, and nicotine use during adolescence and young adulthood has been associated with lasting cognitive and behavioural impairments, including effects on working memory and attention. E-cigarettes also have detectable levels of toxic cancer-causing chemicals, including an ingredient used in antifreeze.The aerosol from e-cigarettes with a higher voltage level contains more formaldehyde, another carcinogen.

Diacetyl, a buttery flavoured chemical often added to food products such as popcorn, caramel, and dairy products, has also been found in some e-cigarettes with flavours and can cause a serious and irreversible lung disease commonly known as “popcorn lung.” There are concerns about poisonings too with the use of e-cigarettes as data released by the Centers for Disease Control and Prevention (CDC) shows that e-cigarette liquid poisoning comes from accidental ingestion of the e-liquid or exposure through the eye and the skin. Ingestion of e-cigarette liquids containing nicotine can cause acute toxicity and possibly death. Due to lithium batteries which are easily overcharged and have a short circuit, some of these devices have also exploded in their users’ faces or simply in the pockets of their denims while seriously injuring them.

In most places, indoor smoking is not allowed and it is interesting to note that no such rule applies with e-cigarette use even though they also contain harmful substances. It is true that e-cigarettes do not contain smoke, however they do expose others to secondhand emissions. Formaldehyde, benzene and tobacco-specific nitrosamines (all carcinogens) have been found coming from second-hand emissions and the American Lung Association supports prohibiting the use of e‐cigarettes in worksites and public places, and including e-cigarettes under smoke free laws with other tobacco products.

There are various reasons for their use. One of the reasons why the youth use e-cigs is because of the flavours. However, their use can serve as a gateway to using real cigarettes as they develop tolerance to the nicotine in e-cigs. Owing to these factors, the use of e-cigs among youth is now a significant public health concern as the youth are using them at increasingly alarming rates. Between 2011 and 2015, the U.S. Surgeon General found e-cigarette use among high school students increased by 900%, with more teens now using e-cigarettes than cigarettes. The tobacco industry aggressively markets e-cigarettes to youth, glamorizing their use in advertisements. These devices also do not have a legal age restriction and can be sold to anyone. However, the manufacturers of these devices market them as a means for cigarette smokers to quit smoking and that’s currently their main use.


    1. U.S. Department of Health and Human Services. (2006). “E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General.”
    2. Goniewicz ML, Hajek P, McRobbie H. (2014). “Nicotine Content of Electronic Cigarettes, its Release in Vapour and its Consistency Across Batches: Regulatory Implications.” Addiction. 109:500-7.
    3. Centers for Disease Control and Prevention. (2016). “Quickstats: Percent Distribution of Cigarette Smoking Status Among Adult Current E-Cigarette Users, by Age Group, National Health Interview Survey”, United States, 2015. Morbidity and Mortality Weekly Report. 65(42):1177.

Bakani M. Ncube is the ZPSA Student Exchange Officer 2016-17, Contact Person 2017-18 and the World Healthcare Students Symposium International Campus Ambassador. He is passionate about writing and Public Health. [email protected]