Understanding Rising Electronic Cigarette Use

Abstract

Vaping is the act of inhaling an aerosol generated by an electronic cigarette (e-cigarette), a battery-powered device that heats a reservoir of liquid, typically nicotine-containing, to deliver contents to the user. E-cigarettes were initially introduced as a means of smoking cessation, although evidence of their effectiveness is limited. There is a widespread perception that these products are a safer alternative to conventional cigarettes, driven in large part by marketing efforts by e-cigarette manufacturers. Yet to achieve vaporization, temperatures are so high that components of the device hardware, such as metals, plastics, rubber and foam, are aerosolized and inhaled along with the vaporized e-liquid containing nicotine, flavoring and solvents. We do not fully understand the health consequences of such aerosol exposure, particularly long-term effects, but short-term negative cardiovascular and respiratory effects have been demonstrated. Very few studies have evaluated the reproductive effect of e-cigarette use. We do not know whether vaping during pregnancy affects birth outcomes or the lifelong health of the fetus. There has been an exponential rise in the use of e-cigarettes in the United States since their introduction, particularly among youths, while concurrently there has been a laudable reduction in conventional cigarette use. It is imperative that obstetrician-gynecologists have a basic understanding of e-cigarettes, screen all patients as is consistently done for conventional smoking, and provide resources to patients about potential negative consequences of use.

Fig. 1.

Components of an e-cigarette. Reprinted from Centers for Disease Control and Prevention. E-cigarette, or vaping: products visual dictionary. Accessed December 1, 2020. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/pdfs/ecigarette-or-vaping-products-visual-dictionary-508.pdf. Reference to specific commercial products, manufacturers, companies, or trademarks does not constitute its endorsement or recommendation by the U.S. Government, Department of Health and Human Services, or Centers for Disease Control and Prevention. Wylie. Background on Vaping for Ob-Gyns. Obstet Gynecol 2021.