World No Tobacco Day falls on May 31st every year. The World Health Organization recognizes the dangers of smoking, the impact on the health of smokers, and equates it to “second-hand smoke” because those nearby will also be exposed to cigarette smoke indirectly, leading to severe diseases just as if they were smoking directly. While we have been familiar with traditional cigarettes for a long time, e-cigarettes are relatively new, and there is not enough research data to determine the dangers of each chemical in e-cigarettes, especially if used over a long period in the long term. However, the absence of data indicating hazards does not mean there are no dangers. It is essential to collectively campaign to reduce, discourage, and quit not just traditional cigarettes but also e-cigarettes, which are equally harmful.
Dr. Jatuphat Khunsong, a psychiatrist at the Mind Guard Center Bangkok, Bangkok Hospital, said that e-cigarettes are a type of smoking device that uses electrical mechanisms to generate heat and vapor containing various chemicals without smoke from combustion like traditional cigarettes. They consist of three main components: a battery, an atomizer (which produces vapor and heat), and a liquid. Specifically, the liquid that turns into vapor and enters the smoker’s body contains key compounds such as nicotine, a drug found in both e-cigarettes and traditional cigarettes, that causes addiction to smoking; propylene glycol, a component in substances to generate vapor; glycerin, a humectant that blends with propylene glycol; The Food and Drug Administration (FDA) confirms their safety for use in food and medicine, but it remains unconfirmed how their vapor form affects the body when inhaled, similar to propylene glycol and flavoring and scent chemicals commonly used in food.
Various chemicals found in the liquid can cause harm to the body, such as nicotine which, when entering the body, stimulates the central nervous system, increases blood pressure, heart rate, and respiration, and increases the risk of lung cancer, respiratory disease, oral cancer, esophagus, and pancreatic cancer. Nicotine also triggers an increase in cortisol hormone, which raises blood sugar levels, leading to diabetes. It stimulates an increase in the number of cells in the blood vessel walls, causing vascular constriction and increasing the risk of heart disease and stroke. For pregnant women, nicotine affects the fetal brain development. Exposure to high levels of nicotine (60 mg in adults and 6 mg in children) poses a risk of death. Propylene glycol and Glycerol/Glycerin could cause irritation to the skin, eyes, and lungs, especially in those with chronic lung disease, asthma, and emphysema. Furthermore, e-cigarette vapor contains many compounds known to be harmful, such as heavy metals, arsenic, Formaldehyde, and Benzene groups. Research shows that e-cigarette smoking increases the risk of various diseases, such as heart disease, DNA changes in lung, heart, and bladder cells, raising the risk of cancer. Whether e-cigarettes are addictive, clearly, they contain nicotine, which causes addiction; hence, e-cigarette users can become “addicted” just like traditional cigarette smokers. Moreover, the process and form of smoking e-cigarettes are quite similar to traditional smoking, keeping the user “addicted” to the smoking behavior just like with traditional cigarettes.
A critical question that has been long heard is whether switching from traditional cigarettes to e-cigarettes helps quit smoking and actually reduces traditional cigarette consumption. Contrary to this, using e-cigarettes does not help reduce traditional smoking at all. Worse, it increases the overall smoking rate, partly because of the presence of nicotine, and youngsters who become part of the smoking group (regardless of which type they start with) will eventually exchange and try within the group, becoming familiar with all forms of smoking. Meanwhile, the United States has officially banned companies from advertising that e-cigarettes help quit traditional smoking, as it contradicts clear research data. It is true that e-cigarettes operate without combustion like traditional cigarettes, reducing the risk of exposure to harmful substances from burning, such as kerosene or tar and carbon monoxide, which cause cancer and respiratory diseases.
As mentioned above, other compounds found in e-cigarettes can also cause harm to the body. Additionally, some research suggests that e-cigarette vapors contain smaller particles than traditional cigarettes, allowing them to penetrate deeper into the lungs. These small particles adhere to lung tissue and are absorbed into the bloodstream quickly, making it difficult for the body’s natural mechanisms to expel them.
Currently, e-cigarettes are considered a prohibited product. Individuals who possess e-cigarettes are committing an offense, including importers, sellers, and users. Upon detection of an offense, authorities can arrest the individuals involved. Importers face imprisonment for up to 10 years or a fine of five times the value of the imported goods or both imprisonment and fine. Sellers face up to 5 years imprisonment or a fine of up to 500,000 baht or both. Users or those in possession of e-cigarettes are guilty of possessing illegally imported items, risking imprisonment for up to 5 years or a fine of four times the value of the goods, inclusive of duty, or both. Therefore, for the sake of good health, it is encouraged to campaign for reducing, discouraging, and quitting smoking for your own and your community’s physical and mental health, moving beyond the dangers of smoking.
