Title: E-Ciggerates should be banned
Sub Category: Argumentative Essay
Subject: Academic English
In 2011, e-cigarette had around 7 million users around the globe. Since then this number has seen an increase of 585%. The number of e-cigarettes users in the world currently stands around 41 million (Jones, 2019). This dramatic increase in numbers of e-cigarettes users is commonly attributed to the increased awareness about the products. E-cigarettes are usually presented as healthier alternatives to smoking and a useful aid to quit smoking (Grana & Ling, 2014). Even the US Patent for E-cigarettes mentions it as “an electronic atomization cigarette that functions as substitutes [sic] for quitting smoking and cigarette substitutes” (patent No. 8,490,628 B2) (Hon, 2013). While the advocates and the patent itself might disagree but this essay argues why e-cigarettes are not healthier alternatives to smoking and should be banned.
E-cigarettes aka e-cigs or as nerds would prefer Electronic Nicotine Delivery Systems (ENDS) are electronic devices that deliver what is usually incorrectly referred to as ‘vapor’, which the user inhales. This vapor or more precisely aerosol is created by heating a solution composed of propylene glycol or glycerin and flavoring along with nicotine. Even though e-cigs just like regular cigarettes have nicotine in them, they are entirely different from regular cigarettes. The vapors from e-cigs even though they don’t have some of the harmful substances like tar or carbon monoxide found in traditional cigarettes they do contain other harmful substances generally absent from regular cigarettes like traces of heavy metals. Thus, they both have different health effects. ENDs are continuously increasing in popularity while in 2017, about 15% of Europe’s populations had tried an e-cigarette at least once if not for regular use (WH0, 2017).
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E-cigs even though promoted as a useful aid in smoking cessation are actually not very useful.
As mentioned above e-cigs are usually promoted as an effective tool in quitting smoking, even the patent mentions it so. Around 64% of the websites marketing e-cigs mention it as an effective tool for smoking cessation whether directly or indirectly (Andrade, Hastings, & Angus, 2013). A study points out that smokers who want to quit smoking without professional help were more likely to take up the use of e-cigs to practice abstinence from smoking than those who wanted to quit “cold turkey”. The reasons for this being that e-cigs are usually marketed to the average consumers as effective smoking cessation tools (Brown, Beard, Kotz, Mitchie, & West, 2014). However, evidence has started piling up which shows that e-cigs are not nearly as useful as they are claimed to be for smoking cessation. A significant portion of studies that are often cited as evidence to the claim of e-cigs being an effective smoking cessation tool often lacks a control group of users who did not use e-cigs. A meta-analysis tries to answer the odds of quitting smoking with the help of a control group to minimize the risk of selection bias. 38 studies were included in the meta-review and it was found that the people who used e-cigs as an aid to quit smoking were 28% less likely to quit smoking than the smokers who did not use e-cigs (Kalkhoran & Glantz, 2016).
Another systematic review also found similar results. It showed low odds of smoking cessation for e-cigs users. The odds ratio (OR) of the said study was 0.61 for e-cigs users which means that smokers using e-cigs as an aid were 39% less likely to quit smoking than their counter-parts (Grana, Benowitz, & Glantz, E-Cigarettes: A scientific review, 2014). Thus, in light of the evidence presented above, we can conclude that e-cigs are not necessarily useful in smoking cessation.
E-cigarettes are not safe for bystanders. Since e-cigarettes do not use combustible material they do not emit any second-hand smoke, the former statement whether directly or indirectly was found on 76% of the c-cigarettes marketing websites. Smoking is banned in the majority of public spaces around the world, in an attempt to protect the health of innocent bystanders but e-cigs companies present them as a solution to circumvent smoke-free policies (Andrade, Hastings, & Angus, 2013). However, bystanders are still exposed to the aerosol and particulate matter emitted by these devices. Shripp et. al., (2013) conducted a study in which subjects were asked to smoke in a chamber and then the air content was measured. They found traces of formaldehyde, nicotine, acetaldehyde, isoprene, acetic acid, 2-butadiene, acetone, propanol, propylene glycol, and diacetin in the air. Even though the traces found by them were much lower in content then the traditional conventional cigarette smoke, they were enough to cause irritation and nausea (Schripp, Markewitz, Uhde, & Salthammer, 2013). Another study by Flouris et. al., (2013) simulated the condition of a smoky bar by using both the conventional and e-cigs. It was found that e-cigs released less nicotine in the air than conventional cigarettes because 80% of the nicotine was being absorbed by the users. However, the serum cotinine level, which reflects the amount of recent nicotine exposure, in non-smokers was the same for both the e-cigs and traditional cigarettes Floutis et. al (2013). Moreover, a report by NAESM points out that since e-cigs are not banned indoor they expose the bystanders to a variety of harmful particulate matter (NAESM, 2018). Thus, it would be fair to say that even though emission levels for e-cigs are comparatively lower than traditional cigarettes they still do not guarantee an atmosphere as safe as clean air for the bystanders.
E-cigarettes are a public health threat. Even though literature is scarce and yet to grow on the long term effects of e-cigarettes a number of researches have documented the short term adverse health effects e-cigarettes infer. These researches have focused on the effects e-cigarettes have on the cardiovascular system, lungs and central nervous system among other systems. E-cigarettes are shown to cause the irritation of lungs along with the induction of bronchospasm and cough. Increased e-cigarettes use on the other hand has also shown to cause an increase in the susceptibility to infections like Influenza A and Streptococcus pneumonia. For central nervous systems, the e-cigs are shown to cause memory problems, general mood irritability and drug dependence in both humans and animals. Moreover, they are also revealed as a causative factor of tumors and muscular spasms (Qasim, Kalim, Rivera, Khasawaneh, & Alshbool, 2017).
E-cigs vapor was also found to cause a comparable but more rapid increase of endothelial progenitor cells in the blood which is an indication of vascular injury. Moreover, these vapors in a similar fashion helped in the activation of clotting cascade of platelets within the cardiovascular system, which is one of the key reasons in the development of cardiovascular diseases (Antoniewicz, Bosson, Kuhl, Abdel-Halim, & Kiessling, 2016).
OBJECTIONS AND REPLIES TO OBJECTIONS:
E-Cigarettes have lower nicotine content. In conventional cigarettes, nicotine is attributed as a primary addictive agent. The absorption and nicotine exposure rates are the two main key items that create dependency on nicotine along with increasing the susceptibility of the user for nicotine abuse. Apart from being addictive, nicotine also infers a number of negative health effects. In their defense, e-cigs claim to use less nicotine content than traditional cigarettes. However, recent evidence suggests that despite the less nicotine content, there exists a variation in the amount of nicotine being delivered to the e-cigs user e.g., the batteries and design of the e-cigs can sometimes deliver nicotine in amounts almost equivalent or even greater than the traditional smokes. Studies have also shown that bioavailability and palatability of nicotine vary with the choice of the base being used. The different flavors used on the other hand also have different nicotine contents. The bioavailability of nicotine also changes with change in pH and different flavoring has different pH. The voltage of the e-cigs also changes the amount of nicotine being delivered thus, as a consequence, it is very difficult to extrapolate the amount of nicotine being delivered to the end-users (DeVito & Krishnan-Sarin, 2018).
E-cigs have less toxic chemicals than conventional cigarettes. The proponents of e-cigs usually claim that they do not deliver the harmful chemicals or substances normal cigarettes deliver when you inhale the smoke. Even though e-cigs do not produce tar which is the main cause of lung cancer, found in traditional cigarettes, they do produce formaldehyde, which is a known carcinogen, and that too at more than recommended levels. Moreover, the e-cigs can lodge heavy metals to the lungs of the users, something which is not really common in traditional smokes. These metal ions are released by heating plates and accumulate over the lungs of the users. The liquid solution used in e-cigs like propylene glycol can generate propylene oxide upon breakdown which is considered a 2B carcinogen by the International Agency for Research on Cancer (Williams, Villarreal, Bozhilov, Lin, & Talbot, 2013). In addition, the nicotine delivered via e-cigs aerosol, the very same thing traditional cigarettes have, encourages the cancerous cells metastasis along with reducing the effects of chemotherapy (Tore & Grimsurd, 2015). Thus we can claim that despite the absence of the same chemicals e-cigarettes have certain carcinogens and toxic chemicals of their own.
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Despite the state of scarcity that exists in the data regarding the use of e-cigs, literature has started to show up which reveals the effect e-cigs are having on the users. The essay also shows in light of evidence gathered by researchers how the general arguments around the use of e-cigs are not very sound.
Adriaens, K., Gucht, D., Declerck, P., & Baeyens, F. (2014). Effectiveness of the Electronic Cigarette: An Eight-Week Flemish Study with Six-Month Follow-up on Smoking Reduction, Craving and Experienced Benefits and Complaints. International Journal of Environmental Research and Public Health, 11220-11248. doi: 10.3390/ijerph111111220.
Andrade, M. d., Hastings, G., & Angus, K. (2013). Promotion of electronic cigarettes: tobacco marketing reinvented? British Medical Journal, 347. doi:10.1136/bmj.f7473
Antoniewicz, L., Bosson, J. A., Kuhl, J., Abdel-Halim, M., & Kiessling, A. (2016). Electronic cigarettes increase endothelial progenitor cells in the blood of healthy volunteers. Atherosclerosis , 255, 179–185.
Brown, J., Beard, E. V., Kotz, D., Mitchie, S., & West, R. (2014). Real-world effectiveness of e-cigarettes when used to aid smoking cessation: A cross-sectional population study. Addiction, 109(9), 1531-40. doi:10.1111/add.12623
DeVito, E. E., & Krishnan-Sarin, S. (2018). E-cigarettes: Impact of E-liquid Components and Device Characteristics on Nicotine Exposure. 16(4), 438–459. doi:10.2174%2F1570159X15666171016164430
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Grana, R., & Ling, P. M. (2014). Smoking revolution? A content analysis of electronic cigarette retail websites. American Journal of Preventive Medicine, 46, 395–403. doi:10.1016/j.amepre.2013.12.010
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Hon, N. (2013, 07 23). Electronic Atomization Cigarette. Retrieved 2 20, 2020, from Lens.org: https://www.lens.org/lens/patent/135-024-631-441-796/fulltext
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Kalkhoran, S., & Glantz, S. A. (2016). E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. The Lancent Respiratory Medicine, 4(2), 116-128. doi:10.1016/s2213-2600(15)00521-4
NAESM. (2018). Public Health Consequences of E-Cigarettes. Washington (DC): National Academies Press. Retrieved 2 20, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/29894118
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Schripp, T., Markewitz, D., Uhde, E., & Salthammer, T. (2013). Does e-cigarette consumption cause passive vaping? Indoor Air, 23(1), 25-31. doi:10.1111/j.1600-0668.2012.00792.x
WH0. (2017, 01 23). Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS). Retrieved 02 20, 2020, from World Health Organization: https://www.who.int/tobacco/communications/statements/eletronic-cigarettes-january-2017/en/
Williams, M., Villarreal, A., Bozhilov, K., Lin, S., & Talbot, P. (2013). Metal and Silicate Particles Including Nanoparticles Are Present in Electronic Cigarette Cartomizer Fluid and Aerosol. Public Library of Science , 8(3). doi:doi.org/10.1371/journal.pone.0057987