(haipo) - In the last two months, the lungs of two 16-year-old boys collapsed as a result of using an electronic cigarette. One of them could not recover and died in the hospital.
What is an electronic cigarette, how does it affect the body and what consequences and damages may be caused by its use - in the short and long term • Dr. Yaniv Dotan, director of the Institute for Lung Functions at the Rambam Medical College, explains in an interview to Lahi Fe.
At the beginning of this month (May 2023), the Ministry of Health issued an emergency call regarding the use of electronic cigarettes and began the establishment of a national team that will re-examine the policy on the subject and work to eradicate the phenomenon, this, as mentioned, following two tragic cases that recently occurred in Israel, when the lungs of two teenagers collapsed due to use in the electronic cigarette.
The first case happened last April, when the lungs of a 16-year-old boy collapsed due to smoking electronic cigarettes. The boy was hospitalized in serious condition and connected to an Acmo device, two days later he was pronounced dead. Less than a month after the tragic incident, another boy was hospitalized in serious condition, also 16 years old, when his lungs also collapsed for the same reason.
We talked with Dr. Yaniv Dotan, Director of the Institute for Lung Functions at the Rambam Medical College, to understand from him what an electronic cigarette actually is, which at first seemed quite innocent and whose use has become very common in recent years, what substances it contains and how its use can be fatal.
"there is plenty to discover"
"An electronic cigarette is an electrical device that vaporizes liquid substances - that is, it turns the liquids into vapors, which when inhaled enter through the mouth into the trachea and lungs. Various substances can be vaporized by using an electronic cigarette, starting with nicotine, flavoring agents and THC, which is one of the active ingredients in marijuana ", explains Dr. Dotan.
What are the dangers of smoking an electronic cigarette?
"Using electronic cigarettes carries a number of dangers, but much is hidden from the open, not everything is known about the damages, especially the long-term ones. Among the known damages are the constriction of blood vessels that reduces blood flow to the body's organs, damage to the airways manifested by inflammatory changes in the lungs, inhalation of substances Carcinogenic to the lungs and their absorption into the blood system, and dangerous and significant lung damage manifested in an acute illness that includes respiratory failure, as recently reported in two cases in Israel.
What happens to the body when using an electronic cigarette?
"When a user takes a puff from an electronic cigarette, he causes the liquid in the cigarette cartridge to heat up. The vapors that are created exit the cigarette opening into the mouth cavity, the trachea, the large airways, and the lung bronchi. From the lung bronchi, the substances pass by diffusion into the small blood vessels in the lung, from there to the heart and from there through Avi The arteries to all the organs of the body."
What are the consequences of the electronic cigarette on the body, in the short term and in the long term?
"In the short term, inhalation of electronic cigarette vapors causes inflammation of the airways and immediate effects on the body's organs, for example - inhalation of THC, which is the active ingredient in marijuana, causes the substance to be absorbed through the lungs into the blood vessels and from there to the brain, where the substance binds to receptors in the brain that cause the sensations felt in smoking marijuana. Since it is not known what substances are in an electronic cigarette, it is not possible to predict with certainty what damage will be caused to the body in the long term, but most experts believe that using an electronic cigarette may cause an increase in the incidence of cancer in the long term."
Do all electronic cigarettes contain nicotine?
"No. Some cigarettes contain nicotine that is produced from the tobacco plant, like the nicotine found in a normal cigarette. Other electronic cigarettes contain flavorings and different components of the marijuana plant. There are electronic cigarettes that contain a combination of substances or all together."
What is the difference between an electronic cigarette and a regular cigarette?
"In a regular cigarette, there is a normal burning process in which the substance in the cigarette is burned and the vapor is inhaled into the lungs through the filter. In an electronic cigarette, there is no burning process, but heating to high temperatures of the substance contained in the cartridge to create vapors of a substance that is inhaled into the lungs."
What causes these difficult situations, like the two boys, or those reported in the US?
"Severe cases of morbidity and mortality as a result of e-cigarette use have been known for several years. In 2019, approximately 2,800 cases of lung disease as a result of e-cigarette use were reported in the United States. 69 of them died despite the efforts of doctors.
During the corona epidemic, the reports of this disease decreased, but recently, after the end of the epidemic, reports of the disease called EVALI - E cigarette and vapor associated acute lung injury, or in Hebrew - acute lung damage caused by the use of electronic cigarettes or Mars, began again. The mechanism for the development of the disease is not fully understood, but the main suspect is a substance called vitamin E acetate that is used as a solvent in the electronic cigarette.
Vitamin E acetate is also found in other foods and products, but in them it does not cause harm. Apparently inhaling it into the lungs could cause very severe lung damage, to the point of respiratory failure, the need for artificial respiration and even ECMO, as happened to the boy who died recently."
Is this something that could happen to anyone?
"Yes, but you can't predict who it will happen to. Smoking an electronic cigarette is like Russian roulette because the smoker does not know what substances are in the liquid in the cigarette cartridge, and thus takes a dangerous bet on his life. It is known that the majority of victims of electronic cigarettes are young people, more boys than girls, who have purchased products from unauthorized sources or who prepared the mixture themselves but not only. Also using the products that are sold in an orderly manner may cause the EVALI disease."
Most of the severe cases are young people up to the age of 24
What would you recommend to young people who smoke electronic cigarettes?
"Young people who smoke electronic cigarettes need to know the inherent dangers of using them. Today's youth are educated, curious, smart and have a desire for information. Knowing the medical risks of smoking an electronic cigarette can make responsible boys and girls stop using them. Most of the youth think that electronic cigarettes are a Innocent that is not as harmful as a regular cigarette, but in truth the dangers in the immediate term from smoking an electronic cigarette are greater than smoking regular cigarettes, while in the long term a regular cigarette is known to cause many types of cancer, while an electronic cigarette does not have enough time to know what the diseases are in the long term. Don't be a guinea pig !
In addition, using an electronic cigarette increases the chance of smoking regular cigarettes in the future, which as we know cause many diseases and are a significant cause of death in the world from heart diseases, blood vessels, strokes, cancer, lung diseases and more."
What would you advise parents?
"Parents of teenagers should give their children the information in an objective way. Using techniques of principled resistance may cause the opposite result, while providing the information in an objective way will make the youth think about the dangers inherent in electronic cigarettes, hopefully they will stop using them. Worldwide, so far, about 3000 cases have been reported , most of them in the USA, with a mortality of about 70 patients, most of the cases are of young people, with an average age of 24".
Do young people or adults come to your unit in Rambam who have been harmed as a result of smoking an electronic cigarette?
"No, Rambam has not yet received patients injured by electronic cigarettes, but it is possible that some of the lung injuries that we see commonly result from the use of electronic cigarettes, especially among young people, but this has not been proven so far."
