Cigarette smoking is one of the leading causes of lung disease and lung cancer.
Even though cigarette smoking has slowly declined, many alternatives such as e-cigarettes/vaping have gained popularity.
Prolonged use of smokeless tobacco products also contributes to health issues which include lung, esophageal, stomach cancers and heart disease.
Smokeless tobacco products also contain higher levels of nicotine than conventional cigarettes. Chemicals found in e-cigarettes include:[2]
- Nicotine. It is a highly addictive substance that affects learning and mental abilities.
- Formaldehyde. It is used as an embalming fluid for preserving tissue and also in woodwork.
- Benzene. It is found in car exhaust gases and is a potent cancer-causing chemical.
- Toluene. It is found in paints, lacquer and nail polish. It is a cancer-causing chemical and may cause infertility.
- Diacetyl. Food flavoring agent which can cause serious lung problems when inhaled.
- Metals including lead, chromium, and nickel. Inhalation of metals can cause chronic lung problems.
- Nicotine-derived Nitrosamine Ketone. These are compounds formed during tobacco production and can cause cancerous tumour growths.
Recent cases in the United States also demonstrate vaping-induced lung injury, a new medical entity which appears to include a heterogeneous collection of pneumonitis patterns that include:[1]
- Acute eosinophilic pneumonia
- Organizing pneumonia
- Lipoid pneumonia
- Diffuse alveolar damage and acute respiratory distress syndrome (ARDS)
- Diffuse alveolar hemorrhage
- Hypersensitivity pneumonitis, and
- Rare giant-cell interstitial pneumonitis
These constitute serious lung problems which may lead to sudden death. About 80% of the persons who vaped and became ill reported having used both nicotine products and tetrahydrocannabinol (THC) or cannabidiol (CBD) products.
In short, vaping does not appear to have clear benefits over conventional smoking. Vaping with CBD and THC products may even lead to unexplained and sudden death. To protect the health and ensure the safety of all Singaporeans, new prohibitions on the purchase, use, and possession of emerging imitation tobacco products have been put into place from 1 February 2018.
Under the Tobacco (Control of Advertisements and Sale) Act, a person must not import into Singapore, or distribute, sell, offer for sale or possess for sale in Singapore, any confectionery or other food product, or any toy, device or article —
i) that resembles, or is designed to resemble, a tobacco product;
ii) that is capable of being smoked;
iii) that may be used in such a way as to mimic the act of smoking; or
iv) the packaging of which resembles, or is designed to resemble, the packaging commonly associated with tobacco products.
References:
1. Vaping-Induced Lung Injury | NEJM. New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMe1912032?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed. Published 2019. Accessed September 23, 2019.
2. Healthhub.sg. https://www.healthhub.sg/programmes/153/vaping. Published 2019. Accessed September 23, 2019.
3. Gotts JE. High-power vaping injures the human lung. American journal of physiology Lung cellular and molecular physiology. 2019;316(5):L703-L704. doi:10.1152/ajplung.00099.2019
