IN recent years, the rise of vaping and e-cigarettes has created a new frontier in the battle against smoking.
Traditional cigarette use has seen a decline from 21.3 per cent in 2022 to 19 per cent in 2023 according to the National Health and Morbidity Survey 2023.
However, the allure of e-cigarettes and vaping devices has captivated a younger audience, nearly doubling from 9.8 per cent in 2017 to 14.9 per cent in 2022 according to the National Health and Morbidity Survey 2022 (Adolescent Health Survey).
This shift, however, is not without consequences — both for the smoker and those around them. The shift from conventional cigarette smoking to vaping and e-cigarettes comes with a cost.
While there's no direct link to lung cancer, e-cigarettes contain acrolein, which can cause acute lung injury, popcorn lung, asthma and Chronic Obstructive Pulmonary Disease (COPD).
Acrolein has been linked to changes in cellular deoxyribonucleic acid (DNA) that can increase the risk of cancer, says consultant respiratory and internal medicine physician at Sunway Medical Centre Dr Kow Ken Siong.
The increase in vaping and e-cigarette use among young people is concerning, says Dr Kow, who is also a clinical associate professor at Sunway University's School of Medicine and Life Sciences.
"These sleek devices are often promoted as safer alternatives with various flavours, making them appear harmless and trendy. However, this perception is dangerously misleading, leading many into a trap."
Dr Kow says vaping and e-cigarette devices heat nicotine extracted from tobacco, along with flavourings and other additives, and users inhale this aerosol into their lungs.
While it may eliminate some harmful combustion byproducts, it does introduce a new array of chemicals, including various unregulated chemicals from questionable sources, ranging from cleaning agents to pesticides and even methanol, one of the main ingredients for rocket fuel, which may also be very harmful.
Recent studies have also linked vaping and e-cigarettes to severe lung injuries, increased risk for tobacco and other substance use, mental health problems, pulmonary and cardiovascular disease, and unintentional injuries among adolescents.
Dr Kow says starting smoking young has greater health impacts as lungs mature at about 20 to 25 years of age.
"With vaping, we are treading on dangerous ground where youths are unwitting guinea pigs in an uncontrolled experiment."
A CONCERN FOR ALL
Many young smokers and vapers are under the misconception that their choices affect only themselves.
However, the reality is starkly different. Secondhand smoke is a silent assailant, infiltrating the lungs of those around it.
Secondhand smoke, a combination of smoke from the burning end of a cigarette and the smoke exhaled by smokers, contains over 7,000 chemicals, hundreds of which are toxic and about 70 chemicals that can cause cancer.
Vaping, often marketed as a safer alternative, isn't exempt from scrutiny.
"E-cigarette vapour contains nicotine, ultrafine particles, and volatile organic compounds. While it might lack some harmful chemicals found in traditional cigarettes, it's far from benign."
Children and pregnant women are particularly vulnerable to the effects of secondhand smoke, which can lead to respiratory infections, sudden infant death syndrome (SIDS), and poor cognitive performance.
Furthermore, the often-overlooked threat of thirdhand smoke extends beyond the immediate dangers of secondhand exposure. This residue, which contains nicotine and chemicals, clings to surfaces for months, releasing toxins and carcinogens.
Thirdhand smoke embeds itself in carpets, furniture, and even clothing. Over time, these residues can react with indoor pollutants, forming carcinogenic compounds.
This lingering menace poses risks, especially to infants who crawl on carpets or individuals who spend extended periods in contaminated environments that contain more than 200 chemicals.
"Cleaning or airing out rooms isn't sufficient. Comprehensive measures are required to eradicate these toxic remnants," says Dr Kow.
Awareness is the first step towards change. We need to debunk myths and present hard facts when educating children and adolescents about the dangers of smoking and vaping.
Moreover, the importance of creating smoke-free and vape-free environments to prevent the risks of secondhand and thirdhand smoke is crucial. Homes, cars and public spaces should be smoke-free sanctuaries.
Smoking and Vaping Cessation
There are several effective treatment options for smoking cessation, including nicotine replacement therapies (such as patches, gums, and lozenges), prescription medications, and behavioural counselling, which may increase the chances of successfully quitting smoking and helping young adults.
Dr Kow says while quitting smoking can be challenging, with the right support and treatment plan, it's achievable.
Those who want to quit should consult their doctor who can help tailor a cessation plan that best suits their needs and improves their chances of long-term success.