Secondhand Inhalation, Exposure of E-Cigarettes Can Have Negative Affects

Iowa Department of Public Health Continues to Educate the Public on the Harms of E-Cigarette Use

For about a decade now, the general public has been able to see users of e-cigarettes, or vapes, walking around and exhaling large, thick plumes of smoke; sometimes in very public areas. There has been significant media coverage about the dangers that exist to the firsthand users of these Electronic Smoking Devices (ESDs). Some of these conditions are irreversible lung damage, Chronic Obstructive Pulmonary Disease (COPD)—a chronic lung disease, and even cardiovascular disease. What has not been as readily covered and presented to the public is the risks and health concerns for those who are not firsthand users.

One of the “perks” of using an e-cig, for some, besides the idea that e-cigarettes are “safer”, is the idea and capability that exists for using an e-cigarette in a public area. In homes, in cars, in the workplace, or just about anywhere that you have seen these small pens or large modules that contain the vaping oil being used. Many, due to the idea that the “smoke” being emitted is “just vapors”, believe that there are no negative repercussions in the way of secondhand smoke exposure. According to the Iowa Department of Health (IDPH), the U.S. Surgeon General, the American Lung Association, and the National Academies of Science, Engineering, and Medicine, among others, warn otherwise.

What is an ESD and how does it work?

There are several different vaping modules that exist in our society today. Many of us see them on a daily basis. Juuls, a common e-cig, appear to be a long, rectangular pen. Clear Fusion Vape pens look just like the two words in the name describe; a pen like structure with a glass center. Mini-box mods are slightly larger than the other forms and have a bulky and square design to them. Simply looking up the most popular vapes and a list of images of what these all look like will become available.

When using an e-cigarette, the user is “heating” the e-liquid by using the battery activated flow sensor that leads to the atomizer heating the liquid into a vapor that is then withdrawn from the e-cig, inhaled, and then exhaled by the user. No open flame needed. Most of these devices are operated by a push-button.

What are the “e-liquids” made of?

The thick liquid that is often times flavored contains toxins that can be found in a variety of everyday use materials. Acrolein is a common chemical that is used in combatting weeds in yards. Acetaldehyde is a common and prevalent carcinogen found in tobacco products that is formed by acetic acid. Last, but certainly not least in this mix is formaldehyde—a chemical that is commonly found in glues, lacquers and finishes. These chemicals are caused by the heating of the other two predominant ingredients, propylene glycol and vegetable glycerin. Now, according to the American Cancer Society, formaldehyde “has been linked to some types of cancers in humans, but the effect of exposure to small amounts is less clear”.

Secondhand inhalation dangers of e-cigarettes

In documents provided by the IDPH, the U.S. Surgeon General, the American Lung Association and the National Academies of Science, Engineering, and Medicine “have warned about the risks of inhaling secondhand e-cigarette emissions, which are created when an e-cigarette user exhales the chemical cocktail created by e-cigarettes”. There are similarities to the toxicity of exhaled e-cigarette smoke and regular tobacco smoke, most notably the acrolein, but the Centers for Disease Control (CDC) do say on their website that, “e-cigarettes expose users to fewer harmful chemicals than burned cigarettes”. But the CDC also states that parents should “ensure that your kid is not exposed to the secondhand emissions from any tobacco products, including e-cigarettes”.

The IDPH, CDC, ACA, and other organizations have been attempting to educate the public. Signs, billboards, television and radio commercials, and community education have been attempted in much of Iowa. E-cigarettes do cause significant health concerns based on extensive research done by these same entities and reports from hospitals nationwide have shown the immense repercussions that have occurred from the extended use of e-cigs.

The facts displayed in this article is data compiled from more than 800 different studies collected and reported by the American Lung Association which states on its website, “. . . using e-cigarettes causes health risks. The Academies’ report also states there is moderate evidence that youth who use e-cigarettes are at increased risk for cough and wheezing and an increase in asthma exacerbations”.

According to the American Nonsmokers Rights Foundation (ANRF), in October of 2018 there had been a total of 789 United States municipalities had prohibited the use of e-cigarettes in what is considered “smokefree environments” due to the growing research that is finding that direct contact and exposure have shown negative side-effects in individuals that suffer from asthma or cardiovascular disease. The ANRF says, “there is enough peer-reviewed, published scientific evidence to determine that second-hand aerosol is not harmless”.

As additional research is gained and authored, cities and states across the nation have begun to place new laws restricting the areas that e-cigarettes can be used. Continuing health concerns, especially in adolescents, are also mounting stricter laws into the accessibility to these ESDs and the components that accompany them.


These documents and resources were provided by the Iowa Department of Public Health.

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