The problem of e-cigarettes easily exploding
A 23-year-old man in Georgia, USA, exploded while smoking an e-cigarette, causing fractures and burns to his fingers [82]. The media therefore questioned the safety of e-cigarettes, sparking heated debate. But netizens said the real reason was improper use: the finished atomizer was installed on a mechanical rod containing a very high-wattage power battery. [Source Request]
A man’s e-cigarette in Texas suddenly exploded and fragments penetrated his carotid artery, killing him. [83]
Countries in the United Kingdom and the United States have adopted pre-market review mechanisms to ensure product safety and protect users. The UK uses a pre-market notification mechanism, which stipulates that manufacturers must submit relevant information before listing. The United States requires e-cigarettes to undergo a marketing review, including safety, and prove that the health risks are not more serious than traditional cigarettes before they can be put on the market. [84]
E-cigarette lung injury EVALI caused by illegal additives
Since August 2019, there have been successive outbreaks of severe lung diseases caused by e-cigarettes in the United States. The symptoms of patients include vomiting, shortness of breath, chest pain and other symptoms. In severe cases, some are even admitted to the respiratory intensive care unit and rely on life-support equipment to maintain their lives. The U.S. Centers for Disease Control and Prevention (CDC) announced on October 31, 2019, that a total of 1,888 confirmed cases and 37 fatal cases were reported from 49 states. The only common cause was the use of e-cigarettes within 3 months[85] . Later, this disease caused by e-cigarettes caused severe lung injury was designated as EVALI. After research, it was found that it was closely related to the addition of cannabis ingredient THC and co-solvent vitamin E acetate to the e-cigarette oil. The use of THC and vitamin E acetate was prohibited. No cases of severe lung injury (EVALI) have been found since the use of esters. Now the U.S. Food and Drug Administration (FDA) and the International Health Organization (WHO) also prohibit the addition of these two ingredients in e-liquids and the use of electronic products containing THC. Smoke[86].
Adolescent drug use problems
British scholars studied the “National Youth Tobacco Use Survey” and found that there is no causal relationship between the use of e-cigarettes and the increase in smoking rates. In other words, simply banning e-cigarettes cannot solve the problem of youth smoking from the source. The U.S. National Youth Tobacco Use Survey pointed out that among e-cigarette users, 71% are long-term users of cigarettes (more than 100 cigarettes), 8.4% have never used any cigarette products, and 29% have used non-combustion cigarette products [87] . In other words, the vast majority of people who use e-cigarettes start with paper cigarettes. The 2021 British ASH report on the use of e-cigarettes among teenagers showed that young people aged 11-18 have become more aware of e-cigarettes, but the usage rate has not significantly increased due to their knowledge of e-cigarettes. It is analyzed that the main reason for smoking e-cigarettes is to try them out (49.3%), and it is unlikely that they choose to use e-cigarettes because they are easy to obtain (1.1%) or cheaper than paper cigarettes (0.8%). [88]
