Dr KK Aggarwal
Over the last decade, there are other options for ingesting nicotine which are not only less reinforcing than nicotine delivered in a combustible cigarette, but do not involve the high-level release of toxic chemicals.
These have been called safer nicotine products (SNP) in the report No Fire, No Smoke Global State of Tobacco Harm Reduction, 2018 and they break down into three main types: e-cigarettes, heat-not-burn (HNB) devices and an option that is very far from new but enjoying a renaissance: smokeless tobacco, in the form of snus from Sweden.
Types of e-cigarettes
There are now many types of e-cigarette. They range from entry level disposable types, which cannot be customised and are known as ‘closed systems’, through to mechanical modified types, or ‘mods’, which the vaper is able to fully customise and are at the top end of what are known as ‘open systems’. The higher up the device scale you go, the more control the vaper has over the whole vaping experience.
All e-cigarettes have three basic elements; a battery, which heats up a coil or atomiser, turning the flavoured e-liquid or juice into a vapour, which is then inhaled.
E-liquid comprises four ingredients: vegetable glycerine, propylene glycol, nicotine, and flavouring.
Some liquids can contain no nicotine.
Vegetable glycerine (VG) is a thick, naturally sweet liquid that provides the vapour from the liquid.
Propylene glycol (PG) is a thin liquid, which acts as the flavour carrier. Some people are allergic to PG and e-liquid without that ingredient is available.
The VG/PG ratio is the ratio of VG and PG in a liquid.
The higher the VG percentage, the more cloud and the smoother the vape, but there is less flavour.
Higher PG gives less cloud, more ‘throat hit’ and possibly more flavour. Throat hit refers to the feeling a smoker gets when inhaling nicotine. The problem that most smokers switching to vaping report is the fact that they do not feel the same kind of throat hit that they would with a regular cigarette.
The flavourings are the same as used in food and confectionery production and the range of flavours available for vaping runs into the thousands.
(Source: No Fire, No Smoke Global State of Tobacco Harm Reduction, 2018 (2018). London: Knowledge-Action-Change)
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India