The electronic cigarette , “e-cigarettes” or “e-cigarettes”, “e-cigs”, “electronic hookahs” or “e- hookahs”, “mods”, “steam pens”, “vapers”, “ tank systems ”and“ electronic nicotine supply systems ”(ENDS), (CDC, 2019) all of these different names comprise the similar element of the new era of tobacco use. To identify an electronic cigarette, you must check if it has a liquid cartridge, which is the main component of nicotine, which is mixed with different flavors to attract the consumer. The liquid mixture with heat generates a vapor which releases the substances contained in the liquid. Like other types of tobacco, the release of nicotine is where the user begins to feel satiety and need to continue using this type of tobacco. This new trend also generates dependence.
Nicotine is the element of tobacco that creates addiction not only physical, but also social and psychological. This new trend of consumption reflects the three areas of addition since steam generates the same effect as regular tobacco, so the use of this variation becomes one of the problems of public health care.
This element of tobacco starts since 2003 where pharmacologist Hon Lik develops the electronic cigarette (e- cig). Later in 2007 he arrived in US regions where he began to market to stop smoking. From these dates there was little information and it was used as a method to quit smoking, its access was limited by its cost, however, it was becoming more economically accessible and attractive to the eye, by the method of promotion and use.
In Puerto Rico there has been a trend in Vapping bars and restaurants as something socially acceptable and where it is used for sharing. This practice has led to the perception of its use being a less serious level of damage to health. In a recent investigation in Puerto Rico, (Melin et al, 2018) that collected the knowledge and perceptions of electronic cigarettes and the motivations for their use: talking with smokers (electronic cigarettes and / or conventional cigarettes) and non-smokers, I confirm that the population has the perception that this type of tobacco is less harmful than the original, so they use it to replace the common cigarette or as part of smoking cessation techniques.
The monitoring of the consumption of this product led the CDC to publish warnings of the serious health effects of the product. The effects are related to the components of the electronic cigarette aerosol, nicotine is its main component which is addictive, ultrafine particles that can reach the lung, chemical substances that are carcinogenic and flavors such as diacetyl which is linked to severe lung disease, heavy metals such as nickel, tin and lead have also been found, as well as volatile organic compounds. The main damage to health is that it can affect brain development in adolescents so they may have loss of attention, delayed learning, changes in moods and / or impulse control, can cause some types of cancer and severe lung disease
In Puerto Rico there is a restriction on the use of electronic cigarettes as well as conventional cigarettes at the level of use in public places (Law No. 59 of 2011, amended Law No. 40 of 1993), the sale to children under 18 years of age is also prohibited (Law No. 41 of 2015) and the advertising and promotion of all products containing tobacco is regulated (Law No. 92 of 2015). The Coalition for a smoke-free Puerto Rico in conjunction with the Puerto Rico Department of Health continues to monitor the trends and practices of this new type of tobacco in conjunction with the global initiatives with the CDC. There is a record of cases before the outbreak of lung lesions associated with the use of electronic cigarettes. Although until October 15, 2019 in Puerto Rico there have been no reported cases (see map: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#what-cdc-is- doing), in the smoking cessation line we offer guidance on the signs and symptoms associated with lung lesions, through the smoking cessation orientation in the cessation line. Quit now through 1-877-335-2567.
Melin Kyle, Conte-Schmidt, Nelly, Martinez-Arroyo, Karol, Rosa-Perez, Kellymar, Soto-Aviles, Adriana E. & Hernandez-Muñoz, José (2018) Knowledge and Perceptions of E-Cigarettes and Motivations for their use: Talking to smokers (E-cigarettes and / or convenctional cigarettes) and Non-smokers in Puerto Rico. PRHSJ Vol.37 No. 3, septiembre, 2018. Paginas. 148-154.
What CDC doing. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping Asesado el 22 de octubre de 2019 de https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#what-cdc-is-doing
Secretaria de auxiliar para la promoción de la salud. Agosto 2019. Hoja informativa cigarrillo electrónico, recuperado de www.salud.pr.gov.
Levanthal AM, Strong DR, Kirkpatrick MG, et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA 2015; 314:700–707. doi:10.1001/jama.2015.8950.
Puerto Rico law #41-2015. LexLuris de Puerto Rico. Disponible en: Url: http://www.lexjuris.com/lexlex/Leyes2015/lexl2015041.htm. Asesado el 22 de octubre de 2019.
Puerto Rico law #92-2015. LexJuris de Puerto Rico. Disponible en: Url: http://www.lexjuris.com/lexlex/Leyes2015/lexl2015092.htm. Asesado el 22 de octubre de 2019.