Unfriendly Fire: How the Tobacco Industry is Destroying the Future of Our Children

Abstract

Tobacco has long been known to be one of the greatest causes of morbidity and mortality in the adults, but the effects on the foetus and young children, which are lifelong, have been less well appreciated. Developing from this are electronic nicotine delivery systems or vapes, promulgated as being less harmful than tobacco. Nicotine itself is toxic to the foetus, with permanent effects on lung structure and function. Most vapes contain nicotine, but they also contain many other compounds which are inhaled and for which there are no toxicity studies. They also contain known toxic substances, whose use is banned by European Union legislation. Accelerating numbers of young people are vaping, and this does not reflect an exchange of vapes for cigarettes. The acute toxicity of e-cigarettes is greater than that of tobacco, and includes acute lung injury, pulmonary haemorrhage and eosinophilic and lipoid pneumonia. Given the worse acute toxicity, it should be impossible to be complacent about medium and long term effects of vaping. Laboratory studies have demonstrated changes in lung proteomics and the innate immune system with vaping, some but not all of which overlap with tobacco. It would be wrong to consider vapes as a weaker form of tobacco, they have their own toxicity. Children and young people are being targeted by the vaping industry (which is largely the same as the tobacco industry), including on-line, and unless an efficient legislative program is put in place, a whole new generation of nicotine addicts will result.

Longitudinal bidirectional association between youth electronic cigarette use and tobacco cigarette smoking initiation in Thailand

“…We found non-smoking youths who experiment e-cigarettes were also more likely to become dual product users, similar to a previous study in the USA 39. This evidence supports public concerns that e-cigarettes may be creating a new generation of youth addicted to nicotine 40…”

E-Cigarettes as a Growing Threat for Children and Adolescents: Position Statement From the European Academy of Paediatrics

“…Human studies also suggest that smoking is associated with increased thickness of airway smooth muscle. Immunological consequences of smoking in pregnancy as studied in cord blood include increased mononuclear cell reactivity to allergens; reduced interleukin IL-10 and Toll-like receptor function; and reduced IL13 production, this last may be associated with subsequent early viral induced wheeze ( 1 , 39 ). Finally, maternal smoking sensitises the foetus to adverse effects if the young person subsequently smokes; and early disadvantage, especially including passive smoke exposure, is associated with more rapid adult lung function decline, and a greater susceptibility to adult life occupational exposures ( 40 , 41 ).…”

“…E-cigarette and vaping induced lung injury (EVALI) has become an epidemic. Elsewhere it has been argued that the EVALD (E-cigarette and vaping induced lung disease ) is a better term, because although acute lung injury is certainly one result of e-cigarette use, there are many others, including lipoid pneumonia, organising pneumonia, eosinophilic pneumonia acute pulmonary haemorrhage and nodular lung disease, some of which are fatal ( 1 , 16 , 17 , 22 ). The definition of EVALI/EVALD is still debated.…”

“…The adverse health effects of tobacco, which extend right across the developmental course from transgenerational to antenatal through childhood to old age are well-documented. As legislation increasingly restricts the sale of tobacco, and of course as the current generation of people addicted to tobacco dies off prematurely ( 1 , 2 ), the industry it seems has to find ways to recruit new addicts in order to make money. A new initiative has come in the form of a variety of heated products for inhalation, some but not all of which contain nicotine.…”