E-cigarette was created in 2003, and gained popularity over the past decade. It has been perceived to be good in term of a harm reduction product for chronic smoker, environmental friendly, or even “fashionable”. Although user of e-cigarette may expose to less known toxic substances such as nitrosamines from conventional cigarette, e-cigarette is definitely harmful. The existing evidence shows that e-cigarette aerosol contain multiple toxicants.
Thousands of e-cigarette refill liquid or e-liquid are available in the market. E-liquid commonly contains nicotine of varying concentration, glycerin, propylene glycol and flavour chemicals. The exact ingredients of e-liquid may not be reliably listed. It was found about one-fifth of e-liquid samples had significant discrepancy (>20%) in the labelled nicotine content. Besides, e-liquid may contain high concentration of different flavor chemicals of potential toxicity. One example is the flavor chemical “diacetly”, which is a culprit for “popcorn lung disease”.
From a clinical perspective, e-cigarette poisonings have increased significantly in recent years. Poison centres data suggest majority of the e-cigarette exposure involve children. Although severe toxicity is uncommon, fatality from accidental exposure did occur. The major toxicological concern is acute nicotine poisoning. Besides, e-cigarette “explosion’ resulted in significant burn and blast injury were noted in case reports.
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