[Answered] Explain the mechanism behind Electronic Nicotine Delivery System (ENDS). Discuss various health risks associated with it.

Electronic Nicotine Delivery Systems are battery-operated, handheld devices that are alternatives to traditional smoking of cigarette. It emits doses of vaporised nicotine, or non-nicotine solutions, for the user to inhale. Inhaling e-cigarettes is injurious to health with major health risks.

Components:

AnENDS consists of a

• battery,
• a vaporiser and a heating coil,
• a mouthpiece, and
• a cartridge containing liquid nicotine.

This liquid is vaporised and inhaled. The liquid also contains flavours, anti-freeze, and carcinogens such as nitrosamines.

How ENDS Work?

• As the user inhale on the mouthpiece, a sensor activates a heating element that vaporises a flavoured liquid solution held in the mouthpiece. The person then inhales, the aerosol solution.
• A small plastic cup within the mouthpiece holds an absorbent material soaked in the liquid solution.
• The atomiser is a heating element that heats the liquid, causing it to vaporise. The solution can then be breathed in, or inhaled.
• The solution, also known as e-liquid or e-juice, is made by extracting nicotine from tobacco and mixing it with a base, usually propylene glycol, and flavouring.

Associates health risks and other ill effects of ENDS:

1. Drugs intake: They are now being used for other purposes such as inhaling various drugs etc.
   • This lead to increase in drug consumption among youth.
   • Continued use of nicotine can make other drugs, such as cocaine, more pleasurable.
2. Addictive: Most e-cigarettes contain nicotine, which is addictive and lead to changes in the adolescent brain. Nicotine is more addictive than tobacco.
3. Risk to heart: E-cigarettes adversely affects the cardiovascular system with increased risk of hear attacks.
4. Respiratory diseases: It impairs respiratory immune cells function and airways similar to cigarette smoking and is responsible for severe respiratory disease like asthma.
5. Risk pregnancy: It poses risk to foetal, infant and child brain development. Therefore harmful to both mother and child.
6. Carcinogenic: The liquid contains substances that are carcinogens such as nitrosamines.
7. Lung disease:
   • E-cigarettes expose the lungs to different substances.
   • One of these is diacetyl, which can causes severe and irreversible lung disease.
8. Fatal: Accidental swallowing of liquid from e-cigarette has been fatal in many cases.
9. Not a smoking cessation device:
   • People who use or who have used e-cigarettes are less likely to stop smoking altogether as they stop using conventional and medically monitored methods of doing so.
   • A 2017 analysis of PATH data found that smokers who used e-cigarettes to quit smoking were more successful than non-e-cigarette users.
10. Dual users: Teens who use e-cigarette products are more likely to start using regular tobacco as well.

Thus ENDS poses major health risks. Ensuring Health of citizens is state’s responsibility. Therefore, the Union Health Ministry in 2018 issued an advisory to all states and UTs to stop manufacture, sale and import of ENDS. Some states have already banned use and sale of e-cigarettes. Recently India proposed a complete ban on ENDS product which is a right step.