•Vaping
The trend of using electronic cigarettes is on the rise, especially among youths in Nigeria. The low awareness on the dangers to the health of users and public health in general should be taken as a serious concern, writes Juliet Jacob Ochenje.
Smoking kills, and there is no secret about it. Tobacco smoking is the world’s leading preventable cause of premature death globally. According to the Nigerian Health Foundation (NHF), tobacco use and second-hand smoke is a major risk factor for cardiovascular disease (CVD), including coronary heart disease, stroke and peripheral vascular disease; contributing about 12 per cent death from heart disease.
In 2018, the World Health Organisation (WHO) stated that tobacco use kills seven million people worldwide each year and that number is predicted to grow unless anti-tobacco actions are increased.
In Nigeria, there are at least 11 million smokers, majority of them young people who engage in an ever growing nightlife culture. According to statistics by Macrotrends, the prevalence of smoking among men and women ages 15 and over who currently smoke any tobacco product on a daily or non-daily basis have been on a decline, even though the number of casualties remain high.
It stated that Nigeria smoking rate for 2020 was 3.70%, a 0.2% decline from 2019; 2019 was 3.90%, a 0% increase from 2018; 2018 was 3.90%, a 0.8% decline from 2015 and 2015 was 4.70%, a 1.2% decline from 2010.
However, the harms of smoking persist with Nigeria suffering 17, 000 annual deaths from smoking related disease. This is despite efforts of anti-tobacco advocates who have sustained decades long anti-smoking campaigns in the country. Nigeria has been a signatory to the WHO Framework Convention on Tobacco Control (FCTC) since 2005, and adopted the National Tobacco Control (NTC) Act in 2015.
The rise of vaping (use of electronic cigarettes)
In a bid to escape the damning consequences of cigarettes, many people are turning to e-cigarettes which is an electronic device that simulates tobacco smoking. Instead of smoke, the user inhales vapor, hence the word, “vaping”.
Some look like traditional cigarettes and most are reusable. The vapor mainly comprises propylene glycol and/or glycerin, usually with nicotine and flavouring. Its exact composition varies, and depends on several things including user behaviour.
There is increasing interest in vaping in Nigeria, though it is not a common sight yet but is popular among young adults. Mr Alechenu Desmond, a young adult who African Health Report (AHR) approached for a chat on this subject on a street in Abuja, said he doesn’t smoke but knows about vaping because many of his friends do it.
Desmond said: ”I got to know about e-cigarette when I was in my final year in school. I was walking with a friend one day when he brought out something that looks like a pen. He flicked something on its side and put it in his mouth. As he was sucking on the pen-like object, which had a flickering light inside, I was so curious and asked him what it was and he said it was a vaped pen. That was the first time I saw it, then when I tried to do more research about it as an inquisitive person that I am, I came to realise that it is also called e-cigarette and it can be used in place of the normal cigarette that people smoke. I also discovered that it is less harmful than the other cigarette.”
But while vaping is likely far less harmful than smoking, it is still harmful. According to John Hopkins Medicine, vaping cigarettes heat nicotine (extracted from tobacco), flavourings and other chemicals to create an aerosol that the user inhales. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. The long-term effects of use are unknown, though evidence is accumulating on the adverse health effects of e-cigarettes.
The number of people turning to vaping is on a steady growth, though not as many as stick cigarettes, maybe due to the high cost of the product. One of such people is a young man who simply identified himself as Sadiq.
He told African Health Report (AHR) that he has been smoking the regular cigarette for years and will stick to it because he cannot afford e-cigarettes. He said he has seen it with a friend before and was really attracted to it but lost interest when he was told how much it costs. According to him, the friend told him that the least model was about 6,000 naira and knowing he couldn’t afford it, he would rather continue smoking the regular cigarette that he is already used to.
When asked if there was any difference between the two of them or the health benefits of the e-cigarette compared to the regular cigarette, Mr Sadiq said he has no idea, that he just liked the appearance of the e-cigarette and that’s all.
A study by the National Library of Medicine titled ”Electronic cigarettes use among young adults in Nigeria: Prevalence, associate factors and pattern of use” which was published online on October 22, 2021, also corroborated the position that the relatively high cost of e-cigarettes may account for the lower prevalence among Nigerians.
The study stated further that with increasing marketing and access to e-cigarette shops, the use of e-cigarettes can rise correspondingly and produce a higher prevalence in the future, serving as gateway products for young adults to progress to combustible tobacco use and a concurrent increase in tobacco-induced diseases.
Furthermore, the research found that young adults above 18 years were more likely to use e-cigarettes than adolescents between 15 and 18 years. Similarly, more males than females used e-cigarettes, with significantly higher odds of ever-use among males than females. Also, those who had friends who vape were more likely to pick up the habit than those who don’t. Therefore, the study suggested that a targeted health warning and messaging based on gender differences and age is crucial in mitigating the uptake of e-cigarettes, especially among adolescent and young adult never-users in the country.
Lack of regulation, information on vaping promoting more use
Presently, there are no restrictions to the purchase, sale, and advertising of e-cigarettes, according to the National Tobacco Control Regulations, 2019. Similarly, there are no regulations surrounding the contents and labelling of these products. The lack of policies regulating e-cigarettes can potentially allow the tobacco industry to freely market these products, encouraging unintended effects that can be compounded by their inherent novelty, flavours, and addictive nicotine content.
A review of e-cigarette products at a major online retail store in Lagos, according to the research cited above, indicates the presence of 2nd to 4th generation devices at prices ranging from 4500 naira to 50,000 naira. These prices suggest e-cigarettes are more expensive than combustible cigarettes (a pack 400 naira).
Despite the high price, many smokers prefer to patronise e-cigarettes based on the assumption that it does not contain harmful chemicals and would not have adverse effects on their health like the stick one.
Vaping addictive, hazardous to health – Dr. Ikhu-Omoregbe
African Health Report (A.H.R) spoke to Dr. Roberts Osas Ikhu-Omoregbe of the Maitama District Hospital, Abuja, on the health implications of smoking e-cigarettes. He elaborated on how it works, saying that vaping enables smokers to consume or take the main substance they desire in cigarettes, which is nicotine, without having to take other components that are contained in a regular cigarette.
He also noted unlike marijuana, skunk and the likes that have to be ignited to generate smoke, with about five to six thousand chemical compounds or thereabout found in the regular cigarette, e-cigarettes selectively identifies the main substance, which is nicotine, without burning it.
”Rather, it is added to liquid with other additives and flavours which would also be added, depending on the user’s choice, and be made into vapor without necessarily burning anything at all,” he explained.
The doctor added that there’s no consumption of other undesired compound and chemical that are found in the regular cigarette in vaping and because nothing is being burnt, it does not cause teeth staining, gum or lip darkening and does not expose non-smokers to undesired or hazard effect like the regular cigarette does. In addition, he noted that it does not constitute an environmental hazard because there is no carbon monoxide or sulphur compound released into the air while using it.
However, Dr. Ikhu-Omoregbe warned that e-cigarettes can be easily abused because the quantity of nicotine to be added to the liquid to be vaporized could actually be determined by the user and nicotine, being highly additive, can create tolerance in the system of the user which might result into increase intake of the nicotine.
He explained: ”As we already know, nicotine carries so much hazards that are risky to one’s health because it causes muscular diseases, hypertensive diseases, heart diseases, liver problem and so on. Conventional smoking has that risk of lung cancer, chronic airway diseases and so on, the e-cigarette just modifies it, not like it doesn’t cause those challenges too but it might not be that hazardous like the regular cigarette because of the absence of carbon monoxide being burnt. Like I mentioned earlier, they can also be highly additive. So as for young adults, it is never advisable to abuse substance, whether the regular smoking or the e-cigarette, because of the health risk involved and also by smoking either of them, it always easier to result into smoking or taking other dangerous substances that are life threatening.”
Since it has been established that vaping is a heath hazard to users and would increase the burden of public health institutions, it is expedient that immediate action should be taken to regulate the use and inform the public on the harmful effects of vaping.
