Sir, I read with interest the recent correspondence in the BDJ entitled 'Rethinking e-smoking' by R. Lee.1
It would be worth mentioning that in addition to vapourised nicotine, e-cigarette aerosol contains particles of an ultrafine nature which may be inhaled into the deeper portions of the lungs, diacetyl flavouring recognised as a causative agent for serious lung disease, carcinogenic chemicals, organic compounds (volatile) and heavy metals.2
Moreover, consumers might not be aware of what their product contains and certain 'zero percent nicotine' products have been evidenced to actually possess nicotine content.3
Further, it is also relevant to ask patients what kind of substances they have used with their vaping product as these may include THC or CBD.4
References
Lee R. Rethinking e-smoking. Br Dent J 2023; 234: 12.
Centers for Disease Control and Prevention. Electronic Cigarettes. Available at: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm (accessed January 2023).
Goniewicz M L, Gupta R, Lee Y H et al. Nicotine levels in electronic cigarette refill solutions: a comparative analysis of products from the US, Korea, and Poland. Int J Drug Policy 2015; 26: 583-588.
Centers for Disease Control and Prevention. Don't Forget to Ask. Assessing the risk of lung injury in patients using e-cigarette, or vaping, products. Available at: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/healthcare-providers/pdfs/dont-forget-to-ask-assessing-the-risk-of-lung-injury-508.pdf (accessed January 2023).
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Sahni, V. Ultrafine particles. Br Dent J 234, 136 (2023). https://doi.org/10.1038/s41415-023-5563-9
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DOI: https://doi.org/10.1038/s41415-023-5563-9
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