E-cigarettes. A quick fix or a ticking time bomb?

In the past few years, the use of e-cigarettes has become increasingly common, with shops dedicated to vaping popping up in the majority of UK towns. Designed to help smokers quit, e-cigarettes deliver the nicotine craved by users and release a cloud of water vapour in order to replicate the appearance and feeling of smoking. In general, this new alternative is regarded as safer than the use of traditional cigarettes due to the absence of tar and some other harmful chemicals. However, in recent months I have been strongly irritated by the way in which e-cigarettes have been marketed as
safe and harmless, when in truth they have the potential to cause multiple health problems.

Do you notice the similarities?

E-cigarettes still contain the drug nicotine, which has been proven to be strongly addictive, causing withdrawal problems such as depression and feelings of agitation. Evidence suggests that it can have negative impacts on those with existing heart problems, and increases the risk of complications during pregnancy. Furthermore, some e-cigarettes contain formaldehyde, a substance used in antifreeze and building materials, proven to increase the risk of cancer.

Introduced to the American market in 2007, e-cigarettes have been used for a relatively short period of time, and so their long-term health risks remain unknown. Although they have the potential to be relatively safe, the uncertainty surrounding their use is worrying.

To make matters worse, the sale of e-cigarettes is incredibly uncontrolled, with 68% of sales made in the UK being illegal. The inability to control the sales and therefore quality of the product, only increases the potential risks to public health. In addition, a recent article published by the BBC stated that "40% of sellers targeted in an operation by trading standards in England" were found to be illegally selling e-cigarettes to under 18's. The easy access, low costs and alluring flavours such as bubble-gum, chocolate and pink lemonade, entice young people into using the devices even if they had not previously been smokers, putting the future generation's health at risk. The problem is not limited to the UK, but stretches across the pond to America, with a recent study by the CDC stating that "a quarter-million youth who had never smoked a cigarette used e-cigarettes in 2013".

With so little research into the long term health risks this new trend poses, it is impossible to say whether or not e-cigarettes truly are a quick fix to tobacco smoking, or a ticking time bomb in the public health sector.

The Harsh Reality of Medicine

As I told you in my previous post, I've spent the last two weeks on work experience in the histopathology unit of a local hospital. Prior to this, I thought I had a relatively good understanding of what being a doctor entails. I had been warned of the long working hours, the academic challenge, the tremendous responsibilities and I knew that not every patient can be saved. However, I underestimated the impact the utter human tragedy witnessed in this gruelling yet immensely rewarding career would have on me.

On my first day, despite being taken on a tour of the mortuary, I kept a stern face and was fully able to accept the concept of death as a natural and unavoidable occurrence. Inured and composed I continued with the work I had been assigned. However, yesterday I observed a change in my typical response to tragedy. The doctor I have been working with showed myself and another student cases from an account on forensic science and post-mortems, at first I was, once again,unaffected by the deaths recalled in the book. However, we soon turned over the page onto a section discussing still born babies who had been victims of deformities. As my eyes looked over photos of innocent victims of diseases such as Harlequin-type ichthyosis, cyclopia and encephalocele, the reality of medicine really hit home as I began to question the injustice inflicted upon the pure and helpless individuals. I find it difficult to put my new found feelings into words, at the time I showed no emotional response and continued to listen to the cases, but I feel that I need to write this blog post in order to acknowledge that emotion I felt. Perhaps it was a moment of vulnerability, perhaps realising that I would be unable to save some patients in the future but only provide support for their families, made be feel weak and helpless, out of control, an image I did not typically associate with medicine at the time.

By no means has this experience discouraged me from persuing my dreams of being a doctor, if anything, I now feel more inspired to reach my goal.

The experience was not all doom and gloom, whilst in the pathology laboratories, I was allowed to observe the rewarding aspect of medicine.  In one particular incident, I observed the 'cut-up' of two breasts, removed from a patient who had undergone a double mastectomy the previous day. One out of eight women will be diagnosed with breast cancer in their lifetime, making it a major disease in the Western world, and a disease which has had a personal impact on members of my family, making this case particularly intriguing. Within the labs, lymph nodes and sections of the breast surrounding the tumour were removed and converted into slides which were later sent up to the consultants for analysis. Fortunately, the cancer was not metastatic and the operation had been successful in saving the life of this particular patient.

After my experience in the pathology unit, I would definitely consider this area of medicine as a future career pathway. Pathology underpins the basis of all medicine and the consultants, although often have very little patient contact, determine the prognosis and treatment of the individual. They have a great  responsibility and play such a vital role in medicine, making it a challenging yet fascinating career choice.