Air Force warns Airmen of e-cigarette risks Published Dec. 12, 2019 By Shireen Bedi Air Force Surgeon General Public Affairs FALLS CHURCH, Va. -- With more than 2,000 reported cases of lung injury associated with electronic cigarettes nationwide, it is vital that Airmen understand potential impacts on their health. While restrictions exist, the Air Force, much like the civilian population, is seeing a decrease in traditional tobacco use, but an increase in e-cigarette use. Specifically, use is highest among younger, enlisted Airmen. “E-cigarette use has gone up to about 6.4% among the Total Force,” said Col. Thomas Moore, chief, Air Force Health Promotions Branch. “When we first reported this, it was at 4% use.” Air Force Health Promotions leadership stressed that the use of e-cigarettes does not come without risks. “The thing with inhaling these highly addictive nicotine products, especially ones that have been modified in some way or come from smaller, informal shops, is that you don’t always know what you are inhaling and how much nicotine you are taking in,” said Dr. Regina Watson, Air Force Health Promotions Branch program manager. Moore explains that many e-cigarette products also contain a higher concentration of nicotine. Not knowing how much nicotine an e-cigarette user is taking in also poses challenges to understanding its long-term effects. Because e-cigarette cartridges can vary from brand to brand, it is difficult to measure nicotine intake. “Measuring nicotine intake with e-cigarettes is challenging compared to traditional cigarettes and tobacco products,” said Moore. “With traditional cigarettes, you can ask a smoker how many packs they go through in a day. With an e-cigarette user, you don’t know who much they inhale at one time. Do they take one puff? Do they smoke for 10 minutes? These are hard to measure and it’s challenging to assess usage.” Another significant challenge of understanding the long-term impact of e-cigarette use is that it is a relatively new product and little data is available. As Moore explains, the link between traditional cigarette smoke with cancer and other serious illnesses has several decades worth of data behind it. “E-cigarettes, on the other hand, are not much more than a decade old, so we don’t have anywhere near the length of time to have studied its impact,” said Moore. Additionally, some studies that have been done on e-cigarette use and its impact on health, some of which have shown that these products contain certain chemicals that are known to be harmful. At the same time, there is still insufficient evidence. According to the Centers for Disease Control and Prevention, the best way to avoid risks during investigations into the recent string of injuries is to consider refraining from the use of all e-cigarette products. The Air Force Medical Service continues to track tobacco use through the annual periodic health assessment, and, since 2016, e-cigarette use is being tracked. Targeted e-cigarette educational materials are also under development. “The thing about e-cigarettes is that there are risks, and the long-term impact is unknown,” said Moore. “And with the recent incidences of lung injuries associated with e-cigarettes, it is important for Airmen to be aware of the potential risks they face when they choose to use e-cigarettes.” The Air Force’s policy on tobacco products applies the same restrictions to the use of e-cigarette products. “You must be at least 50 feet from building entrances and air intakes, you are not allowed to use them in military treatment facilities, and they are prohibited during basic military training and while on duty during technical training,” said Moore.