Everyone is aware of the dangers of both active and passive smoking and the recent smoking in public places regulations highlight this awareness. E-cigarettes are claimed by Public Health England(PHE) to be 95% less harmful than conventional cigarettes, largely because they do not subject the user or people nearby to tar and carbon monoxide. This is not endorsed by the National Institute of Clinical Excellence(NICE) as a smoking cessation device. Some respiratory specialists are concerned that Vaping “risks a further epidemic of lung disease for today’s children”.
The nicotine is vaporised with a mix of polypropylene glycol and glycerine and often other flavourings. The vape material can cause adverse changes in the lining of the lungs which can lead to Chronic Obstructive Pulmonary Disease(COPD) and may be associated with heart disease (myocardial infarction). Vapes that contain nicotine salts rather than free based nicotine are less volatile and as such more of the nicotine reaches deeper into the lungs.
As vaping has only been round for a relatively short time, we do not know all its adverse effects. We do know that the chemicals in the vapour such as formaldehyde are toxic to the ocular surface and can cause irritation and dry eye. This can apply to passive vaping as well as direct use.
The nicotine itself can affect the eye especially in diabetics, by speeding up diabetic retinopathy and diabetic macular oedema. By reducing the retinal blood flow nicotine can contribute to the early development of Macular Degeneration (AMD). Eye Care Practitioners need to be alert for signs of these conditions in Vape users.