Vaping/Electronic Cigarettes & Regular Cigarettes: What Are The Differences In Using Them Before Surgery?


What is an e-cigarette?

An e-cigarette is a battery-operated device that people use to inhale an aerosol that is formed by heating a liquid. The user breathes this aerosol and exhales. It is typically used to deliver a nicotine containing substance but it can also be used for marijuana and other drugs.


What are other familiar terms for e-cigarettes?

Other names include e-cigs, e-hookahs, hookah pens, vape pens, vapes, mods, tank systems, and electronic nicotine delivery system.


What do e-cigarettes look like?

Some resemble traditional tobacco cigarettes, cigars, or pipes. Others look like pens or USB sticks. Regardless of their appearance and design, these devices function in an identical manner and are composed of similar ingredients.


How do e-cigarettes work?

Most e-cigarettes are composed of four parts: 1) a reservoir or cartridge which contains a liquid (e-juice or e-liquid) that contains nicotine, flavors, and other chemicals; 2) a source of power (battery); a heating element (atomizer); and a mouthpiece that the user inhales from. When an individual takes a puff, this activated the heating device via the battery which aerosolizes the liquid contained within the cartridge.


What is in the e-cigarette gas (aerosol)?

It is tough to know what is really contained within e-cigarettes but in general they contain nicotine, propylene glycol, glycerin, heavy metals (e.g. lead, nickel, tin), organic compounds, flavoring (e.g. diacetyl – which can cause lung disease), and cancer-causing compounds.


Are e-cigarettes better for you than regular cigarettes?

Depends on your perspective.  E-cigarettes are safer than regular cigarettes, when people who smoke on a regular basis switch to them as a complete replacement. However, this does not mean that they are safe. In general, they contain fewer toxins than the 7,000 chemicals contained in regular cigarettes. Regardless, the lungs are still exposed to numerous chemicals during the heating process. Studies have shown that vapor can contain toxic chemicals, carcinogens, and toxic metal nanoparticles from the device itself.


How does smoking e-cigarettes affect your health?

E-cigarettes contain nicotine which is highly addictive. Research suggest that it may even prime the brain’s reward system, potentially increasing the risk for addiction to other drugs. Furthermore, nicotine has been shown to hard growing fetuses and negatively affect adolescent brain development. They can also cause lung disease. Swallowing, breathing or absorbing e-cigarette liquid has been shown to be toxic to both adults and children. More physical disadvantages of e-cigarettes include starting fires and explosions. You can also be exposed to the aerosol and chemicals in it through secondhand smoke.


Do I need to discontinue e-cigarettes before plastic surgery?

Yes.  I would recommend stopping all nicotine products (cigarettes, gum, e-cigarettes, patch) before surgery at least 6 weeks before and 6 weeks after surgery.  The nicotine affects blood flow and healing capability of the skin.  Ask your plastic surgeon to confirm timelines before surgery.


Can e-cigarettes be used as a quit smoking aid?

The data on this is mixed. Two studies found that e-cigarettes indeed helped smokers to quit compares to a placebo by lowering nicotine cravings. However, a recent study by the CDC reported that most adults will supplement regular smoking with e-cigarettes, although this did help them cut down on smoking regular cigarettes. To date, the FDA has not approved the use of e-cigarettes as a quit smoking aid.


Are e-cigarettes regulated?

The FDA has strict regulations that companies which manufacture or sell e-cigarettes must follow. One example, is the minimum age of 18 permitted for purchase of these products.


Who is smoking e-cigarettes?

Today, a majority of e-cigarette users are middle (4.9%) and high school (20.8%) students; accounting for approximately 3.6 million. Moreover, studies have demonstrated that teens using e-cigarettes were more likely to smoke regular cigarettes in the future. Minors no longer have the ability to purchase e-cigarettes online or in stores. As of 2017, only 2.8% of U.S, adults have smoked e-cigarettes.



Centers for Disease Control and Prevention. About Electronic Cigarettes (E-Cigarettes). Available at Accessed 4/9/2019

National Institute on Drug Abuse. Electronic Cigarettes (E-cigarettes). Available at Accessed 4/9/2019


Ahmed Ibrahim, MD, PhD, Samuel J. Lin, MD, FACS

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