Electronic cigarettes disguised as toys lure young people

After dinner, Ms. Ngoc's son experienced tremors in his hands and feet, dizziness, difficulty breathing, and convulsions, and had to be hospitalized. Doctors at the National Children's Hospital determined that the "toy" the child used was actually a sample of an electronic cigarette (ELC), and diagnosed poisoning due to smoking an electronic cigarette. The test results of the ELC sample the child smoked showed that it contained some addictive substances, and this was the cause of the child's poisoning.

"I was shocked," Ngoc said, adding that she did not expect that children's everyday toys would be "disguised" as e-cigarettes. Her son said that he was encouraged to use e-cigarettes by older students, then he went online to find information and ordered some to smoke "just to know."

Ngoc's son was only slightly poisoned, but not everyone is so lucky. The Poison Control Center, Bach Mai Hospital regularly receives patients with e-cigarette poisoning, mainly young people. Recently, the center treated a 20-year-old male patient who was in a coma and had convulsions. Test results of the e-cigarette sample he smoked found marijuana. This is the second time in more than a year that this patient has been poisoned by e-cigarettes. The last time the patient was also treated at the Poison Control Center, Bach Mai Hospital, but this time his condition was more severe due to brain and heart damage, severe metabolic acidosis, and kidney failure.

Electronic cigarettes disguised as toys, food, contain drugs

The above patients were among more than 1,200 hospitalizations due to the use of e-cigarettes and heated tobacco products in 2023, according to a summary report from nearly 700 medical facilities. Of these, about 6% were under 18 years old; 10% were female; 6.6% were first-time e-cigarette users; 90% were dual users, meaning they also smoked regular cigarettes. Each patient was treated for an average of 1-6 days, of which 62 people suffered from complications after treatment.

Doctor Nguyen Trung Nguyen, Director of the Poison Control Center, Bach Mai Hospital, said that the symptoms of patients hospitalized due to smoking e-cigarettes are mainly allergies, poisoning, acute lung injury, the most dangerous being the condition of e-cigarettes mixed with drugs. The common point of the patients is that they are in a very serious condition with symptoms of convulsions, excitement, restlessness, hallucinations, uncontrolled behavior, damage to the brain and many other organs. Test samples show that e-cigarettes are mixed with 3-4 types of drugs, while previously there was only one.

"The solution used to suck e-cigarettes contains nicotine and many substances that are harmful to the body, so when mixed with foreign substances, stimulants, and drugs, the consequences cannot be predicted," said Dr. Nguyen, adding that the group of users are mostly young people, many of whom are students. In July 2023, a 22-year-old male patient was in critical condition after smoking e-cigarettes mixed with four drugs.

According to data from the Ministry of Public Security, in the first 6 months of 2024, related to electronic cigarettes containing narcotics, the police nationwide discovered, arrested, and prosecuted 35 cases with 83 defendants; handled 24 cases, 31 defendants buying, selling, transporting, storing, and using electronic cigarettes containing narcotics. New cigarettes are not only smuggled into Vietnam, but have also appeared from a business that imports components, essential oils, and organizes processing and production in large quantities.

The World Health Organization (WHO) defines an e-cigarette as a product with an electronic delivery system (e-cigarette) in the form of a device or separate parts, designed not to burn but to vaporize a solution that the user inhales. This solution may or may not contain nicotine, along with other toxic substances such as fine particles (PM), propylene glycol, glycerin, formaldehyde, acetaldehyde, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), nitrosamines (TSNAs), metals, silicate particles, dicarbonyl substances (glyoxal, methylglyoxal, diacetyl) and hydroxycarbonyl (acetol). E-cigarette smokers will inhale the above chemicals, causing harm to themselves and those around them.

In fact, the tobacco industry is implementing a product development strategy aimed at young people such as: eye-catching, compact product designs, such as lipsticks, milk cartons, ice creams with many flavors, etc. Cheap prices, from 17,000 VND, with promotions such as buy 2 get 1 free, free essential oils. In addition, they also use young people and celebrities to advertise cigarettes, and sell them through e-commerce sites. In particular, TLĐT is disguised as toys and food such as milk cartons, lego toys, funny animals, etc.

"Therefore, the younger generation has easy access to these products, and parents cannot control them," said Nguyen Trong Khoa, Deputy Director in charge of the Department of Medical Examination and Treatment Management (Ministry of Health), adding that in the past 5 years, the rate of e-cigarette use has been very high. These products are not allowed to be imported but are currently traded and easily accessible. According to preliminary results of a survey in 11 provinces/cities in 2023, the rate of use among students aged 13-17 is 8.1%, 3 times higher than 5 years ago. Meanwhile, the rate of heated tobacco use among the 13-15 age group is 1.4%. The rate of use in large cities and urban areas is higher than in rural areas.

At the end of October, the Ministry of Health announced the harmful effects of e-cigarettes and heated tobacco products based on research conducted by the Institute of Health Strategy and Policy (Ministry of Health). The research was conducted by synthesizing and analyzing international and domestic studies and reports on the harmful effects of new cigarettes, in order to propose measures to prevent new cigarettes. This research also pointed out 4 harmful effects of new cigarettes.

For health, e-cigarettes cause acute harm, which can lead to fatal acute lung injury (EVALI). Users are at risk of injury and burns due to exploding batteries and devices. Many people are poisoned by overdoses of nicotine and other drugs mixed into e-cigarette solutions.

This type of cigarette contains nicotine - a highly addictive substance, harmful to brain development, causing respiratory diseases in humans, and impairing/disrupting lung function. E-cigarettes also aggravate respiratory disorders such as asthma, chronic obstructive pulmonary disease (COPD), alter the function of bone marrow cells, including granulocytes, thereby affecting allergic diseases... Long-term use of e-cigarettes has long-term harmful effects on cardiovascular function, cancer, and oral diseases.

Electronic cigarettes should be banned.

Dr. Ulysses Dorotheo, Executive Director of the Southeast Asia Tobacco Control Alliance (SEATCA), assessed that Vietnam, like other ASEAN countries, is facing the problem of increasing use of e-cigarettes, especially among young people.

“A ban on e-cigarettes is the most effective way to address this problem and avoid repeating the mistake of allowing the tobacco epidemic to grow,” he said.

Currently, more than 40 countries and territories have banned e-cigarettes. In ASEAN, Brunei, Cambodia, Laos, Singapore and Thailand have banned them. Meanwhile, Indonesia, Malaysia and the Philippines - countries that have bowed to pressure from the tobacco industry and allowed the sale and advertising of these products - are having difficulty dealing with the e-cigarette use among young people.

"Vietnam should consider lessons from these countries when deciding whether to ban or regulate," Dr. Dorotheo said, adding that some countries that ban e-cigarettes have the lowest smoking rates in the world, such as Singapore (10.1%), Brazil (9.1%) and Hong Kong (9.5%).

Mr. Nguyen Tuan Lam, WHO representative in Vietnam, commented that there is currently no e-cigarette market in Vietnam, mainly floating trade through hand-carried goods and over the Internet. "Therefore, it is very feasible to issue a ban before these products are widely used in the market," Mr. Lam said.

Dr. Nguyen Khanh Phuong, Director of the Institute for Health Strategy and Policy, shared the results of the Global Youth Tobacco Survey in 75 countries (2015-2019), showing that countries that ban the sale of e-cigarettes have much lower rates of use among 13-15 year olds than countries that allow sales and age restrictions for adolescents. In the ASEAN region, Singapore and Cambodia are two countries that have been successful in reducing the rate of e-cigarette use among both adults and children through ban policies. In 2022, the rate of e-cigarette use in Cambodia will decrease from 2.4% to 0.9% among children, with adults decreasing to 0.02% in 2021.

At the question-and-answer session with Minister of Health Dao Hong Lan on the afternoon of November 11, the issue of e-cigarettes and heated tobacco products was of interest to National Assembly deputies. Minister Lan said that "the Ministry of Health's stance is to ban" and suggested that the National Assembly have stronger solutions to address the issue of e-cigarette trade. The Ministry of Health hopes that the National Assembly will issue a resolution on banning e-cigarettes and heated tobacco products before the Law on Tobacco Harm Prevention and Control is submitted to the National Assembly in the near future.