E-Cigarette Danger: A Growing Global and National Burden
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E-cigarettes (Electronic Cigarettes), also known as Vapes, Vapourizers, or Electronic Nicotine Delivery Systems (ENDS), are smoking devices that use an electrical mechanism to produce heat and vapour containing various chemical substances, rather than smoke from combustion like traditional cigarettes.
1. Key Components and Ingredients
The main components of an e-cigarette are the Battery, the Atomizer (for vapour and heating), and the E-liquid/Juice.
The E-liquid, which is vapourized and inhaled, contains several key compounds:
Nicotine: A highly addictive substance found in both e-cigarettes and regular cigarettes, which makes the body dependent on smoking.
Propylene Glycol: A chemical component used to create the vapour.
Glycerin: A Humectant (moisture-retaining substance) combined with Propylene Glycol. While the FDA has approved it for safe use in food and medicine, it is not approved for inhalation.
Other Chemicals: Illegal products, and even legal ones, may contain carcinogenic chemicals in very low amounts, and reports indicate a long-term cancer risk.
2. Global Burden of E-Cigarette Use
E-cigarette use is rapidly spreading worldwide, particularly among young people, and is becoming a significant public health burden.
Total Users: The estimated global number of e-cigarette users (Vapers) reached 82 million in 2021, a significant increase from 68 million in 2020. (The South-East Asia region accounted for about 14.3 million users in 2021).
Youth Prevalence: According to WHO data, at least 15 million children aged 13 to 15 globally use e-cigarettes. In countries surveyed, children are on average nine times more likely to use e-cigarettes than adults. Current usage rates among youth aged 16-19 in some countries range from 7.7 per cent to 9.4 per cent.
Gateway Effect: Strong evidence suggests that e-cigarette use by young people who have never smoked can lead to nicotine addiction and nearly triple the chances of them moving on to regular cigarette use.
3. WHO Framework Convention on Tobacco Control (WHO FCTC) Cop11 Resolution
I attended the Conference of the Parties (COP11) to the WHO Framework Convention on Tobacco Control (WHO FCTC) as a WHO Guest Advisor. The meeting was held in Geneva, Switzerland, from 16 to 22 November 2025. The main focus of the conference was the urgent need to address Emerging and Imitation Tobacco Products, particularly e-cigarettes.
At the conference:
It was emphasized that e-cigarettes are a dangerous Gateway Effect that can lead young people towards regular cigarette use by causing nicotine addiction.
All Member States resolved to prioritize protective measures for youth against e-cigarettes and to establish strict regulations.
4. Myanmar’s Burden
E-cigarette use is also increasing in Myanmar, especially among students and youth.
Myanmar’s Prevalence and Impact
Prevalence Among Smokers: A 2020 study of tobacco smokers in Myanmar found that 11.6 per cent (95 per cent Cl: 5.1 per cent-24.3 per cent) of respondents had Ever Used an e-cigarette.
High-Risk Groups: Use is significantly higher among males, students, youth aged 18 to 29, and residents of the Mandalay Region.
Youth Danger: Data from the 2016 Global Youth Tobacco Survey (GYTS) showed that smoking among students aged 13-15 in Myanmar increased from 6.8 per cent in 2011 to 8.3 per cent in 2016. The entry of new products like e-cigarettes normalizes tobacco use, necessitating stronger preventative measures.
Health Burden: Currently, 56,841 people die annually in Myanmar from smoking-related diseases. The rise in e-cigarette use will exacerbate this long-term health burden.
Social Consequence: A recent incident in Singapore, where a Myanmar teenager had their long-term immigration pass revoked and was deported for possessing a Kpod containing etomidate, illustrates the severe social consequence of e-cigarette-related legal violations.
5. Adverse Health Effects
Although e-cigarettes do not produce smoke from combustion, the resulting vapour (Aerosol) contains chemicals harmful to health.
Respiratory Diseases: Can cause lung inflammation, or cause or worsen conditions like asthma and other respiratory diseases.
Cardiovascular Issues: Nicotine causes elevated blood pressure, increased heart rate, and raises the risk of heart disease.
Brain Development Impairment: Nicotine can harm the developing brain of adolescents, reducing concentration and learn abilities.
Cancer Risk: Some compounds, such as Formaldehyde, released when E-liquid is heated, pose a cancer risk.
6. Is it Addictive?
Yes, it is addictive. Nicotine, the main ingredient in e-cigarettes, is one of the most highly addictive substances. Nicotine stimulates the Reward System in the brain, causing a rapid addiction and prompting the user to seek repeated use.
7. Is it Worse than Regular Cigarettes?
It cannot be considered safe.
Regular cigarettes are extremely harmful because their combustion process releases thousands of hazardous chemicals, including tar and carbon monoxide.
E-cigarettes may have fewer toxic substances than regular cigarettes because they do not involve combustion, but they still contain nicotine, Propylene Glycol, Glycerin, and other chemicals, meaning they are not completely safe.
The Critical View: E-cigarettes must be seen as a dangerous Gateway that leads non-smokers, especially youth, to nicotine addiction and subsequently to regular cigarette use.
8. Can it be Used as a Smoking Cessation Aid?
While there is some evidence that e-cigarettes may be used to quit smoking, their safety and long-term effectiveness remain controversial.
Official Recommendation: Most health organizations, including the WHO, do not officially recommend e-cigarettes as a smoking cessation method.
Pattern Change: Since e-cigarettes continue to deliver nicotine, using them may simply be a change in the pattern of nicotine use, not a true cessation.
Recommendation: Individuals who wish to quit smoking should seek medications or advice officially recognized by the Ministry of Health.
9. Myanmar’s Prevention and Control Measures
To combat the dangers of tobacco and e-cigarettes, Myanmar enacted the “Control of Smoking and Consumption of Tobacco Products Law” on 4 May 2006, and the “Order 453/2001” concerning standardized packaging and printing of Pictorial Health Warnings on tobacco products, which were revised and enacted on 12 October 2021, came into force on 1 April 2022.
Under these laws and orders, the import, sale, distribution, possession, use, and purchase of e-cigarettes (Vape) and imitation tobacco products are legally banned. This order takes effect from 31 December 2024.
The Ministry of Health, in collaboration with relevant departments, continues to strive for more effective enforcement, inspection, seizures, and legal action against the illegal trade of e-cigarettes/vapourizers.
In the Cigarette Pictorial Health Warning Global Status Report 2025, released in October 2025, Myanmar’s efforts in tobacco control are highly ranked globally:
Pictorial Health Warning (PHW): Myanmar is ranked 18th globally for requiring PHWs to cover at least 75 per cent of the cigarette packaging.
Plain Packaging: Myanmar is the second country in the Asian region to prepare for the implementation of Plain Packaging.
10.Call to Action
E-cigarettes are not an escape from the dangers of smoking but a path to a new nicotine addiction that threatens the health of the younger generation. While WHO resolutions, Myanmar’s robust laws, and international-standard preventive measures provide strength in tackling this danger, individual understanding, cooperation, and conscious avoidance are the key to success.
Let us collectively protect the health and future of the new generation by acknowledging the dangers of e-cigarettes and all tobacco products.
References
FAQs on E-Cigarettes, Vapourizers and Heat-Not-Burn Tobacco Products – Ministry of Health.PDF (Singapore MOH FAQs (2018)
Myanmar teen first foreigner to lose Singapore long-term immigration pass for possessing Kpod – CAN (2025)
WHO Framework Convention on Tobacco Control (WHO FCTC) Reports / Statements on ENDS/E-cigarettes (Cop11) (Information regarding the Cop11 resolution to prioritize the protection of youth against e-cigarettes (2025)
WHO: The global prevalence of E-cigarettes in youth: A comprehensive systematic
review and meta-analysis (2025)
Action on Smoking and Health (ASH) C Euromonitor. Estimation of the global number of vapers (2023)
Myint, HS, Hlaing, SH, C Htay, N Prevalence of e-cigarette use among tobacco smokers in six states and regions of Myanmar (2020)
WHO. New WHO report highlights tobacco and e-cigarette trends. (2025)
Global Youth Tobacco Survey (GYTS) 2016 Data. Prevalence and determinants of tobacco use among youth in Myanmar.
