How Electronic Cigarettes Work You're at your favorite restaurant, enjoying a meal.A diner at the next table is puffing on a cigarette, letting out a cloud of smoke.Because smoking isn't allowed in the restaurant, you're thinking about asking the smoker to put the cigarette out.But before you protest, consider this: Your neighbor may not be smoking at all.Electronic cigarettes, also known as smokeless cigarettes, e-cigarettes, or e-cigs, are an alternative method of consuming nicotine, the addictive chemical found in tobacco.Manufacturers often design e-cigarettes to look like regular cigarettes, but they contain no tobacco and don't require a match -- or any flame at all.An e-cigarette is a battery-powered device that converts liquid nicotine into a mist, or vapor, that the user inhales.There's no fire, no ash and no smoky smell.E-cigarettes do not contain all of the harmful chemicals associated with smoking tobacco cigarettes, such as carbon monoxide and tar.Manufacturers and satisfied customers say the e-cigarette is a healthier alternative to tobacco cigarettes, which cause millions of deaths every year.

Some users say e-cigs have helped reduce their "smoker's cough," sharpened their senses of taste and smell, and even improved their sleep.ecigarette fuitThe electronic cigarette was invented by Chinese pharmacist Hon Lik, who patented the device in 2003 and introduced it to the Chinese market the following year.e cigarette exeterNumerous companies are now selling e-cigarettes to customers around the world.e cigarette dhgateBut as e-cigarette smoking -- or "vaping" as it's sometimes called -- has grown in popularity, some have concerns about its safety, including the possibility that the vapor created by the devices contains dangerous chemicals.e cigarette and running

Is the electronic cigarette a cleaner, healthier choice for smokers?Or is it a dangerous device with hidden risks?e cigarette knowledgeBoth viewpoints have their merits, but on the next page we'll start with the basics: how the product works, and why it's popular.e cigarette ocean city nj1 4 5 Citation & Date More to ExploreBy Kathy Walsh AURORA, Colo.(CBS4) – Recently, the U.S.surgeon general called the surging use of e-cigarettes “a major public health concern.” That’s no surprise to a doctor at the University of Colorado Hospital after what he found in his own study on vaping.Dr. Fred Deleyiannis cautions patients against smoking tobacco before surgery because it alters circulation and can affect wound healing.But when he saw a teenage patient puffing an e-cigarette before her operation, he wasn’t sure of the possible health effects.

“You’re concerned about the same things tobacco would introduce — ‘Is there going to be a problem with healing?Is it going to affect their ability to tolerate anesthesia?'” Deleyiannis told CBS4 Health Specialist Kathy Walsh.There was little data, so the plastic and reconstructive surgeon at the University of Colorado Hospital and professor of surgery at the CU School of Medicine launched a study.“Are electronic cigarettes really healthier than tobacco cigarettes?” said Deleyiannis.In a smoking chamber in a lab, researchers exposed some rats to tobacco smoke, others to e-cigarette vapor, 4 hours a day for 20 days.“It’s like second-hand smoke, basically,” said Deleyiannis.The rats then had skin surgery.“The areas that are black are areas of necrosis or cell death,” Deleyiannis pointed out in photos.Researchers concluded exposure to e-cigarette vapor was as harmful to wound healing as exposure to tobacco smoke.“It’s basically causing circulation not to meet its final endpoint — the skin,” said Deleyiannis.

“Nicotine is certainly one factor and I do believe there are other substances in the electronic vapor that are also toxic or harmful.” The data also suggests that, like tobacco smoke, e-cigarette vapor may increase the risk of emphysema.The study was funded by a CU Department of Surgery grant and will be published in a plastic surgery journal.Deleyiannis believes electronic cigarettes need more scrutiny.He’s counseling patients to cut out vaping at least a month before surgery to reduce the risk of complications.Kathy Walsh is CBS4’s Weekend Anchor and Health Specialist.She has been with CBS4 for more than 30 years.She is always open to story ideas.Follow Kathy on Twitter @WalshCBS4.BIKE MSCBS Local AppSend A News Tip CBS Radio News KCNC CBS4 LiveWhether you smoke cigarettes, e-cigarettes (electronic cigarettes), use other types of tobacco or not—you will be interested in what five spine surgeons had to say.SpineUniverse asked five of its Editorial Board members—orthopaedic spine surgeons and neurosurgeons—questions about tobacco use, vaping and spinal surgery.

Joshua M. Ammerman, MD — Neurosurgeon Obviously smoking cessation is the key, and I emphasize to my patients that it often requires multiple attempts to stop smoking and that failure after the first try should not discourage them from trying again.That said, simply reducing the amount smoked can lead to a meaningful reduction in overall mortality and death due to cardiovascular disease.Choll W. Kim, MD, PhD — Orthopaedic Spine Surgeon Smoking remains an important issue when it comes to back pain and spinal surgery.Smoking affects circulation of blood in the small vessels.Blood carries oxygen and nutrients to cells.This is important because there is little circulation to the the shock-absorbing discs that cushion our spine.Cigarette smoking further reduces blood flow, meaning blood flow to the discs is less.The same problem affects wound healing after surgery.Smokers have a higher risk of wound problems, including infections.In addition to the blood flow issue, nicotine in cigarettes inhibits bone healing.

In patients who undergo spinal surgery involving fusion, smoking increases the risk of non-union, also known as pseudarthrosis.I recommend that patients who plan to have spinal surgery give up smoking for about 6 weeks after surgery.This includes e-cigarettes until more information about their effects are known.Although we do not require smoking cessation prior to fusion surgery, we make every effort to assist patients in this regard.For patients, who cannot stop smoking, we mitigate risks by using minimally invasive techniques to decrease the likelihood of wound problems and optimize fusion by using interbody fusion and bone morphogenetic protein (BMP).Reginald Q. Knight, MD, MHA — Orthopaedic Spine Surgeon I tell patients who smoke that there are several reasons to consider stopping outside of the cardiopulmonary (heart/lungs) concerns.First, patients who smoke are known to have an increased risk of back pain.Stop smoking, and your back pain may improve.Second, if a smoker requires surgery, they have an increased risk of complications, including lower rates of fusion and increased infection rates.

Lastly, many insurance companies no longer approve surgery for smoking patients in the absence of neural (nerve) compression.Praveen V. Mummaneni, MD — Neurosurgeon/Todd Vogel, MD — Neurosurgeon We require all elective spinal fusion patients to quit tobacco products.Lali Sekhon, MD, PhD, FACS, FAANS — Neurosurgeon Smoking accelerates degenerative disc disease.If spinal surgery is performed, the outcomes are impaired.Anesthesia is more challenging and spinal fusions are less likely to heal.Patients can’t stop smoking if others in the family continue to smoke, so spouses/partners need to stop at the same time.Nicotine is the culprit, so nicotine patches and gums are to be avoided if fusion surgery is to be performed.I suggest patients talk to their primary care physician.Options, such as Chantix, hypnosis, acupuncture, and even laser therapy are used.Often smokers need to try to stop smoking many times in order to succeed.Cutting down is also better than nothing.Joshua M. Ammerman, MD — Neurosurgeon Yes.

While e-cigarettes appear to contain lower levels of potentially carcinogenic compounds, there is still a significant amount of nicotine in the aerosol created by e-cigarettes.Nicotine has been demonstrated to have a detrimental effect on the cells of the spinal disc (nucleus pulposus) and therefore, may potentiate degenerative disc disease.Furthermore, nicotine has been implicated as a risk factor for the loss of bone density in the skeleton, including the spine; a condition known as osteoporosis.Osteoporosis can lead to spontaneous fractures of the skeleton, including the spinal bones (vertebrae).Reginald Q. Knight, MD, MHA — Orthopaedic Spine Surgeon Nicotine is the problem with smoking and spinal surgery.Anything that continues to provide nicotine to the system should be discontinued prior to elective spinal surgery.Particularly, if there are no indications that surgery or neural (nerve) decompression is urgent.Praveen V. Mummaneni, MD — Neurosurgeon/Todd Vogel, MD — Neurosurgeon Yes.

These agents also have nicotine, which has some effect on wound healing.Lali Sekhon, MD, PhD, FACS, FAANS — Neurosurgeon Probably.Nicotine impairs fusion healing.Joshua M. Ammerman, MD — Neurosurgeon In addition to the effects nicotine has on the cells of the spinal discs, the substances contained in tobacco reduce blood flow to the spine.Reduced blood flow can potentially accelerate degeneration of the spine, and is a well-documented risk factor for failure of spinal bones to heal (fuse) after surgery.Additionally, this reduction in blood flow can impair healing of the surgical wound and potentially increase the risk of an infection at the surgical site.With regards to surgery, we aggressively encourage patients to stop smoking at least 8 weeks prior to surgery, particularly any procedure involving spinal fusion, in an effort to enhance their chances for a successful outcome and to minimize their risks related to their lung function.In some cases, I will order an external bone stimulator to try to help overcome some of the effects of tobacco use in patient who needs surgery urgently or is unable to stop smoking.

Reginald Q. Knight, MD, MHA — Orthopaedic Spine Surgeon I believe the working hypothesis is nicotine causes vasoconstriction.Vasoconstriction affects soft tissues by decreasing blood flow and increasing the risk for infection.During fusion, a healthy blood flow is essential to the formation of new bone.Vasoconstriction stunts the development of new bone and may result in failure of the fusion process.In the absence of clear spinal instability or the need for neural (nerve) decompression, I prefer not to operate on elective surgical patients who smoke.This being said, smoking is the most difficult addiction to fight.Of course, there are exceptions to every rule.Smokers need to be educated about the risks they take and the reduced improvement in outcomes associated with smoking.Praveen V. Mummaneni, MD — Neurosurgeon/Todd Vogel, MD — Neurosurgeon Cigarette smokers are at an increased risk for low back pain caused by disc degeneration and spinal instability.This process is accelerated as a result of increases in serum proteolytic activity (cellular breakdown) by releasing proteolytic enzymes (proteins) from neutrophils (white blood cells) and inhibiting the activity of alpha-1-antiprotease (cellular breakdown).