On the face of it, smoking e-cigarettes, a process also known as ‘vaping’, is significantly healthier than using tobacco cigarettes. E-cigs were created as a means of allowing smokers to enjoy the addictive nicotine that compels them to purchase tobacco cigarettes, without exposing them to the hundreds of carcinogens in traditional cigarettes.
The statistics surrounding traditional smoking are terrifying. According to the CDC*, cigarette smoking is the #1 cause of preventable death in the United States, and it is a similar story around the world. Smoking-related diseases kill 480,000 people in the U.S. annually and up to six million globally. However, recent research suggests that vaping could be bad for you as it can cause a myriad of medical conditions. Is it all Big Tobacco backed hyperbole or is vaping not all that it seems?
A Brief History of Vaping
Although e-cigarettes are a modern phenomenon, the process of vaping has been practiced for thousands of years. The ancient Egyptians used very hot stones to vape herbs for example while the ancient Indians used the shisha pipe millennia ago. Joseph Robinson is alleged to have come up with the idea for an e-cig back in 1927 but Herbert Gilbert’s patent for the smokeless non-tobacco cigarette was the first to gain any real attention for such a device in 1963.
Hon Lik is accredited with the first modern-day e-cigarette when he registered his patent in 2003 and it was available for sale in China in 2004. Within two years, the e-cig was in Europe and became available in the United States by 2007. Fast forward to 2018 and tens of millions of people are vaping all over the world. So, are they deluding themselves by thinking their e-cigarettes are a safer alternative to smoking? Moreover, are teenagers becoming lured into the market? Keep reading to learn the answer to those critical questions, and a whole lot more.
Is There a Vaping Epidemic Amongst Teenagers?
According to the CDC (in 2016), an estimated two million American middle and high school students used e-cigarettes in the past 30 days; a figure which equates to over 11% of high school students! The research also showed that in 2015, 3.2% of adults used the device and could be broken down into the following three categories:
- 58.8% also smoked tobacco cigarettes.
- 29.8% who used vaping as a substitute for regular cigarette smoking.
- 11.4% who were never regular cigarette smokers.
In the last few years, the CDC claims that vaping is effectively an epidemic amongst teenagers with 38% of high school students and 13% of middle school students trying an e-cigarette, according to vape statistics from 2017-2018. Since these figures are based on self-reporting, there is every chance that the number is much higher.
Furthermore, a National Youth Tobacco Survey from 2016 revealed that 1.7 million high school students had used e-cigarettes in the previous 30 days. It seems as if flavors such as cotton candy and tutti frutti appeal to the younger generation. If the number of teenagers that vape continues to rise, tighter regulation is a certainty.
With so many young people experimenting with vaping, is it something we should be concerned about? Certainly, the addictive nature of nicotine, the substance inhaled while vaping an e-cigarette, is a concern.
How Does Vaping Compare with Tobacco Cigarette Smoking?
When looking at the effects of vaping on the human body, it is essential to compare it to cigarettes smoking because that is what e-cigs are designed to replace. There are some concerns over vaping (which we explore later), but the body of evidence that supports electronic cigarettes over tobacco ones is overwhelming.
In the United Kingdom, research from the prestigious Royal College of Physicians of London suggested that any health hazards from using e-cigarettes over the long-term were “unlikely to exceed 5% of the harm from smoking tobacco.”
A study by the Roswell Park Cancer Institute, published in the British Medical Journal in 2013, found that e-cigarette vapor toxicants were up to 450 times lower than what was found in tobacco cigarette smoke.
In 2014, a different study by Farsalinos et al. investigated the effects of e-cigarette smoking compared to its traditional counterpart and found that it had little effect on the overall cardiovascular system. The team’s research also discovered that replacing tobacco cigarettes with e-cigs would likely cause improvements in a person’s long-term health.
Without wishing to sound glib, tobacco cigarettes are about the closest thing to slow suicide as possible. The smoke it emits contains over 7,000 chemicals including hundreds of toxic ones and at least 70 known carcinogens. Even brief second-hand smoke exposure damages health and since 1964, at least 2.5 million people have died due to health problems caused by second-hand smoke exposure.
As you probably know, a burning cigarette gives off a host of noxious gases such as hydrogen cyanide and carbon monoxide. It also contains tar which is where most of the carcinogens found in cigarettes are located. An e-cigarette doesn’t produce the toxic gases or the tar. Instead, it contains a cartridge of e-liquid normally made up of propylene glycol, glycerol, flavorings and nicotine. A battery-powered vaporizer heats the liquid and turns it into vapor.
So, What’s the Problem with E-Cigarettes?
It would be remiss of us to suggest that vaping is entirely safe. While it is unquestionably a better option than tobacco cigarettes, there are several concerns about what could be a case of ‘out of the frying pan and into the fire.’ First and foremost, we have to point out that a lot of the hysterical anti-vaping headlines came as a result of data from misleading studies.
The Formaldehyde Fiasco
A study conducted by Portland State University, published in the New England Journal of Medicine in 2015, created headlines around the world. Its findings suggested that e-cigarettes produce the known carcinogen, formaldehyde. Big Tobacco had found an opportunity and sure enough, news outlets began running the ‘e-cigarettes are no safer than tobacco’ headlines.
However, to say that the study’s headline was ‘misleading’ would be doing it greater service than it deserves. There was one kernel of truth: the e-cigs in the study DID produce formaldehyde, but only when vaped at an exceptionally high voltage. In the study, a high voltage of 5 volts was used when the harmful substance was produced. At a lower voltage of 3.3V, the team “did not detect the formation of any formaldehyde-releasing agents.”
Other studies investigated the claim of the Portland State University team and found that it was almost impossible to inhale the vapor at such high voltages. We must also make it clear that the PSU team was unhappy with how the results of their study were interpreted. According to one of the authors, David Peyton, it was ‘frustrating’ that the researchers are associated with saying e-cigs are more dangerous than tobacco cigarettes when their study did NOT come to that conclusion.
Potential Health Problems Associated with Vaping
There are several studies which illustrate that vaping is not 100% safe and it is worth mentioning them here. While e-cigarettes are unquestionably healthier than their tobacco counterpart, it would be irresponsible to say they are free from side effects. A 2012 study by Bergman et al. found that chronic exposure to nicotine could result in increased insulin resistance and type 2 diabetes.
On the flipside, this risk could be offset by the chemical’s appetite suppressant properties. Alas, nicotine can increase blood pressure and heart rate when inhaled. According to a 2012 study by Goriounova and Mansvelder, nicotine could even impair the prefrontal brain development of adolescents resulting in poor impulse control and attention deficit disorder. This is a genuine concern given the popularity of vaping amongst teenagers. Accidental e-liquid ingestion has increased by 1,500% in three years which has resulted in a marked rise in e-liquid poisonings.
It is important for users to be wary of flavored e-liquids if they contain diacetyl, a harmful chemical compound. It is associated with bronchiolitis obliterans, a rare lung disease capable of permanently damaging your bronchioles.
In January 2018, the National Academies of Sciences, Engineering, and Medicine released a report that analyzed the impact of e-cigarettes on health. David Eaton was the chair of the committee that created the report which looked at 5,000 studies and compiled evidence from 800 of them. Here is a quick look at what they found:
- Young people who vape are more likely to use a conventional cigarette than those who don’t.
- Nicotine exposure is variable and depends on the e-liquid and the vaping device. Experienced users are capable of extracting as much nicotine as they would from a typical tobacco cigarette.
- Exposure to potentially toxic substances is ‘significantly’ lower with vaping devices when compared to tobacco cigarettes.
- Although vaping could lead to dependence, you are less likely to be addicted to electronic cigarettes than traditional ones.
- You reduce exposure to toxins and carcinogens when you make the switch from tobacco to e-cigs. There is ‘substantial’ evidence that a total switch reduces short-term negative outcomes in your organs such as the heart and lungs.
- Animal studies suggest that vaping over a long period may increase your risk of cancer. There is no evidence that it happens in humans.
- Second-hand exposure from e-cigs is much lower than in tobacco cigarettes.
- E-cigarettes can explode and cause serious injury.
- Drinking or touching e-liquids increase your risk of suffering a seizure or brain injury; vomiting is a common symptom.
While opponents of vaping will doubtless point out the negative findings, there is evidence to counteract most of them. While there is no doubt that nicotine is addictive, the notion that non-smokers try vaping and become addicted to nicotine, and then switch to tobacco cigarettes, is not one backed up by evidence.
In fact, a 2014 study conducted by the Health Survey for England, found that amongst non-smoking men, only 1% had tried e-cigarettes. Meanwhile, 6% of ex-smokers had tried vaping along with 29% of existing smokers. The proportions were similar amongst women according to the report. These findings somewhat contradict the data in the National Academies of Science report although we readily acknowledge that e-cigarette usage amongst teenagers is concerning.
It is encouraging to note that almost 30% of smokers in that study had tried e-cigs since that’s why they were invented in the first place! A study by Giovenco and Delnovo, published in January 2018, revealed some great news about how electronic cigarettes were persuading tobacco users to quit. Highlights of the study include:
- Over 50% of daily electronic cigarette users in the sample had quit smoking traditional cigarettes in the previous five years.
- Daily vapers were three times more likely to quit tobacco than non-vapers.
- Ex-smokers are using e-cigs to prevent a relapse.
This followed on from a European study published in the Addiction journal in 2016 which found that an incredible 15 million smokers in Europe had quit or reduced their intake of tobacco cigarettes with the aid of e-cigs.
While it is also true that e-cigarette batteries explode, instances are extremely rare. In fact, there were only 243 recorded instances of explosions in the first decade of e-cig use. Newer batteries are larger and more likely to cause injury in the event of an explosion, but they are less likely to blow in the first place. A significant percentage of incidents are caused by user error; overcharging the battery is the most common mistake. Again, it barely compares with the estimated 7,500 fires caused by tobacco smoking in the United States each year.
Nicotine: A Question of Addiction
As everyone knows, it is the nicotine in tobacco cigarettes that keeps users coming back for more. E-cigs don’t contain tar or the dozens of carcinogens, but their e-liquid cartridges do contain nicotine. For a long time, the public believed that it was the nicotine in tobacco cigarettes that caused cancer, but now we know that isn’t the case. What’s even more interesting is the suggestion that nicotine by itself is not as addictive as once thought.
An enormous PATH study has found that vaping is not as addictive as tobacco cigarette smoking. 5% of respondents were exclusive vapers compared to 95% who smoked traditional cigarettes only. 93% of the e-cig users were once regular tobacco smokers; another statistic which casts doubt on the idea that non-smokers are flocking to vaping. The study clearly showed that traditional cigarette smokers had significantly stronger ‘urges’ to smoke than their e-cigarette using counterparts.
If nicotine is as addictive as advertised, surely there would be little difference between addiction in e-cigarette users and traditional cigarette users? In reality, there are dozens of chemicals in tobacco cigarettes and several of them are extremely addictive. This is why smoking is harder to give up than most illegal narcotics.
A host of new studies have shed light on the issue. When you smoke a tobacco cigarette, there is a marked decrease in the level of monoamine oxidase (MAO) you produce. MAO is used by the body to break down dopamine so when you have less MAO, you have a higher level of dopamine which results in heightened addiction.
It was initially believed that tobacco cigarettes had around 4,000 chemicals. Improved technology has revealed that there are over 7,000! Tobacco companies have long since been lambasted for their dubious ethics and a study by Harvard University, published in 2015, only makes the picture clearer. It found that tobacco companies now include an additive called pyrazines to their products, especially in so-called ‘lighter’ cigarettes.
The discovery that tobacco smoking caused cancer threatened to ruin the industry as sales declined rapidly. Big Tobacco started producing ‘light’ cigarettes with less tar but these products failed miserably. Then, tobacco companies added pyrazines to make their products more addictive. The Harvard study found that pyrazines optimized the level of nicotine delivery to the brain which helped promote addiction. In simple terms, while nicotine is unquestionably addictive, it pales in comparison to the cocktail of chemicals found in tobacco cigarettes.
One of the many advantages of vaping is its ability to help you cut back on your nicotine intake. Most brands sell their e-liquid cartridges in a variety of strengths. Typical options include 24mg, 18mg, 12mg, 6mg and 0mg of nicotine. Over time, you can lower your intake of nicotine by choosing a lower dose.
Are There Other Harmful Chemicals in E-Cigarettes?
Unfortunately, that depends on the manufacturer. Low-grade e-cigs may come with e-liquid that contains heavy metals such as lead, volatile organic compounds and carcinogens. Higher-end brands tend to play it safe and include minimal amounts of chemicals in their e-liquid. We should point out that vaping is not a good idea for pregnant women because of the nicotine and other ingredients in e-liquid.
The relatively small body of research surrounding e-cigarettes doesn’t help matters but is to be expected since the industry is still relatively new. The FDA showed an understanding of the situation in July 2017 when it delayed regulations that threatened the e-cigarette market by four years.
Initially, the FDA was planning to introduce a strict set of laws that would have removed a huge chunk of e-cigarette products from the market. Greg Conley of the American Vaping Association spoke of his relief. According to Conley, 99% of vaping products would have been pulled from the shelves had the original plan stood.
There are a few risks associated with e-cigarette use that are perhaps being overlooked. For example, a research team from New York’s University of Rochester found that the vapors we inhale from e-cigs could destroy the tissues that hold our teeth in place. The severe gum disease this would cause could result in loss of teeth.
The potential impact of vapor on the lungs is less clear. One suggestion is that vapor could damage special cells called fibroblasts that protect our major organs. These cells are responsible for repairing or replacing damaged tissue. A reduction in fibroblast production would slow down the healing process. However, such a hypothesis has yet to be properly tested.
Final Thoughts – Is Vaping Bad for You?
Although we are unashamedly an advocate for replacing tobacco cigarettes with vaping, we are not like other websites that are content to bury their collective heads in the sand. We have yet to see conclusive evidence that determines what happens when we vape in the long-term. It is a question that must be answered because millions of teenagers are using electronic cigarettes.
What we do know is that e-cigarettes are substantially safer than their tobacco counterpart and there is really no contest. There are few known carcinogens in e-cigs and without the tar and tobacco, you are enjoying a healthier experience without question. It is also a fact that nicotine alone is nowhere near as addictive as the combination of chemicals in tobacco cigarettes.
While vape devices explode in rare circumstances, accidents can be avoided by using a bit of common sense and not overcharging your vape pen. Ultimately, many of the negative things written about e-cigs are down to misleading headlines, propaganda, and bad science. Let’s conclude by providing you with a list of e-cig pros and cons.
Pros of Vaping
- Significantly cheaper than smoking; up to $2,400 per annum according to most estimates.
- Lack of combustion decreases the risk of fire.
- Effects from second-hand smoke are significantly lower.
- The range of delicious flavors.
- Doesn’t contain the carcinogens found in tobacco and tar.
- Doesn’t produce chemicals such as carbon monoxide.
- Doesn’t cause your clothes to smell.
- Although it involves nicotine consumption, it is less addictive than smoking.
- Research shows that it can help people quit smoking.
Cons of Vaping
- Research on e-cigarettes is still relatively limited.
- Chronic use could cause damage to your teeth and gums.
- Still involves using nicotine.
- The flavors attract teenage users in large numbers.
- Some research suggests that chronic use may result in ‘smoker’s cough’.
- Low-grade e-liquids may contain toxic metals.
- Could cause injury if the vaping device is used incorrectly.