It is fair to say that vaping is no longer a fad; rather, it is a movement! According to the United States Surgeon General, there was a 900% increase in e-cigarette use in American high schools from 2011 to 2015. The CDC claims that up to nine million people use a vaping device (such as an electronic cigarette). Although since these figures come from 2014, we have to assume that the number has increased exponentially since then.
Even so, vaping is way behind tobacco use as almost 40 million American ‘adults’ smoke cigarettes along with millions of teenagers. Those who champion e-cigs claim, with some justification, that vaping is a far safer alternative to tobacco cigarettes. Mind you, that isn’t a hard task as cigarettes kill 480,000 Americans a year and 16 million people live with a serious illness caused by smoking.
It is hoped that vaping will make a dent in these figures and encouragingly, we are getting the hint and cutting back on smoking. In 1965, an incredible 40% of Americans smoked tobacco cigarettes. This had fallen to 18% by 2012 although the growth of our population means the ‘actual’ fall is relatively small. Everyone in the world knows that tobacco cigarettes are bad for you and that vaping is healthier. However, new research suggests that our e-cigarette habit doesn’t come without a cost.
Why Do People Prefer Vaping?
As you probably know, the process of ‘vaping’ involves heating an e-liquid containing nicotine or cannabis without burning the substance. These devices use a heating element which turns the active ingredients into vapor which you inhale. This method of consumption reduces ingestion of toxins such as tar and ammonia and helps you steer clear of hundreds of carcinogens.
For those who formerly smoked tobacco cigarettes, it means you can enjoy your nicotine fix with less damage to your health. It also seems as if nicotine is nowhere near as addictive on its own as it is when consumed via tobacco. Vaping is a safer choice for marijuana users too. Although cannabis smoke is safer than its tobacco counterpart, around 100 toxins are released when weed is burned. E-liquid contains a few chemicals, such as propylene glycol and some additives but the limited research that’s available suggests these chemicals are better than what’s found in tobacco.
Medical marijuana users with respiratory problems can inhale weed vapor rather than risk irritating their lungs with smoke. Early studies showed that expired carbon monoxide is significantly reduced when vaporization is used for cannabis when compared to smoking. A 2014 study* by Malouff, Rooke, and Copeland, involved 100 volunteers and they preferred vaping to smoking for several reasons. For example, vaping was more potent, offered a better taste and there was no nasty smoke smell.
If you read vaporizer reviews, pay special attention to a device’s temperature control because it plays a major role in the safety of vaping. A 2009 study* by Pomahacova, Van der Kooy, and Verpoote, determined that vaporized cannabis produces fewer toxins at temperatures of 392 degrees and 446 degrees Fahrenheit than at 338 degrees. For the record, THCA is released at 220 degrees whereas CBC is released at 451 degrees. Therefore, consider the marijuana compounds you need when using it for medical use. A higher temperature is better but make sure you don’t burn the cannabis!
Is Vaping Safe? – The Great Unknown
E-cigarettes have only been around for little over a decade while marijuana vaping devices only hit the mainstream a few years ago. Therefore, while there is plenty that we know about vaping, there is a LOT that we don’t. We know that vaping is increasing in popularity amongst teenagers and contains nicotine, an addictive substance, when e-liquid is used.
Vaping also involves the inhalation of multiple chemicals such as propylene glycol and glycerin. At very high temperatures, these chemicals degrade into acetaldehyde and formaldehyde, two notorious carcinogens. On the plus side, this only happens at temperatures that vapers never reach.
What we don’t know is the long-term health status of people who vape. Remember, these devices have only been available for ten years and most long-term studies begin at the 30-year mark. As a result, we don’t know if vaping increases the risk of cancer or other serious diseases. With hundreds of brands, thousands of flavors, and millions of users, this lack of information is disconcerting.
Vaping & Your Lungs
We now arrive at the crux of the matter; does vaping damage your lungs? We’re aware that tobacco cigarettes cause all manner of respiratory problems and deadly illnesses such as lung cancer. While vaping is unquestionably better, it doesn’t necessarily mean it is ‘safe’ as an increasing number of studies are beginning to show.
A study* published in the American Journal of Respiratory and Critical Care Medicine in October 2017, found that e-cigarettes potentially trigger harmful immune responses in the lungs. The researchers analyzed the sputum samples of 44 individuals and divided them into three groups:
- 15 non-smokers.
- 15 e-cigarette users.
- 14 tobacco cigarette smokers.
The team discovered that e-cig users exhibited noticeable increases in NET-related proteins in their airways. Although these proteins play an important role in fighting pathogens, they can also lead to inflammatory lung diseases such as cystic fibrosis and COPD. Vapers also showed a significant increase in NETs outside the lungs. NETs are associated with cell death in the tissues that line the organs and blood vessels.
Worryingly, users of vaping devices exhibited some of the same negative consequences as tobacco smokers. This included enhanced mucus secretions such as mucin 5AC which is associated with lung problems including asthma and chronic bronchitis. However, it is important to note that five of the 15 e-cigarette users occasionally smoked cigarettes and 12 of them had smoked tobacco cigarettes in the past!
A small study of 25 people, published in Toxicology and Applied Pharmacology in July 2014*, found that vaping and tobacco cigarettes had similar short-term effects on the lungs; notably, lung damage and inflammation.
If you enjoy specific e-cig flavors, a study* by the University of Salford, published in Science Daily in January 2017, has some bad news for you! According to the researchers, you are at greater risk of lung damage if you use flavors such as butterscotch and menthol. It was the first study to test flavored liquids on normal lung tissue. The team studied 20 refills in nine flavors including blueberry, vanilla, and strawberry brought from several different vendors.
In lab tests, adult and embryonic cells were exposed to vapor at varying concentrations over 24, 48 and 72 hours. Every flavor proved toxic to the cells. While the fruit flavors were least toxic, the worst options were coffee, butterscotch, tobacco, menthol, and bubblegum flavors. Although the study found that cells could recover after 48 hours, there were ‘serious implications’ once the cells were exposed for 72+ hours.
Yet another study*, this time by the New York School of Medicine and published in PNAS in January 2018, suggested that vaping damaged DNA in mice and could increase the risk of cancer. At least, this was the alarmist headline in the notorious British tabloid, the Daily Mail Online.
In the study, researchers exposed mice to e-cigarette vapor for three hours a day, five days a week, for 12 weeks; a total of 180 hours’ worth of exposure. These mice were compared to a second ‘control’ group that was not exposed at all. At the end of the 12 weeks, the team tested cells from the lungs, bladders and hearts of the mice. Then, they repeated the experiment on human lung and bladder cells which were exposed to varying levels of nicotine solution.
Overall, the mice exposed to the e-cigarette vapor experienced a greater level of mutation in their DNA cells, a lower level of DNA repair activity, and lower levels of two protein types that bolster DNA repair in cells. According to the researchers, the results showed that e-cigarette smoke is carcinogenic which means vapers are at a higher risk of lung cancer than non-smokers. They were also more likely to develop heart diseases and bladder cancer.
Despite the sensationalist headlines, the study was laden with limitations. First of all, animal study results don’t always translate to humans. Also, the mice were exposed to around ten years’ worth of e-cigarette smoke in three months. It’s obvious that the extra exposure had a far greater effect on DNA repair than a ‘normal’ level of exposure.
Vaping and Popcorn Lung
Bronchiolitis Obliterans, also known as ‘popcorn lung’ was only recently discovered and has been linked with vaping. It is an irreversible disease which involves the damaging of tiny air sacs in the lungs. It gets its name because numerous cases of the condition were discovered amongst employees of a microwave popcorn factory in Missouri between 1992 and 2000.
The prime suspect is a chemical called diacetyl, which is found in a concerning number of e-liquid cartridges. The National Institute of Occupational Safety and Health (NIOSH) found that diacetyl, a flavoring agent, was one of the ingredients in popcorn; it gives it the ‘buttery’ taste consumers love. Interestingly, it is okay to ingest the substance so popcorn lovers are fine, but inhaling it causes the lung condition known as popcorn lung.
What About Vaping & Second-Hand Smoke?
One of the biggest dangers attributed to tobacco cigarettes is the damage caused by second-hand smoke. It has killed millions over the years as unfortunate non-smokers get cancer and other diseases because they inhaled another person’s cigarette smoke. As vaping involves vapor rather than smoke, should there be a concern over second-hand vape smoke?
Yes, according to a study* led by Wolfgang Schober and published in the July 2014 edition of the International Journal of Hygiene and Environmental Health. Nine volunteers used e-cigarettes with and without nicotine in a well-ventilated room for two hours across six vaping sessions. The study concluded that the e-cigarettes were “not emission-free and their pollutants could be of health concern for users and second-hand smokers.”
Overall, Schober and this team found that vaping decreased the quality of indoor air and increased the concentration of PAHs, aluminum, particulate matter, and nicotine. Although the evidence doesn’t look good for vaping initially, the FDA is remaining cagey and says that more data is needed to determine the risks of second-hand exposure.
Igor Burstyn of Drexel University is certainly not on the fence in this issue. He is adamant that e-cigarettes do not pose a danger via second-hand smoke and referred to the FDA’s announcement as “propaganda mixed with willful ignorance.” According to Burstyn, thousands of measurements from vaping devices show that it is safe for bystanders. Toxicologist Maciej Goniewicz points out that vapor has only a handful of carcinogens at much lower levels than in tobacco cigarettes which also have hundreds of harmful chemicals.
The Biggest Problem Facing the Vaping Industry
The vaping industry has a multitude of problems. First, it seems likely that using an e-cigarette causes some harm to your lungs; far less than when you use tobacco cigarettes, but definitely more than if you don’t vape at all. Then there are question marks over the long-term effects, the ingredients in e-liquid, and whether vaping emits harmful second-hand vapor. Add in the fact that teenagers are flocking toward e-cigarettes in their droves, and it’s fair to say that all is not rosy for the industry.
However, the biggest problem could be the influence of Big Tobacco on a market that is supposed to exclude that particular industry. Although vaping has exploded in popularity, it has barely made a dent in the tobacco industry which is worth trillions as almost 250 billion cigarettes are sold per annum in the U.S. alone. Big Tobacco companies have fought back against negative publicity with blank checks and the industry spends almost $10 billion a year on advertising.
Meanwhile, even with the fast growth of the e-cigarette market, it will only be worth a maximum of $48 billion in 2023. Even so, tobacco companies are adopting an ‘if you can’t beat them, join them” mindset. In the last few years, major firms have made big moves including Lorillard’s $135 million purchase of Blu in 2013.
Meanwhile, tobacco firm Reynolds American is the biggest player in the e-cig market and was responsible for over 48% of unit sales in the industry in 2016. In fact, all of the top-performing e-cigarette brands are tobacco subsidiaries and the largest independent company is NJOY which had a market share of just 4.4% in 2016.
Critics of the vaping industry are concerned about what they see as similarities between pro-electronic cigarette studies today, and the notorious tobacco studies of the 1950s. These individuals have a point; if Big Tobacco is in complete control of the market, perhaps it is worth engaging in a double take?
On the other hand, is it fair to view the vaping industry in the same light as the tobacco industry since the latter only came on board in recent years? Remember, e-cigarettes were designed to eliminate combustion and smoke, and enable you to wean yourself off deadly tobacco cigarettes. The premise is sound and research clearly shows that is much safer than tobacco. Whether it is completely safe is another matter entirely.
Final Thoughts on Vaping & Its Dangers
It would be foolish to suggest that vaping is the ‘perfect’ alternative to tobacco. First of all, e-liquid contains nicotine which is an addictive substance, albeit not as much as once believed. If you are addicted to smoking, an e-cig is a way to get your fix and reduce your carcinogen intake significantly. However, there is a danger that teenagers can become addicted to the chemical after initially being attracted by the fruity e-liquid flavors.
The big issue, and the subject of this article, is whether vaping damages the lungs. While the answer is a definitive ‘yes’, the extent of the damage is not known and won’t be for decades when the results of long-term studies are released. While it is the chemical diacetyl that causes popcorn lung, research suggests that the vaping process itself could damage lung tissue and reduce the organ’s ability to repair itself.
As a result, we have to tell e-cigarette users to be careful; don’t assume that your habit won’t cause long-term damage because results are inconclusive. However, it is important to view vaping for what it is: As a means of weaning yourself off tobacco cigarettes. The e-cigarette’s design was patented back in the 1960s but it was Hon Lik who helped popularize it. The Chinese pharmacist was inspired to create his device after seeing his father die from lung cancer after decades of tobacco use.
Lik is also a heavy smoker (and uses both e-cigs and tobacco cigs today) and wanted to design something that was safer than tobacco smoking. He succeeded and while vaping probably causes a certain level of lung damage, its extent is less than that caused by tobacco cigarettes. If you have been using tobacco heavily during your life, it is a step in the right direction.