- 5 Vaping Facts You Need to Know
- 1: Vaping Is Less Harmful Than Smoking, but It’s Still Not Safe
- 2: Research Suggests Vaping Is Bad for Your Heart and Lungs
- 3: Electronic Cigarettes Are Just As Addictive As Traditional Ones
- Vaping: What You Need to Know
- Vaping may be more dangerous than we realized
- Vaping may be linked to a heightened risk of seizures
- The nicotine in e-cigarettes may stress the cardiovascular system
- The microscopic particles e-cigarettes emit have been linked to heart attacks, high blood pressure, and coronary artery disease
- E-cigarette vapor may irritate the lungs
- The devices can explode
- Does vaping help people quit smoking or lead to more smoking?
- Listen to Today, Explained
- First of all, what is vaping?
- Is vaping healthier than smoking regular cigarettes?
- What are the negative side effects of vaping?
- Another danger:
- Vaping: Is it bad for you?
- What is Vaping and How Does it Work?
- Vaping: The Magic Bullet for Smoking Cessation?
- So is Vaping Helping Smokers Quit?
- Vaping for Teenagers and Young Adults
- Is Vaping a Drug?
- Is Vaping Without Nicotine Bad for You?
- What is Popcorn Lung (and is it Really Dangerous)?
- Do the Benefits Outweigh the Risks? The Public Health View
- The US/UK Divide (Or, Why are Americans So Afraid of Vaping?)
- How to Use Vaping to Quit Smoking
- What’s known about e-cigs
- The unknowns about e-cigs
- Is vaping safe?
5 Vaping Facts You Need to Know
You might be tempted to turn to electronic cigarettes (e-cigarettes, vape pens, and other vaping devices) as a way to ease the transition from traditional cigarettes to not smoking at all. But is smoking e-cigarettes (also called vaping) better for you than using tobacco products? Can e-cigarettes help you to stop smoking once and for all? Michael Blaha, M.D., M.P.H., director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, shares health information about vaping.
1: Vaping Is Less Harmful Than Smoking, but It’s Still Not Safe
E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create a water vapor that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. While we don’t know exactly what chemicals are in e-cigarettes, Blaha says “there’s almost no doubt that they expose you to fewer toxic chemicals than traditional cigarettes.”
However, there has also been an outbreak of lung injuries and deaths associated with vaping. As of January 2020, the Centers for Disease Control and Prevention (CDC) confirmed 57 deaths in patients with e-cigarette, or vaping, product use associated lung injury (EVALI).
“These cases appear to predominantly affect people who modify their vaping devices or use black market modified e-liquids. This is especially true for vaping products containing tetrahydrocannabinol (THC),” explains Blaha.
The CDC has identified vitamin E acetate as a chemical of concern among people with EVALI. Vitamin E acetate is a thickening agent often used in THC vaping products, and it was found in all lung fluid samples of EVALI patients examined by the CDC.
The CDC recommends that people:
- Do not use THC-containing e-cigarette, or vaping, products
- Avoid using informal sources, such as friends, family or online dealers to obtain a vaping device.
- Do not modify or add any substances to a vaping device that are not intended by the manufacturer.
2: Research Suggests Vaping Is Bad for Your Heart and Lungs
Nicotine is the primary agent in both regular cigarettes and e-cigarettes, and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is also a toxic substance. It raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack.
Is vaping bad for you? There are many unknowns about vaping, including what chemicals make up the vapor and how they affect physical health over the long term. “People need to understand that e-cigarettes are potentially dangerous to your health,” says Blaha. “Emerging data suggests links to chronic lung disease and asthma, and associations between dual use of e-cigarettes and smoking with cardiovascular disease. You’re exposing yourself to all kinds of chemicals that we don’t yet understand and that are probably not safe.”
3: Electronic Cigarettes Are Just As Addictive As Traditional Ones
Both e-cigarettes and regular cigarettes contain nicotine, which research suggests may be as addictive as heroin and cocaine. What’s worse, says Blaha, many e-cigarette users get even more nicotine than they would from a tobacco product — you can buy extra-strength cartridges, which have a higher concentration of nicotine, or you can increase the e-cigarette’s voltage to get a greater hit of the substance.
Vaping: What You Need to Know
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What Is Vaping?
Vaping is the inhaling of a vapor created by an electronic cigarette (e-cigarette) or other vaping device.
E-cigarettes are battery-powered smoking devices. They have cartridges filled with a liquid that usually contains nicotine, flavorings, and chemicals. The liquid is heated into a vapor, which the person inhales. That’s why using e-cigarettes is called “vaping.”
What Are the Health Effects of Vaping?
Vaping hasn’t been around long enough for us to know how it affects the body over time. But health experts are reporting serious lung damage in people who vape, including some deaths.
Vaping puts nicotine into the body. Nicotine is highly addictive and can:
- slow brain development in kids and teens and affect memory, concentration, learning, self-control, attention, and mood
- increase the risk of other types of addiction as adults
- irritate the lungs
- may cause serious lung damage and even death
- can lead to smoking cigarettes and other forms of tobacco use
Some people use e-cigarettes to vape marijuana, THC oil, and other dangerous chemicals. Besides irritating the lungs, these drugs also affect how someone thinks, acts, and feels.
How Do E-cigarettes Work?
There are different kinds of e-cigarettes. But many people use the Juul. This e-cigarette looks like a flash drive and can be charged in a laptop’s USB port. It makes less smoke than other e-cigarettes, so some teens use them to vape at home and in school. The Juul pod’s nicotine levels are the same as in a full pack of cigarettes.
Do You Have to Vape Every Day to Get Addicted?
Even if someone doesn’t vape every day, they can still get addicted. How quickly someone gets addicted varies. Some people get addicted even if they don’t vape every day.
What About E-cigarettes That Don’t Have Nicotine?
Most e-cigarettes do have nicotine. Even e-cigarettes that don’t have nicotine have chemicals in them. These chemicals can irritate and damage the lungs. The long-term effects of e-cigarettes that don’t have nicotine are not known.
Why Should People Who Vape Quit?
People who vape need the right motivation to quit. Wanting to be the best, healthiest version of themselves is an important reason to quit vaping. Here are some others:
Unknown health effects: The long-term health consequences of vaping are not known. Recent studies report serious lung damage in people who vape, and even some deaths.
Addiction: Addiction in the growing brain may set up pathways for later addiction to other substances.
Brain risks: Nicotine affects brain development in kids and teens. This can make it harder to learn and concentrate. Some of the brain changes are permanent and can affect mood and impulse control later in life.
Use of other tobacco products: Studies show that vaping makes it more likely that someone will try other tobacco products, like regular cigarettes, cigars, hookahs, and smokeless tobacco.
Toxins (poisons): The vapor made from e-cigarettes is not made of water. The vapor contains harmful chemicals and very fine particles that are inhaled into the lungs and exhaled into the environment.
Sports:To do their best in sports. Vaping may lead to lung inflammation (irritation).
Money: Vaping is expensive! The cost of the cartridges over time starts to add up. Instead, someone could spend that money on other things that they need or enjoy.
To go against tobacco company advertising: Many e-cigarettes are made by the same companies that produce regular cigarettes. Their marketing targets young people by making fun flavors for e-cigarettes and showing young, healthy people vaping. They are trying to make kids and teens of today into their new, lifetime customers.
How Can Kids and Teens Quit Vaping?
For kids and teens who want to quit, it can help to:
- Decide why they want to quit and write it down or put it in their phone. They can look at the reason(s) when they feel the urge to vape.
- Pick a day to stop vaping. They can put it on the calendar and tell supportive friends and family that they’re quitting on that day.
- Get rid of all vaping supplies.
- Download tools (such as apps and texting programs) to their phone that can help with cravings and give encouragement while they’re trying to stop vaping.
- Understand withdrawal. Nicotine addiction leads to very strong cravings for nicotine. It can also lead to:
- feeling tired, cranky, angry, or depressed
- trouble concentrating
- trouble sleeping
The signs of withdrawal are strongest in the first few days after stopping. They get better over the following days and weeks.
How Can Parents Help?
To help kids understand the risks of vaping and take control of their health, you can:
- Share the just-for-teens version of this article with your child.
- Suggest that your child look into local programs and websites that help people quit vaping. Your health care provider can help you and your child find the right support.
- Lend your support as your teen tries to quit.
- Set a good example by taking care of your own health. If you smoke or vape, make the commitment to quit.
Talk to your kids about the reports of serious lung damage, and even deaths, in people who vape. Call your doctor right away if your child or teen vapes and has:
- coughing, shortness of breath, or chest pain
- nausea, vomiting, or diarrhea
- tiredness, fever, or weight loss
Reviewed by: Lonna P. Gordon, MD Date reviewed: September 2019
Vaping may be more dangerous than we realized
When e-cigarettes first appeared on store shelves a few years back, they were marketed as a sleek, discreet technology that could help adult smokers kick a potentially deadly habit.
Flash-forward to 2018, the year the Juul vape device took over three-quarters of the US e-cigarette market. Instead of catering to adult smokers, the e-cigarette industry appeared to overwhelmingly target nonsmoking youth.
Maciej Goniewicz, one of the leading e-cigarette researchers based at Roswell Park Comprehensive Cancer Center in Buffalo, New York, has watched the shift unfold up close: The volunteers who come forward for his e-cigarette studies seem to be getting younger.
“ people who were breathing pure air for a long time and have never smoked tobacco cigarettes, who now have started using e-cigarettes,” Goniewicz said.
He and other researchers around the world are now scrambling to figure out what impact this new habit might have on developing bodies and brains in the long term. And they’re finding that e-cigarettes may be more dangerous than we’ve appreciated, especially for hearts, lungs, and brains. There’s also a growing body of research suggesting that vaping can lead to smoking.
But before we dive into the latest health concerns, a couple of notes of caution. The new evidence doesn’t mean cigarettes are safer than e-cigarettes. In fact, medical experts agree that vaping is far better for health than smoking, one of the deadliest habits known to humankind. (And that message about relative risk appears to be getting lost, as more and more people erroneously believe e-cigarettes are as or more dangerous than tobacco.)
What’s more, since people haven’t been vaping for very long, the science on the health effects is still preliminary — and far from conclusive. It may take decades for any diseases possibly caused by e-cigarettes to fully surface, particularly in the young, healthy people now using them.
There’s also the problem of making generalizations about e-cigs: There are hundreds of devices on the market, and each one delivers different levels of nicotine (or no nicotine at all) and a slightly different combination of chemicals.
With these caveats in mind, I asked researchers to share what worries them most. Here’s what they told me.
When you turn on an e-cigarette, you’re heating a liquid that contains flavors and other chemicals, and often nicotine.
Some devices, in particular Juul, deliver astoundingly high doses of nicotine. (Juul says one of its e-liquid pods is equal to a pack of cigarettes in terms of nicotine.)
The Food and Drug Administration has been warning that nicotine-induced seizures could be a rare side effect of vaping. Over the past decade, there have been at least 35 reports of seizures — sudden and uncontrolled disturbances in the brain — following e-cigarette use. The cases were reported through the FDA’s adverse event reporting system, a database of voluntary reports from patients, product manufacturers, and health professionals, and to poison control centers across the country.
“While 35 cases may not seem like much compared to the total number of people using e-cigarettes, we are nonetheless concerned by these reported cases,” FDA’s former director Scott Gottlieb said in a press release. “We also recognize that not all of the cases may be reported.”
Researchers have long known that seizures can be a side effect of nicotine poisoning — recognized as a risk in agricultural workers who handle tobacco leaves, and in toddlers who accidentally swallow e-cigarette liquid.
Gottlieb warned that it’s not yet clear from the FDA’s reports that vaping caused the seizures. For example, there was no easily identifiable pattern of use linked to the side effect: While some of the cases involved first-time users and just a few puffs, others happened in experienced users after more prolonged exposure. A few cases also happened in people with a history of seizure diagnosis, and in users of marijuana or amphetamines.
The agency also wasn’t able to determine whether a particular brand or type of e-cigarette was most likely to be implicated, since many of the reports lacked that data. (Though it is notable that some devices, in particular Juul, deliver very high doses of nicotine.)
So the FDA is calling for more investigation into whether there is a connection, and asking doctors and the public to come forward if they know about cases.
The nicotine in e-cigarettes may stress the cardiovascular system
There are also nicotine’s heart health concerns. “Nicotine does the same thing as cigarettes,” said Neal Benowitz, a professor of medicine at the University of California San Francisco who’s been studying the link between e-cigarettes and heart health. It can increase the adrenaline circulating in our bodies and activate the sympathetic nervous system (our “fight or flight” response), raising blood pressure, speeding up the heart rate, and causing the arteries — the vessels that carry blood — to narrow.
In January 2018, the National Academies of Sciences, Engineering, and Medicine in its assessment of the evidence on the health impact of vaping determined that there was “insufficient” evidence that e-cigarette use leads to long-term changes in heart rate and blood pressure.
But Goniewicz told Vox that’s rapidly changing. E-cigarettes’ impact on the body’s cardiovascular system is an emerging area of research, with more studies piling up to suggest vaping could in fact be bad for the heart.
For a June 2019 study published in the Journal of the American College of Cardiology, researchers exposed human endothelial cells — which line the blood and lymphatic vessels — to six e-liquid flavors with different levels of nicotine. They discovered that the e-liquid damaged the cells, exacerbating “endothelial dysfunction, which often precedes cardiovascular diseases.”
In a review of the literature, for the Nature Reviews Cardiology journal, Benowitz and his co-authors made the case that while we don’t yet know what that means for long-term health outcomes, it’s certainly possible nicotine in e-cigarettes will also contribute to cardiovascular events, “particularly in people with underlying cardiovascular disease.”
Several recent observational studies uncovered a link between regular vaping and an increased risk of heart attack, stroke, and coronary artery disease. The studies don’t prove e-cigarettes cause these conditions, but given the known cardiovascular effects of nicotine, there’s likely a lot more to learn about vaping and its effect on these diseases.
Even when vapor is nicotine-free, it may carry other heart health risks. The heating element in e-cigarettes emits tiny particles, sometimes including metals, which can lodge themselves deep into the lungs and get absorbed into the body’s circulatory system. “That’s where we see the potential cardiovascular toxicity,” Goniewicz said.
Recent studies have shown that puffing on e-cigarettes increases concentration of these microscopic pollutants — in particular, PM2.5 and ultrafine particles — in indoor environments.
Researchers don’t yet know what risks e-cigarette aerosol particles carry, but these tiny particles have been studied extensively in the context of air pollution and tobacco smoking. In those studies, researchers have linked exposure to small particles with a range of bad cardiovascular outcomes, including heart attacks, high blood pressure, and coronary artery disease.
The thinking is that when we’re exposed to large particles, like dust, our bodies mount a defense against them. Namely, we cough, kicking these foreign pollutants out of our respiratory tract. But with fine particulate matter, that defense mechanism doesn’t kick in — and, again, these micro-contaminants can seep into our lungs and cardiovascular system.
Same goes for other toxic chemicals e-cigarettes produce when they’re heated, such as acetaldehyde, formaldehyde, and acrolein.
“We already have sufficient evidence from hundreds of studies that link exposure to those chemicals with disease outcomes,” Goniewicz said. “We know that formaldehyde can cause cancer and that acrolein can cause certain cardiovascular diseases.” So there’s no conclusive evidence directly linking this aspect of e-cigarette use to long-term cardiovascular outcomes. But based on these studies, researchers believe such a link is plausible.
E-cigarette vapor may irritate the lungs
Much of the harm caused by tobacco smoking comes from the combustion process — smoke wears down the cells lining the lungs, damaging them and making them more penetrable to the irritating, cancer-causing chemicals in cigarettes. Since electronic cigarettes don’t burn tobacco, the vapor they produce is thought to be much less harmful than conventional cigarette smoke. But that doesn’t mean vapor is harmless.
Breathing vapor into the lungs can irritate them, which has been demonstrated in recent research on wheezing. Wheezing — that high-pitched sound caused by narrowed and abnormal airways — is more than just an annoyance: It can be a sign of emphysema, heart failure, and lung cancer.
Researchers recently tracked 28,000 adults to tease out whether e-cigarettes exacerbate wheezing. Some of the people in the study were current vapers who used only e-cigarettes; others were smokers only; still others were dual users (who smoked and vaped); and finally, there were also folks who didn’t smoke or vape at all.
Compared with that last group, the non-users, the risk of wheezing among the vapers nearly doubled.
When the researchers looked at the study participants’ history of vaping or smoking, they came to even more interesting findings: The risk of wheezing was higher in current vapers who were also ex-smokers than in ex-smokers who did not vape. In other words, it wasn’t just a vaper’s potential history of smoking that was driving the uptick in wheezing among vapers. “Therefore,” the authors concluded, “promoting complete cessation of both smoking and vaping will be beneficial to maximize the risk reduction of wheezing and other related respiratory symptoms.”
Other studies have focused on whether e-cigarette users are more likely to develop chronic obstructive pulmonary disease (COPD), a set of lung complications that make it hard to breathe. Research in mice and human airway cells showed that nicotine-containing e-cigarette vapor seemed to trigger “effects normally associated with the development of COPD.”
In preliminary human studies, researchers also found associations between regular vaping and COPD. But again, this human research was observational, not experimental, so it’s not yet clear that vaping caused COPD. (For example, it’s possible the people who have COPD are more likely to use electronic cigarettes, such as ex-smokers seeking a harm reduction method.)
Still, Benowitz said, “you don’t want to put stuff in your lungs that could cause lung inflammation. My biggest concern about e-cigarettes is that if you’re not a cigarette smoker, they could potentially aggravate asthma, cause a cough, and increase the risk of respiratory tract infection — like cold, flu and bronchitis.”
The devices can explode
A reconstructed computed tomography showing a teen’s injuries after an e-cigarette exploded in his mouth. NEJM
There are also more immediate potential e-cigarette harms. A recent New England Journal of Medicine case study described a 17-year-old Nevada teenager who showed up in the emergency room after a VGOD e-cigarette exploded in his mouth “He had a circular puncture to the chin, extensive lacerations in his mouth, multiple disrupted lower incisors, and bony incongruity of the left mandible,” the doctors who treated the boy wrote in their report.
According to the New York Times, the doctors believe the device’s battery caused the explosion. “This technology hit the market by storm and people are not aware,” Katie W. Russell, a pediatric surgeon at the University of Utah and author on the report, told the Times. “But the fact is they can burn you. They can explode in your pocket. They can explode in your face. I think there’s a health concern.”
The FDA has warned that while these explosions are rare — they can happen, and lead to serious injury. One analysis estimates there were 2,035 e-cigarette explosion and burn injuries at US emergency rooms between 2015 and 2017. A smaller study of e-cigarette explosion patients who showed up in Seattle’s University of Washington Medical Center counted among the most common injuries flame burns, chemical burns, and blast injuries. One fifth of patients wounded their faces, 33 percent had hand injuries, and 53 percent had thigh or groin injuries.
Does vaping help people quit smoking or lead to more smoking?
We still don’t know for sure whether the rise in vaping is leading to fewer adults smoking tobacco. The best available research on the question was published earlier this year in the New England Journal of Medicine. The randomized trial on e-cigarettes showed people who were randomly assigned to use e-cigarettes quit smoking at almost double the rate of people who were randomly assigned to nicotine replacement therapy.
But while e-cigarettes performed better than nicotine replacement therapy in the study, they only helped a minority of participants in the vaping group quit.
On the other hand, there is strong evidence that e-cigarettes may act as a gateway to traditional cigarette smoking among youth. The National Academies of Sciences, Engineering, and Medicine report on the health impact of e-cigarettes assessed 10 high-quality studies on this gateway question, and they all pointed to the same effect.
“The evidence base was large enough and consistent enough and strong enough to conclude that there’s an association between e-cigarette use and ever-use of combustible tobacco ,” said Adam Leventhal, a member of the report committee, in January 2018. But what’s less clear is whether young people are just more likely to try cigarettes after vaping, or whether they then go on to become long-term smokers.
Either way, this is a very important finding because another key question about the introduction of e-cigarettes to the market has been what impact they’ll have on youth smoking rates, which have dropped precipitously in recent years. Right now, like many e-cigarette health questions, we don’t know the results for certain. But it’s probably time we start paying attention to the possibilities.
Listen to Today, Explained
Hear Vox senior health correspondent Julia Belluz explain the mysterious illness linked to vaping on this episode of the daily news podcast.
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Just a few years ago, no one had ever heard of vaping or JUULing. If you wanted to get a buzzy head rush from inhaling nicotine (along with all the other carcinogens and other toxic chemicals), you had to do it the old-fashioned way, by lighting up a cigarette. But since first coming on the U.S. market about a decade ago, e-cigarettes have taken off at an almost unimaginable rate, especially among kids: In addition to about 10.8 million adult users, around 3.6 million middle-school and high-school students now use electronic cigarettes. And since regulations about advertising and marketing e-cigs are still being worked out, you and your kids have likely been bombarded by commercials, billboards, and ads for the products.
But there is a lot of confusion over whether these smoking alternatives are better, worse, or the same for your health as the kind of cigarettes that famously dangled from the lips of smokers from James Dean to Leonardo DiCaprio. Because the devices are so new, researchers are still in the process of discovering the long-term health effects of this high-tech habit, but here’s what we know right now:
First of all, what is vaping?
There are several different types of e-cigarettes, including vape pens, tanks, and the extremely popular JUUL, which looks like a flash drive, making it easy to hide from unsuspecting parents and teachers. What they all have in common is a battery-powered heating element; when you add a liquid containing nicotine, flavorings, and other chemicals, the heat converts the liquid into an aerosol or “vapor” (hence the name vaping), which is then inhaled directly into the lungs. Though Christy Sadreameli, MD, a pediatric pulmonologist at Johns Hopkins University School of Medicine and a spokesperson for the American Lung Association, takes issue with the very name vaping. “People hear that it’s a vapor and they think of water vapor,” she says. “But water vapor is benign, and we don’t think that the vapor from these products is benign.”
Is vaping healthier than smoking regular cigarettes?
This is a somewhat loaded question: For adults who are already addicted to cigarettes, switching to vaping can be a healthier move, says Vaughan W. Rees, PhD, director of the Center for Global Tobacco Control at the Harvard T.H. Chan School of Public Health — though of course it is far less healthy than not smoking at all. “We want to try to prevent the use by young people, while also allowing adult smokers the ability to switch to e-cigarettes, which will create better health outcomes,” he explains.
Let’s start off with the fact that smoking traditional cigarettes is one of the most dangerous things you can do to your body — one large study showed that regular cigarette smoking chops an entire decade off your life expectancy by increasing your risk for cancer, cardiovascular disease, and respiratory disease. And though e-cigarettes are too new to have any long-term health data, they do seem to be less deadly than a regular old pack of Marlboros.
The difference is in how the tobacco is converted to an product that can be inhaled, says Dr. Rees. “Cigarettes are harmful when the tobacco is combusted,” he explains. When you light a match and set fire to tobacco, “there is a mix of thousands of toxic chemicals, including at least 60 known carcinogens, that you inhale deeply into the lungs, which increases your risk of cardiovascular disease and respiratory problems and does damage throughout all the organs.”
Vaping products, on the other hand, don’t contain the byproducts of combustion, Dr. Rees adds. “They’re not free of health risks,” he warns. “But the risks are greatly reduced.”
Of course, vaping has created a whole set of alarming, previously unseen risks: Thousands of people have become seriously ill because of vaping, and dozens have died from what is now being called e-cigarette, or vaping, product use associated lung injury (EVALI).
What are the negative side effects of vaping?
The more we learn about e-cigarettes, the more risks we discover. The aerosol that gets inhaled so deeply into your lungs (where it then enters the bloodstream and travels to the brain) contains a whole slew of substances in addition to nicotine, including volatile organic compounds such as benzene, formaldehyde and acetaldehyde, which can cause lung disease, plus ultra-fine particles and heavy metals including nickel, lead, and tin, says Dr. Sadreameli.
Even the flavors — think pineapple, watermelon, mango, and other kid-friendly choices — may cause damage to an extent as yet unknown, says Dr. Sadreameli. “People are inhaling these flavors in very high concentrations, and in many ways it’s unprecedented,” she explains. One study found that a chemical called diacetyl was present in 39 out of 51 e-cigarette flavorings that were tested. Diacetyl has been linked to a serious lung disease called bronchiolitis obliterans, also known as “popcorn lung” because it was found in workers who inhaled butter flavoring in a factory that produces microwave popcorn. While these chemicals are considered safe when eaten, they are not meant to be inhaled into the lungs, Dr. Sadreameli explains.
Recent studies have also shown that e-cigarettes almost double your risk of a heart attack (when compared with non-smokers), as well as increasing inflammation of the lungs and bronchitis-like symptoms. And then there are the risks that are unique to the battery-heated-liquid devices: There have been several reported cases of e-cigarettes exploding, causing severe burns and facial damage. In addition, if those fruity-flavored liquids are swallowed — a particular risk if small children find them — they can cause nicotine poisoning, which can lead to nausea, vomiting, seizures, and even death.
The main concern about vaping, and specifically about JUULing, is that it is a trend that has spread like wildfire among young people, says Dr. Sadreameli. A recent study in the New England Journal of Medicine found that vaping is now the single most popular form of tobacco use among adolescents. In fact 25% of high school seniors reported vaping in the past month, along with 20% of 10th graders, and nearly 10% of 8th graders.
Not only are these kids dealing with the risks of vaping at a very crucial time in their development, but there is concern that they will move on to smoking traditional cigarettes. A study in Pediatrics found that kids aged 12 to 17 who used e-cigarettes were more than twice as likely to move on to smoking old-school combustible cigarettes as kids who never vaped.
The bottom line: If you’re addicted to nicotine and are looking for a way to step down from the massive health risk of combustible cigarettes — and you’re not pregnant — vaping is a viable alternative. But better yet, look here for ways to quit smoking altogether. But if you are just curious about vaping, consider this: Nicotine is a highly addictive substance, and once you start vaping, you may start looking for other ways to get that buzz; even if you just stick with e-cigs, you will be putting your health at greater risk than not smoking or vaping at all. All bad habits are hard to break, so why even start?
Marisa Cohen Marisa Cohen is a Contributing Editor in the Hearst Health Newsroom, who has covered health, nutrition, parenting, and the arts for dozens of magazines and web sites over the past two decades.
Vaping: Is it bad for you?
Vaping can have several potential adverse effects on a person’s body, including the heart, lungs, teeth, and gums.
A recent review indicated that vaping could cause problems with a person’s heart, lungs, and circulation. The evidence suggests that e-cigarettes release toxins that can cause harm. However, the researchers indicate that further research is needed to determine the long-term effects of vaping.
One 2019 study found that there was no connection between vaping and heart disease. However, the researchers did indicate that anyone who uses either traditional cigarettes or vaping devices are at an increased risk of developing heart disease.
Another 2019 study looking at the same data found an association between vaping and an increased risk of heart attack, heart disease, stroke, or angina.
Researchers working on a study in 2018 had similar findings. They found that vaping leads to an increased risk of heart attack regardless of the user’s other lifestyle choices.
Further research into the safety of vaping is required to determine the relationship between vaping and the heart. Most researchers do agree that vaping is still safer for the heart than smoking, but vaping still presents risks.
Overall, vaping may be better for a person’s lungs than smoking cigarettes. However, researchers must carry out further studies to identify the short- and long-term effects vaping has on lung health. The evidence so far is mixed.
One small study published in 2019 found that there was no significant increase in risk to lung health between people who only vaped and those that neither smoke nor vape.
A 2018 study indicated that there is some evidence that vaping can affect the circulatory system. However, the authors suggest that more research is needed to determine vaping’s effect on lung health.
However, a 2018 study using rats found that e-cigarettes are just as bad for the lungs as smoking and that long-term exposure has the potential to cause significant lung damage. Researchers did state, however, that they only studied one type of e-cigarette.
Teeth and gum health
Vaping may cause issues with teeth and gum health. Several studies have indicated that vaping can irritate the gums and throat and may make a person more prone to tooth decay.
For example, a study in 2016 found that people who vaped have an increased risk of developing periodontal diseases.
A 2014 review that analyzed 44 articles on the effects of vaping on health also found that vaping can irritate the gums and throat.
A further study from 2018 found that vaping with sweet flavored liquids increases the likelihood that a person may develop tooth decay due to increased bacterial growth.
In the world of popular vices, vaping is still the Wild West – there’s not a great deal of official regulation, the rules aren’t firmly in place, and the social, cultural, and public health impact of vaping isn’t really clear yet. After all, vaping hasn’t been around long enough to see any long-term studies or long-term effects. We don’t have thousands upon thousands of pages of research about how vaping affects the body, like we do with conventional smoking, and much of what we know about vaping is a mixture of circumstantial evidence, anecdotal evidence, and subjective opinions and conjecture. So the big questions – Is vape bad for you? Is vaping a drug? Does vaping have side effects? – are still up in the air.
What is Vaping and How Does it Work?
Everybody knows how smoking works: dried and shredded tobacco is wrapped in a paper tube, which is then set on fire at one end, while the smoker inhales the smoke through the other end. As it turns out, vaping is only slightly more complicated, though it requires a lot more electronics. In vaping, a device (the vape pen or vape mod) heats a volatile liquid in a cartridge, which the user inhales from the device. That’s it; rather than burning tobacco, a vape simply turns a liquid to vapor (oh, that’s where they get the name!).
That process can be as simple or a complicated as the user wants it to be, and vape enthusiasts are nothing if not gearheads. For instance, many e-cigarettes include an LED light that simulates the burning end of a cigarette – a completely useless, but aesthetically satisfying, feature. Middle-of-the-road vape pens may include bells and whistles like electronics that allow the user to set how much vapor they want the device to give off, while high-end “mods” are completely customizable, and, of course, way more expensive.
The second part of the process – the “smoke” – offers just as much variation as the device. As a thorough article in Gizmodo by a vape maker explains, the main ingredients in e-liquid – or, as it’s more popularly (and ickily) called, vape juice – are pretty simple: glycerin, for the clouds of vapor; propylene glycol, for the flavoring to bind to; flavoring, for… well, flavor; and nicotine, which is obtained as a pure, pharmaceutical-grade concentrate.
Vaping: The Magic Bullet for Smoking Cessation?
A lot of the attention e-cigarettes and vaping received early on was due to its potential for helping people stop smoking. After all, that was their original intention – the first modern vape was developed by a Chinese pharmacist and inventor, Hon Lik, who was tired of the continual failure of nicotine patches to help him stop smoking. Hon realized that emulating the act (or habit) of smoking, without the harmful carcinogens of burning cigarettes, would make it easier to stop smoking actual cigarettes.
It took a couple of years of experimenting with the contents of the e-liquid and the best method for heating it – as well as how to miniaturize the whole contraption to make it more like smoking (it’s easy to imagine early versions looking more like a malfunctioning breathing apparatus). By 2003, Hon had patented his design and e-cigarettes were being sold on the market in China; they came to America a few years later – to virtually no acclaim.
In fact, it was not until the 2010s that vaping became a viable business in the US, once anti-smoking ordinances hit a kind of critical mass – and the turning point was really New York City’s outdoor smoking ban in 2011. By that time, bars, restaurants, and theaters had been off-limits for some time; most workplaces had already banned indoor smoking; even many apartment buildings and rental homes had no-smoking policies written into the lease. Once smokers began to feel that even the outdoors was a no-go, the path forward for vaping had opened up.
So is Vaping Helping Smokers Quit?
As usual, nothing drives innovation like necessity, and for the more than 37 million smokers in the US, not being able to light up anywhere but home created a necessity that needed to be filled. Early on, vaping was marketed explicitly as a smoking-cessation aid, a way to get off more dangerous cigarettes and eventually wean off nicotine altogether – if that’s what they want.
Studies are showing that, for adult smokers, vaping can work to stop smoking; an estimated 2000 smokers quit in 2015 by substituting with vaping. On the face of it, that’s a clear public health win, since smoking costs the American economy nearly $100 billion in health care expenses every year; every smoker who stops is a gain for everybody.
The reality is more complicated though, because the same study of 70,000 users found that vaping nicotine still doubles the risk of heart attack over not vaping at all, and (more of a concern) many people who vape to stop smoking actually end up doing both – multiplying their risk of heart attack by five. Give it a little thought, and it’s not surprising; most smokers who also vape are only vaping because they can’t smoke in most public places. In other words, they’re not actually trying to stop smoking, just settling for vaping because they’re not allowed to smoke.
Vaping for Teenagers and Young Adults
In the last few years, vaping has overtaken cigarette usage among teenagers – in a 2016 Pediatrics study, 11% of 10th graders had used electronic cigarettes, versus 5% who used conventional cigarettes; more than 4% of middle schoolers had tried vaping. In all, more than 2 million teenagers admitted to vaping within the last 30 days. In some respects, that could be considered a good thing; if the choice is between vaping and smoking, vaping is relatively safer, without the harmful chemicals the come from burning tobacco and paper. However, vaping raises its own worries when it comes to teenagers.
The biggest concern for teenagers vaping, especially among parents, is whether vaping can act as a gateway to smoking conventional cigarettes. While the idea of a “gateway drug” has been largely disproven (studies have shown, for instance that smoking marijuana does not typically lead to harder drugs), there is ample evidence that young people who vape are highly likely to move on to conventional cigarettes.
The irony, then, is that vaping has been proven to help adult smokers quit, but has also been shown to lead teenagers to move from e-cigs to real cigarettes. A 2015 study shows that for 2000 adults who used vaping to stop smoking, more than 160,000 teenagers and young adults made the transition in the opposite direction. That is definitely a public health concern, and even more so if young people continue to vape as well as smoke – the risk of heart attack, for instance, is increased five times by both vaping and smoking.
In addition to the problem of vaping leading to smoking, the Pediatrics study found that the volatile chemicals in e-cigarettes, like propylene glycol and glycerol, can form carcinogenic compounds when heated, and that those compounds were found in the urine of the 16 year olds who were tested. While it’s just one study, it does indicate that vaping does cause a risk of exposure to potential cancer-causing substances – less than conventional cigarettes, perhaps, but still not as safe as vape marketing likes to claim.
Is Vaping a Drug?
One of the main questions vape-curious folks want to know is “Is vaping a drug?” Of course, on its own, vaping is not a drug – it’s a method of drug delivery, just like smoking, drinking, or injecting. In and of itself, vaping is neutral; a vape pen or mod can vape any substance that can be suspended in vape liquid. Most commonly, that is nicotine, but it can just as easily be THC, opioids, or synthetic “designer” drugs like DMT or MDMA – even meth.
An ongoing study at Virginia Commonwealth University is looking into the dangers of recreational drug use with vape, and have found that many of the substances for sale on the Dark Web – such as e-juice containing heroin and morphine – are not just Nancy Reagan’s worst nightmare come to life – they’re real, functional, and obtainable.
So the short answer is, of course vape is not a drug – just like a cigarette is not a drug, and a hypodermic needle is not a drug. But as a drug-delivery system, vaping has the potential to deliver just about any drug a user could want. That fact has sparked a lot of worry about parents especially, but at this time, it’s mostly conjectural.
Is Vaping Without Nicotine Bad for You?
Is vape bad for you? Kind of – that’s the short answer. If you’re vaping nicotine, you’re still upping your chances of heart attack and stroke, but if your vaping helps you stop smoking tobacco, you’re decreasing your chances of cancer, lung disease, and all sorts of other nasty effects of smoking. As far as we know, high-quality vape juice, used with a well-designed, high-end vape pen or mod, is safe. If the user is vaping nicotine, they’re better off than if they were smoking. Is vaping without nicotine bad for you? Not at all – without any drug in the vape juice, you’re just inhaling vaporized glycerin and flavorings.
However, that’s only true of higher-end, “connoisseur” vaping, where users trust that the ingredients and process are safe, clean, and transparent. There are legitimate concerns when it comes to cheaper foreign products, like gas-station e-cigs. While the FDA has approval to regulate e-cigarettes and vaping, very little actual “regulation” takes place. Essentially, vape makers are required to inform the FDA of what is in their product, but there is no public disclosure. Companies can tell customers as much or as little as they want.
And there are a lot of valid concerns when consumers don’t know what they’re consuming. For a simple example, most vape liquid uses propylene glycol – a completely harmless chemical that also makes asthma inhalers work – to suspend and deliver the flavorings. However, cheap, mass-market vapes have been found to contain diethylene glycol – an industrial solvent which is definitely poisonous. (It’s the reason why spilled antifreeze should be cleaned up immediately, since its sweet taste will attract pets and make them sick.)
In mass-market e-cigs made in foreign countries, where there is even less regulation, there are realistic concerns about the presence of heavy metals and banned chemicals. Some of the common ingredients in vape juice are known to turn carcinogenic when overheated; while higher-quality vapes control temperature to avoid this problem, many cheaper products do not. And, of course, there is the slim but still realistic chance of a battery exploding or catching fire.
What is Popcorn Lung (and is it Really Dangerous)?
Since the popularity of vaping has grown, the term “popcorn lung” has hit the mainstream is a way that would almost be laughable, if there were anything funny about pulmonary obstruction. The vaping-popcorn lung connection has been driven home by the media, making “What is popcorn lung?” one of the most popular vaping-related searches on Google. Because “popcorn lung” sounds at once completely absurd and unsettlingly creepy, it’s caught public attention more than any other possible side effect of vaping.
So what is popcorn lung? The medical name is “bronchiolitis obliterans,” unfortunately abbreviated to BO – if it’s embarrassing to ask a doctor if you might have “popcorn lung,” just try asking a doctor if you have BO. Bronchiolitis obliterans can results from exposure to many different chemicals that cause inflammation and obstruction of the bronchioles, the smallest passages in the lungs.
But the specific chemical associated with popcorn lung symptoms is diacetyl, a food additive that was once used to make popcorn taste buttery without butter. That’s where the name comes from – BO was first linked to diacetyl when workers in a popcorn factory began getting sick.
One of the particular dangers of popcorn lung is that popcorn lung symptoms look indistinguishable from lots of other lung diseases, like asthma or bronchiolitis obliterans organizing pneumonia (which has the inappropriately whimsical acronym BOOP). Popcorn lung symptoms include:
- Shortness of breath
- Dry cough
Because numerous other lung diseases cause the same symptoms, popcorn lung can often go undiagnosed, and therefore improperly treated, allowing the damage and scarring that causes popcorn lung symptoms to increase.
So what is the vaping-popcorn lung connection? Most high-end vape makers don’t use diacetyl, but in 2015, more than half of the mass-market e-cigarettes studied were found to contain the chemical – especially flavored vape juice. The diacetyl makes the flavors richer, but because the vapor is being breathed in, it exposes users to the risk of popcorn lung, which increases the longer these liquids are vaped. Particularly concerning is the fact that diacetyl is primarily found in flavored e-liquids – which tend to be more appealing to teenagers.
Do the Benefits Outweigh the Risks? The Public Health View
So is vape bad for you? It’s complicated. Because vape juice is manufactured, it’s entirely possible to vape with any amount of nicotine the user wants; that means, theoretically, it would be easy to switch from smoking to vaping, and slowly wean off nicotine altogether. Nicotine, after all, is the danger to heart health, while other substances generated by smoking contribute to lung disease, cancer, tooth decay, and the other ills.
So, simply comparing vaping to smoking, vaping is obviously healthier – and insofar as vaping can help smokers stop smoking, vaping is a net positive for public health. A former smoker’s health improves every year after quitting, as their body naturally works to repair the damage, and within 10 years, nearly all of the dangers of smoking are reduced or reversed altogether. The sooner a smoker quits, the better. So the question, “Is vape bad for you?” can be answered, “Well, it’s better than smoking.”
Obviously, though, complete, permanent smoking cessation – without substituting another nicotine delivery system – is the healthiest option. Nicotine is still linked to heart disease, stroke, high blood pressure, and other cardiovascular problems (although, to nicotine’s credit, it’s also linked to attentiveness, memory improvement, and may even be used medicinally to combat Alzheimer’s and Parkinson’s). When the potential side effects of vaping are added to the mix, it’s obvious that we’re operating on a sliding scale – vaping is safer than smoking, but more dangerous than not vaping or smoking at all.
The US/UK Divide (Or, Why are Americans So Afraid of Vaping?)
So is vaping good for public health? At this time, considering what we know and what we hypothesize, the answer is a tentative and qualified “yes.” It helps adults cut down or stop smoking altogether, improving public health in the long run, and while concerns about whether vaping leads to smoking in teenagers are valid, they’re not definitive.
A very interesting divide occurs when we compare how the US has approached vaping, as opposed to how the UK has approached it. As reported by the Guardian, the British public health authorities have almost unanimously embraced as an alternative to smoking, reasoning that the greater good to public health outweighs the potential (and unsubstantiated) dangers.
From the outside, initiatives like New York City’s ban on indoor vaping seem like typical American fear-mongering. While the Royal College of Physicians in the UK has declared vaping almost completely safe, and a definite improvement over smoking, the National Institute on Drug Abuse in the US focuses on the potential for harmful chemicals. Meanwhile, while the FDA has dragged its feet on either further study or regulation, prompting conspiracy theories about the influence of Big Tobacco, UK citizens rate vaping their number one choice to stop smoking.
Ironically, its seems as though the American anti-smoking movement of the last 40 years or so has been too successful. While smoking bans and public health announcements have drastically reduced the number of people who smoke, and made significant improvements in public health, smoking and nicotine have been so thoroughly stigmatized that even a healthier alternative – namely, vaping – is subject to the same stigma.
Unfortunately, as with other addictions, stigma and bias makes it harder for smokers to ask for help, or to help themselves. When people who have addictions are made to feel ashamed, they are more likely to become defensive and less likely to seek help. By offering the alternative of vaping, without the stigma, the US could potentially see a significant reduction in smoking.
How to Use Vaping to Quit Smoking
The consensus seems to be clear. If you don’t smoke and don’t vape, don’t start. The health risks of both, compared to never using, are too great to be worth it.
But if you smoke, you can successfully use vaping to quit smoking. It’s never easy to quit smoking, but there’s a mountain of anecdotal evidence that quitting is easier with vaping than with cold turkey – as long as you don’t get sucked into adding a new habit to your existing one.
There are some factors to keep in mind if you want to use vaping to quit smoking:
Spring for a quality vape device. If you’re serious about quitting, making the extra investment in a higher-quality vape pen or mod has material and psychological benefits. For one, the greater expense can actually have the effect of making you take your decision more seriously. A cheap e-cig is easy to give up on; a device you paid $100 or more for demands some respect. Higher-quality devices also give users a more satisfying experience, closer to real smoking, which can help smokers give up the smoke.
Limit your exposure to harmful chemicals. Big Tobacco has made extensive forays into vaping, but it’s primarily in the form of cheap, disposable convenience-store vapes. Because they’re so common and cheap, these are usually where people start when they’re trying to use vaping to quit smoking. Unfortunately, these are also the devices where you’re most likely to encounter chemicals like diacetyl, as well as other hazardous ingredients.
Gradually reduce your nicotine levels. A high-quality vape will give you much more flexibility in your choices of vape liquid. One of the biggest benefits of that flexibility is the opportunity to buy liquids of varying nicotine concentrations, and gradually wean off the nicotine. In fact, many vape users will work their way down to no nicotine at all, and continue to vape for the enjoyment of vaping itself. Even if you keep using nicotine, though, the health benefits from stopping smoking are still significant.
Don’t smoke and vape! One of the pitfalls of using vaping to quit smoking is that smokers often end up using both – vaping in public, when they are not allowed to smoke, and still smoking at home. We have to underscore the fact that this is defeating the purpose: health dangers are intensified by combining smoking and vaping, and while it may still reduce smoking, cutting down on smoking and quitting smoking are not the same.
Electronic cigarettes, or e-cigs, have been on the market in the U.S. since 2008 and have gained wider use in recent years. Now, evidence is beginning to emerge on e-cigs’ short-term effects, and their positive and negative impact on people’s health.
E-cigarettes are battery-powered devices that heat a liquid — usually containing nicotine mixed with the chemicals propylene glycol and glycerin, and often flavorings ranging from bubble gum to watermelon — into a vapor that users can inhale. They deliver nicotine, a highly addictive drug, to the body without producing any smoke.
This month, the U.S. Food and Drug Administration announced that its authority to regulate tobacco products will now extend to include e-cigarettes. The devices — along with cigars, hookah and pipe tobacco — will now be regulated in a similar way to conventional cigarettes. The new rules, which take effect on Aug. 8, also banned the sale of these products to people under age 18 both in stores and online.
But because e-cigs are relatively new nicotine-delivery products, there are many unanswered questions about their safety and health impacts, including questions about their long-term use and effectiveness in helping traditional smokers to quit. What, exactly, is in an e-cigarette, and how do these chemicals affect the heart and lungs as well as a person’s overall health? Live Science asked two tobacco experts for their insight into these questions, and here is what they said.
What’s known about e-cigs
“There is no question that a puff on an e-cigarette is less dangerous than a puff on a conventional cigarette,” said Stanton Glantz, a professor of medicine and the director of the Center for Tobacco Control Research and Education at the University of California, San Francisco.
Because e-cigarettes create a vapor rather than produce a tobacco smoke, they generally deliver less nicotine to users than cigarettes do, Glantz said.
However, this doesn’t mean the devices always represent a safer step down from cigarettes. In fact, one of the most dangerous things about e-cigarettes is that they may keep people smoking conventional cigarettes longer, rather than encourage them to attempt to quit, he said. Although estimates vary, anywhere from 70 to 90 percent of e-cigarette users are “dual users,” meaning they continue to smoke regular cigarettes after they begin vaping, Glantz said.
But regardless of how the nicotine is delivered — whether through e-cigs or conventional cigarettes — it still has effects on the body. The drug is a cardiovascular stimulant, and can potentially worsen heart disease in people who already have severe heart conditions. However, it’s not known whether nicotine alone can cause heart disease in people who don’t have heart problems, said Dr. Michael Siegel, a tobacco researcher and professor of community health sciences at the Boston University School of Public Health.
But there’s some evidence that e-cigarettes can have a substantial effect on blood vessels, and may increase people’s heart attack risk in that way, Glantz said.
(Image credit: NeydtStock .com)
What’s more, nicotine is poisonous in its concentrated, e-liquid form, and there have been an increasing number of cases of infants and young children accidentally ingesting it, Siegel said.
Nicotine also has effects on reproductive health, and exposure to nicotine during pregnancy, regardless of its delivery method, can harm the developing fetus and lead to babies born with low birth weights, he said.
The use of e-cigarettes by kids of high school age has soared – CDC statistics show that 1.5 percent of high school teens had tried e-cigs in 2011, compared with 16 percent in 2015. The rise has occurred even as researchers are finding more evidence that nicotine can be toxic to a young person’s still-developing brain and body systems, Glantz said. Studies have also shown that kids who use e-cigarettes have more respiratory problems and take more days off from school, he said.
In addition to the nicotine, e-cigs’ other chemicals may also affect health. Research on the vapors emitted and inhaled from e-cigarettes has shown they deliver particles small enough to reach deep into the lungs and that they are not the “harmless water vapor” that marketers may claim, Glantz told Live Science.
Propylene glycol, a chemical found in e-liquids, can irritate the eyes and airways, Siegel said. Early studies have also revealed that when propylene glycol or glycerin are heated and vaporized, they can degrade into formaldehyde and acetaldehyde, he said. Both of these chemicals are considered carcinogens, although it’s not yet clear how repeated exposure to them may cause cancer, he said.
One of the biggest safety risks of e-cigarettes is the potential for their lithium-ion batteries to explode, sometimes into a person’s face or eyes, Siegel said. There is clearly a need for standards to make these batteries safer, he said.
But all in all, even if e-cigarettes involve some health risks, they are not more toxic than smoking cigarettes, and so anything that can get people away from tobacco is moving them in the right direction, Siegel said. He believes that vaping gives people a safer alternative because although users are still getting nicotine, they are getting lower levels of some of the toxic substances and carcinogens found in cigarette smoke, he said.
Eventually, the goal is to get people off vaping and to quit completely, but people have to start somewhere, Siegel said. He also acknowledged that many of his colleagues in public health don’t share his opinion. Rather, they view e-cigarettes as a gateway to smoking conventional cigarettes, especially for young people, or as a method of getting nicotine that actually diminishes people’s interest in quitting.
Glantz falls into this latter category. In an analysis he and a colleague published earlier this year, they found that adult smokers who use e-cigarettes are about 30 percent less likely to stop smoking than people who attempt to quit smoking without turning to vaping, he said. One possible explanation is that people may generally use e-cigarettes as part of a “taper-down” strategy, which is less effective than quitting cold turkey, he suggested.
The unknowns about e-cigs
Studies evaluating whether e-cigarettes are less harmful than cigarettes have been inconclusive, according to a review of studies published in the journal Tobacco Control in May 2014.
Moreover, the long-term health effects in people who get nicotine in a vaporized form over time are not known, Siegel said. It’s also unclear whether propylene glycol, a known irritant to the respiratory tract, could result in lung problems after decades of vaping, he said.
And because e-cigarettes have been on the market for only about 10 years, there have been no long-term studies of people who have used them for 30 to 40 years. Therefore, the full extent of e-cigs’ effects on heart and lung health, as well as their cancer-causing potential, over time is not known, Glantz told Live Science.
Another unanswered question is how the flavorings used in the devices may affect people’s health. Nearly 500 brands and 7,700 flavors of e-cigarettes are currently on sale, according to the American Lung Association. This wide variety of flavors has helped make vaping appealing to young people.
It’s not yet known whether these flavorings have any respiratory effects when they are vaporized and inhaled, Siegel said. More research is needed to identify any hazards associated with the potential inhalation of flavoring agents, he said.
In addition, little is known about how the flavoring agents in e-cigarettes may influence nicotine’s addictive qualities, Glantz said.
More work needs to be done to understand the dynamics between smoking traditional cigarettes and also using e-cigarettes in people who are dual users, he said. Future research also needs to look at whether using both traditional cigarettes and e-cigs interferes with the desire to quit, and whether using e-cigarettes is an effective strategy for quitting smoking compared with other methods, such as the nicotine patch and behavioral counseling, Glantz said.
The FDA has not approved e-cigarettes as a smoking cessation aid, he added.
Follow Live Science @livescience, Facebook & Google+. Originally published on Live Science.
Is vaping safe?
It’s hard to escape the facts about smoking. The health risks associated with cigarettes are well documented, and the large, graphic warnings on every pack are obvious. But when it comes to e-cigarettes, making a healthy decision can be more difficult.
Some celebrate the arrival of these “smokeless” nicotine tools as a safe alternative to cigarettes, cigars and other tobacco products. The devices don’t emit the same cancer-causing tar and toxins that burning tobacco leaves produce.
But that’s not the whole story. Many e-cigarettes are loaded with addictive nicotine and even those without nicotine may contain toxic chemicals.
So is it safe to vape? We talked to Jason Robinson, Ph.D., associate professor in Behavioral Science, about the dangers of e-cigarette aerosol.
What is vaping?
E-cigarettes are nicotine delivery devices that have a battery, a heating element and a container for liquid. When the liquid is heated, users inhale the aerosol. The liquids are usually flavored and contain nicotine, so users experience a taste sensation as well as a hit of the same addictive stimulant found in cigarettes.
Vaping or vaporizing is the word used to describe inhaling the aerosol produced by e-cigarettes or similar devices like vaporizers or vapor pens. One brand, Juul, has become so popular that a new verb, Juuling, is widely used.
The risks of vaping
Researchers do know that e-cigarette aerosol contains toxic chemicals like those found in glue and paint. What’s less clear is if the amounts are high enough to cause diseases like cancer.
“The biggest problem is that we don’t know exactly what goes into all the flavorings, and there are thousands of them,” says Robinson. Experts say it could take 20 years to know the long-term health effects of vaporizing.
But there are some clear dangers to e-cigarettes, particularly when it comes to nicotine.
Nicotine is addictive. In fact, it’s one of the most addictive substances available. An addiction to nicotine can lead e-cigarette users, especially kids, to escalate to regular cigarettes.
“The fear is that these young people who would never have tried cigarettes are now getting dependent on nicotine at the most impressionable time,” Robinson says.
Nicotine is harmful. This is particularly true for young, developing brains. Nicotine use can stunt an adolescent’s ability to learn and affect their behavior. It lowers their ability to resist addiction, leading to more nicotine use. Nicotine also worsens conditions like depression and anxiety.
If you have asthma, e-cigarette aerosol can irritate your throat and lungs.
If you’re a smoker, vaping could support your habit, not break it. Instead of transitioning from cigarettes to e-cigarettes, some smokers end up using both.
“There’s no evidence that people can switch and stay switched, some people go on to dual use,” Robinson says. “They may cut back on cigarettes but they use e-cigarettes to get nicotine in areas where smoking is banned.”
This increases their nicotine addiction instead of lessening it, he says.
Nicotine patches, nicotine gum and other smoking cessation products are designed to help smokers wean off nicotine. Unlike e-cigarettes, they are proven to work.
The liquids and devices can be dangerous. E-cigarettes have been known to explode and the fluid is poisonous if it comes into contact with eyes or skin, or if you accidentally or deliberately drink it.
Robinson says the reasons for avoiding Juuls and e-cigarettes are compelling.
“If you’re not already dependent on nicotine, why take the risk of becoming addicted and damaging your health?” he says. “If you are dependent on nicotine, you are much better off using safe cessation tools that are proven to be effective to curb your cravings and get off tobacco products.”
Finally, if you are a smoker, any non-tobacco based nicotine product is better, he says. But try prescription or over the counter forms before e-cigarettes.