E-Cigarettes: More Harm than Good?

Unless you’re in the middle of nowhere, you’ve probably walked along and had a sickly sweet vapour blown in your direction. E-cigarettes are on the rise and hoped to help people give up smoking, but are they actually any better for you?

In 2017, 15.1% of people 18 and over smoked in the UK; that’s roughly 7.4 million people.  There was a 1% rise in smoking related hospital admissions from 2017-2018, rising to 489,300 and 77,800 deaths, equating to 16% of all deaths in those 12 months. The number of smokers has been falling steadily year on year, and some attribute this to the use of e-cigarettes. Again in 2017, 5.5% of the UK population said they used e-cigarettes; ~2.8 million adults. What exactly is an e-cigarette? Often referred to as vaping, a vape allows you to inhale nicotine in a vapour rather than smoke. Unlike cigarettes, vapes do not burn tobacco and do not produce tar or carbon monoxide, (two of the most damaging elements in tobacco smoke). Instead, vapes heat a liquid which usually contains nicotine, amongst other chemicals, and of course, those sickly flavourings.vapesmoke.png

The NHS recommend the use of e-cigarettes to aid people who are trying to stop smoking, as it should help manage the nicotine cravings. They quote a clinical trial whose results were published this year (2019) which found that, when combined with expert face-to-face support, people who used e-cigarettes to quit smoking were twice as likely to succeed as those who did not. So what testing has been done on e-cigarettes? Obviously that study highlights the benefits of vaping for people who are trying to stop smoking and thankfully, in the UK, e-cigarettes are tightly regulated for safety and quality. However, they are not risk free. Even the NHS website emphasises that although vapes do not contain tar and carbon monoxide, the liquid vapour does include potentially harmful chemicals from cigarette smoke, but at lower levels.quitsmoking.png

It is brilliant that there is now a safer and more effective way to quit smoking. However, I’ve heard many people say they vape because it’s not harmful, and there are definitely people who never smoked cigarettes but now vape. So what are the risks? Cancer Research UK agrees with the NHS in that e-cigarettes are far less harmful than smoking, but state that they do not know the long term effects and as a result, do not advise non-smokers to start using them. The main concern is the rising use of vapes in younger people, with vapes being the most commonly used form of tobacco amongst US teens. I’m reluctant to say they could be a “gateway cigarette”, but a study in the US found that children aged 14-15 who had used e-cigarettes were more likely (up to 7 times!) to start smoking within the next year than those who had not; suggesting e-cigarettes may encourage smoking in teens. Here are 4 facts from Cancer Research UK:

Personally I’ve never smoked, nor used an e-cigarette. As a chemist, the idea of ingesting/inhaling something you don’t know the chemical composition of worries me. A study in 2017 of some e-cigarettes showed the presence of known carcinogens (i.e. cancer causing chemicals) amongst other toxic chemicals. Amongst these were toxic metal compounds such as nickel and cadmium, which can cause breathing difficulties. These are likely to come from the heating element in the device rather than the vapour itself, but either way, it’s best not to have any surely? Some studies have shown that in teenage brains nicotine is detrimental to the development of circuits which control attention and learning, as well as higher risk of mood disorders and impulse control. A teenage brain is at an important stage of development, and should be left to develop without drugs, whether that is cannabis, cocaine, caffeine or nicotine.brain_workout

Overall, the use of e-cigarettes by past smokers as an aid to quit smoking, has been proven to help, increasing their chance of quitting and improving their health. However, for those who have never smoked it is not recommended; vaping is not a “safe” form of smoking. Inhaling known carcinogens and metals (even in small amounts) is never a good thing. The long term effects of vaping may not be seen for a few more years, but reports of teens with lung damage after weeks/months of vaping have started to emerge from the US. This does not mean vaping is the cause, it may just be coincidence. However, for those who are not trying to quit smoking, why not wait until there is some more data? People thought cigarettes were good for your lungs not that long ago.

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