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E-cigarettes and Vaping: Unknown Health Dangers

senior man vaping an e-cigarette
March 5, 2019
Lily Moran

E-Cigarettes (also known as e-cigs and vapes) have transformed the landscape of the tobacco industry. So much has changed that it’s not really the tobacco industry anymore but rather the nicotine industry. But the fact remains that, whether you’re smoking it, chewing it, or vaping it, nicotine is an addictive drug.

E-cigarettes are also different in the sense that we don’t have stacks of research about the risks associated with them. The industry is still young (e-cigarettes are less than 10 years old) but it’s growing extremely fast. Top e-cigarette brand Juul is valued at $16 billion – and it’s only four years old!

Because e-cigarettes are relatively new, the research on them is preliminary. I’d like to share up-to-the-minute information with you about what we do and don’t know about e-cigarettes.

E-Cigarettes 101

But first, let’s start with the basics. The “E” in e-cigarettes means electronic. And “cigarette” doesn’t refer to the rolled-up leaf tobacco you are familiar with, but rather a battery-powered device that holds a cartridge of liquid nicotine, flavorings, and other chemicals. There is no fire involved, so as a result there is no tar or smoke. Thus, when you inhale and exhale you see, smell and taste vapor (usually flavored) – hence the term “vaping.” This liquid vapor might be mostly made up of water, but it’s difficult for consumers and research to get an ingredient list for these products. Most companies treat their e-liquid as a business secret.

Unlike tar and smoke, vapor doesn’t blacken your lungs, stain your teeth or contain all of the particulates that cause lung cancer, heart disease, and the myriad of illnesses associated with smoking. I wouldn’t be surprised if research eventually discovers health risks associated with the chemicals tied to vaping, but as of now, there is no research to prove it.

It does contain plenty of nicotine; nicotine’s health dangers include cardiovascular, respiratory, and gastrointestinal disorders. Additionally, it’s a carcinogen, and it’s highly addictive.

Proponents of e-cigarettes say that they are a godsend to smokers who wish to quit tobacco and, eventually, nicotine. They also say that vaping is a safer alternative than tobacco – both for people who vape and those who are “secondhand vapers”. Critics argue that it’s too premature to proclaim any new drug product is safe, especially without a thorough vetting from the Food and Drug Administration.

Let’s cut through the smoke (or vapor) and get at the heart of the debate about E-cigarettes.

Dangers of E-Cigarettes and Vaping

In simple terms, E-cigarettes give you nicotine without the smoke. Instead of smoke, you’ll taste pumpkin pie, buttered popcorn, chocolate, cappuccino, cherry, blueberry, and a growing list of exotic flavors. Vaping or exposure to vaping doesn’t result in a lasting unpleasant smoke smell or taste. Both of these reasons are why E-cigarettes are becoming very popular – especially for teens.

Which leads me back to nicotine – and also the added chemicals that create those flavors.

The popularity of vaping with teens makes me worry that e-cigarettes are creating a new generation of nicotine addicts. Unlike tobacco cigarettes, e-cigarettes give users the option to adjust the levels of nicotine that they inhale. Proponents say that this helps them ween off of nicotine over time by gradually dialing down the nicotine they inhale.

Critics say that the exotic flavors encourage more e-cigarette use in general. It creates a sense that you’ll want to try one new flavor after another. And that’s much easier to do when vaping doesn’t immediately punish your lungs and throat the way smoking does.

To me, one of the biggest unknowns of e-cigarettes surround these exotic flavors and the added chemicals. As of now, researchers can’t possibly keep up with the growing list of flavors and the chemicals that make them. So far though, a couple of popular flavors contain an ominous ingredient, diacetyl, already known to health experts.

Before vapes, it was a chemical used to flavor popcorn, caramel and dairy products. When inhaled, it’s been linked to deaths and cases of bronchiolitis obliterans, an irreversible lung disease. Nicknamed “popcorn lung,” the disease’s hallmark is the scarring of the tiny air sacs in the lungs, narrowing the airways, and resulting in wheezing and shortness of breath.[i]

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Diacetyl has been removed from many food products, but it’s still a common additive in e-cigarette liquids. Be on the lookout for it.

Can E-Cigarettes Help You Quit Smoking?

A recent study of popular smoking cessation techniques showed that vaping was demonstratively a better vehicle to quit smoking than nicotine gum, chews, inhalers, lozenges and patches.[ii] Researchers surmised a couple theories – the fact that nicotine levels can be adjusted in e-cigarettes and because vaping was more enjoyable than other cessation methods.

This was just one study, though. Previous studies did not conclude that e-cigarettes were a reliable cessation method. [iii]Other studies showed that teens who vaped had a higher risk of smoking cigarettes.[iv]

Also, now that marijuana laws have loosened and it’s more widely available in different forms (such as liquid cartridges), people are using e-cigarettes to vape marijuana. Legally in states where marijuana use is legal. Illegally in states where it’s not. And one study showed that teens who vape nicotine are more likely to use marijuana. [v]

E-cigarettes are in their infancy, and more research is necessary to understand its role in smoking cessation and links to present and future drug use.

The Wild West of Nicotine Consumption

What’s known about e-cigarettes is vastly outnumbered by what’s unknown. Many serious questions hang like a cloud over e-cigarettes, including:

  • What are the confirmed risks of using e-cigarettes?
  • Is vaping truly safer than smoking?
  • Is it to proven and safe to be an effective way to quit smoking and nicotine addiction?
  • What are in the chemicals added to flavor the nicotine?
  • Are there any short-term and long-term risks from consumption of those chemicals?
  • Are there short-term and long-term health risks from vaping?
  • Are there short-term and long-term health risk from being exposed to secondhand vaping?

And that’s just a start. E-cigarettes are the wild west of nicotine consumption. It will take years, maybe decades, for the science to settle on even some of the most basic questions. And I would expect that the nicotine industry pushes back against negative findings, causing confusion among users about the risks of vaping.

For now, strongly discourage anyone in your life who is considering beginning to vape. It’s expensive, nicotine has known negative health effects, and the e-liquid and method of delivery have known health effects. If you use e-cigarettes or are considering using them to stop smoking, start working today on your plan to cut down on use. A year from now, you should not be using e-cigarettes at all. In the meantime, stay informed as new research sheds more light on how vaping affects your health.

References

[i]Popcorn Lung: A Dangerous Risk of E-Cigarettes.” American Lung Association. Last updated September 18, 2018.

[ii] Harris, Richard. “Study Found Vaping Beat Traditional Smoking-Cessation Options.” NPR. Published January 30, 2019.

[iii]Public Health Consequences of E-Cigarettes.” The National Academies of Science, Engineering & Medicine. Published January 23, 2018.

[iv] Miech, Richard et al. “E-Cigarette Use as a Predictor of Cigarette Smoking.” BMJ Journals. Published December 2017.

[v] McCabe, SE, et al. “Associations Between Early Onset of E-cigarette Use and Cigarette Smoking and Other Substance Use Among US Adolescents: A National Study.” Nicotine & Tobacco Research. Published July 9, 2018.

 

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