Alan Frischer, MD, MPH
Dangers of Vaping
Like so many, I was optimistic when e-cigarettes first became widely available. Would a vaping device that could taper the dose of nicotine down to 0%, and not endanger others (since the smoke appeared to be clean) be an effective way to satisfy and beat a nicotine addiction? Let’s address whether vaping has proven to be a good alternative to traditional cigarettes, as the marketing promised.
How do e-cigarettes work? When the user sucks on the mouthpiece, a heating element vaporizes the solution, which is then inhaled, (vaped). The nicotine content varies; although e-cigarettes do have a 0% nicotine option, to help the smoker wean off of nicotine, nearly all e-cigarette “juice” contains nicotine. Flavors vary from traditional and menthol to a huge variety of fruit and candy flavors.
In 2004, the use of e-cigarettes exploded. Much of their popularity was due to claims that they could help wean smokers off of traditional cigarettes. By 2018, the most recent year with CDC statistics available, there were over 8 million adults (18 and older) in the United States using them. They are used more frequently by men, and are used far more often by those between the ages of 18 and 24. However, note that this CDC data doesn’t include those under 18. There are likely more than 5 million middle and high school students who use e-cigarettes at least monthly, and 1 million using them daily.
There do appear to be some advantages of e-cigarettes over smoking traditional tobacco cigarettes.
E-cigarettes likely reduce the substantial risk from traditional cigarettes of cancer, heart and lung disease. However, their safety is still under review and long-term data doesn’t exist. Traditional cigarettes release smoke from burned tobacco and contain about 7,000 chemicals, hundreds of which have been proven harmful. E-cigarettes contain fewer chemicals (although those chemicals can also be dangerous).
Can they help smokers to eventually kick the habit? Research is still mixed. A 2019 New England Journal of Medicine study concluded that those who started vaping are 67% more likely to quit smoking. This indicates that they are twice as effective as traditional nicotine replacements, such as patches or gum. And, in that study, they found that 19% of participants who used e-cigarettes to quit smoking were no longer smoking one year later, compared to 9% of those who used patches or gum. However, 80% of the smokers who used e-cigarettes to quit were still vaping a year later, compared to only 9% of smokers who quit by using nicotine replacement products.
How about the disadvantages?
Vaping among kids is skyrocketing, getting new generations addicted to nicotine and thus introducing them to smoking. Teens who use e-cigarettes are four times more likely to try regular cigarettes than those who do not use them. The U.S. Surgeon General has declared youth e-cigarette use an epidemic. The tobacco industry is well aware that flavored tobacco products appeal to youth, and therefore markets e-cigarettes with fruit and candy flavors. (The FDA is actively banning the sale of all e-cigarette flavors in increasing numbers of states and localities.)
It comes as no surprise that there are real health risks from vaping. Those who use e-cigarettes have a 71% higher risk of stroke and 40% higher risk of heart disease. Vaping is also associated with an increased risk of blood clots, kidney disease, respiratory irritation, shortness of breath, and more. E-cigarette vapor, like regular cigarettes, produces formaldehyde, which is a carcinogen.
Due to the significant amount of nicotine present in most vaping products, there is an increased risk of developing gum disease such as gingivitis and periodontitis. Dry mouth and gum recession are common, which leads to dental cavities. Vaping has been associated with clenching and grinding of teeth.
E-cigarettes use lithium batteries, which can catch fire or explode. Because of this, airlines do not allow e-cigarettes in checked baggage.
Let’s be clear. Vaping was designed to be highly addictive. It was created with flavors to attract a younger population, in order to get new generations hooked on nicotine. Just like the traditional tobacco industry, e-cigarette manufacturers knowingly put their customers at risk. Nicotine products, including e-cigarettes, are unsafe for users of any age.