Man with a e-cigarette

Close up of a man inhaling from an electronic cigarette.

Venturing into research on electronic nicotine

delivery devices such as e-cigarettes, vape pens, vape mods and the newer Juuls — the use of which is known as vaping — feels a bit like going down the rabbit hole. 

What do we really know about vaping? Is it less harmful than smoking? What is myth and what is a legitimate concern?  

What science says

With the user only inhaling vapor, not smoke, many people believe vaping has no substantial health risks. But there also is the taste component. With flavors like mint, buttered popcorn, cinnamon and strawberry, the practice certainly doesn’t taste dangerous. 

As vaping has only been around since 2010, there is a substantial lack of long-term studies to conclude if damage is being done to the bodies of those who vape. A casual observer could easily be confused, however, into thinking that the lack of studies equates to the practice being safe. 

Conversely, cigarette smoking is a well-researched topic.

“Cigarettes are the most lethal consumer product ever created,” says Dr. Andrew Hyland, chairman of the Roswell Park Comprehensive Cancer Center’s Department of Health Behavior in Buffalo, New York. “There are 480,000 Americans who die from cigarette smoking every year.”

With such knowledge about cigarettes, it is understandable why people are eager to believe that a potentially benign alternative exists.

“The health evidence as to why cigarette smoking is so harmful took decades to build,” Hyland says. “Many diseases caused by cigarettes take a long time to develop, and there are other causes, like heart disease. Vaping is still too new to have this kind of evidence. E-cigarettes have far fewer toxins than the emissions from traditional tobacco cigarettes.” 

Although long-term effects of vaping are not currently known, there are some disturbing facts. Vaping juice -— the liquid that is heated into a vapor and inhaled into the lungs — has been known to carry toxic heavy metals. Propylene glycol, another ingredient, is safe as long as it is not heated. But in vaping, liquids are commonly heated to 392 to 480 degrees to create the vapor, which is then inhaled. Meanwhile, diacetyl, which is used in some flavorings for vaping liquid, has been linked to a condition that damages the bronchioles, potentially leaving those affected with coughing and shortness of breath. 

Trends

The U.S. Department of Health and Human Services tracked a steady decline in nicotine use in eighth- to 12th-graders from 2000-2015. This was around the time vaping began to gain traction in the younger population. From 2011 to 2016, the percentage of 12th grade students who used an e-cigarette increased from 4.7% to 13%. Health experts agree that an increased use in nicotine is the wrong direction.

Vaping and you

The Centers for Disease Control and Prevention (CDC) has taken the position that vaping is not safe for anyone – with the exception of adults who do not currently use tobacco products. It is an important distinction.

A recent study released in July 2019 by the Journal of the American Medical Association concluded that regular e-cigarette use was associated with a significantly higher decrease in the number of cigarettes smoked per day compared with daily smokers who did not use e-cigarettes. 

However, Hyland points out there are other studies that show e-cigarettes do not help at all. 

“Most adult cigarette smokers want to quit and regretted ever starting,” he says. “Vaping may play a role in helping some smokers quit, but who they help is not known. We have the knowledge to try to thread the needle to keep these products away from kids, however, allowing adults access to a product that might help them get off cigarettes.”

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