Hon Lik was 47 years old when he developed the first modern e-cigarette. The year was 2003 and Lik, a heavy smoker, was struggling to quit. Using his knowledge of Chinese medicine and mechanics, Lik set out to create a product that would satisfy his sharp nicotine cravings without tobacco smoke, that is. Vapour was the key. Today, it is generally believed that vaping is not harmful – or at least, when compared to smoking – but to what extent is this true?
E-cigarette basics: What is vaping?
E-cigarettes, also called e-cigs or vapes, are small lithium battery-powered devices. Rather than burning tobacco leaves, e-cigarettes work by heating a liquid (known as e-liquid) until it turns into an aerosol (vapour). This aerosol is inhaled into the lungs and exhaled as a cloud into the air. Although the chemical compound of the e-liquid can vary, the typical combination includes: nicotine, for the buzz; vegetable glycerine, for the cloud of vapour, flavouring agents, for the taste and smell; propylene glycol, for the flavour to bind to, and other mixing agents that form the liquid – many of which have not yet been identified. Some e-cigarettes are available without nicotine.
Since 2003, the popularity of e-cigarettes has swept the global market, with use not only gaining traction among ex-smokers and smokers, but also among people experimenting with cigarette products for the first time. More than 4.3 million people use e-cigarettes in the UK alone. Of this figure, 2.4 million people are ex-smokers, 1.5 million people are current smokers and 350,000 people had never smoked a cigarette before taking up vaping. The reasons for vaping are far-reaching, from quitting smoking to having a cheaper alternative to regular cigarettes that doesn’t smell as bad and tastes much better.
The silver bullet for smoking cessation?
E-cigarettes were originally designed to help smokers manage the transition from regular cigarette smoking to not smoking at all. Evidence over the years has shown that e-cigarettes may be as twice as effective as conventional smoking treatments. Working like nicotine replacement therapy, e-cigarettes can give vapers the nicotine hit they need to beat their cravings, but without exposing vapers to the toxic chemicals in tobacco smoke. Switching to vaping can thus help to prevent more than 50 health conditions associated with regular cigarettes, including stroke, chronic obstructive pulmonary disease, and 15 different types of cancer.
In fact, e-cigarette aerosol generally contains fewer chemicals than regular cigarettes. This includes solid particles like smoke, which can be deposited deep in the bronchial tree of the lungs. Since there is no ignition involved, tar and carbon monoxide are also absent in e-cigarettes. These are two of the most harmful chemicals found in tobacco smoke. Although studies are limited, there is also no clear evidence so far that the secondhand vapour from e-cigarettes is harmful to the health of others. This compares to the dangers of secondhand smoke from regular cigarettes, which contains more than 4,000 irritants, carcinogens, and toxins, exposing others to the same health risks as smokers.
E-cigarette aerosol is not harmless ‘water vapour’
Yet, while e-cigarettes can help smokers quit, vaping is not completely safe.
Nicotine, the main agent in e-cigarettes, is a highly addictive chemical. It causes intense urges and cravings, as well as withdrawal symptoms that can disrupt quality of life. Nicotine also stimulates the adrenal glands, which leads to the sudden release of adrenaline. This in turn can cause acute increases in blood pressure, heart rate and respiration, which raises the risk of suffering cardiovascular disease, hypertension, or a heart attack. Along with the physical perils, studies have shown that there are also cognitive risks linked to nicotine exposure in the developing brain, which does not fully form until the age of 25. This puts teenagers and young people who vape at risk. Inducing molecular activity, nicotine can harm the parts of the brain responsible for decision-making, memory, learning, and impulse control.
Most nicotine vaping products in the UK are covered by tight quality and safety regulations designed to protect vapers. This includes the banning of certain chemical compounds in e-liquid. Despite this, the wide range of e-liquids available means that vapers don’t always know what chemical ingredients they are consuming in their e-cigarettes. Carcinogens (cancer-causing substances) and ultrafine particles have been found in e-cigarettes, for example, whilst some e-cigarettes marketed as being nicotine-free have actually been found to contain nicotine. Other e-cigarettes can even be modified to deliver higher substance dosages and recreational drugs, such as marijuana.
The heating process of e-cigarettes can also release new chemicals, including formaldehydes, a flammable gas linked to cancer in some studies. Other contaminants like nickel, tin, and aluminum have been found in e-cigarette aerosol as well, which worsen asthma and can potentially cause irreversible chronic lung diseases. One of these risks is the one caused by the flavourings that are used to infuse e-cigarette liquid. Although approved for ingestion, not all of these flavourings have been tested and considered safe for inhalation as aerosol. First-time vapers should especially look out for symptoms of cough, mouth and throat irritation, shortness of breath, and nausea. These may be the signs of e-cigarette associated lung disease.
Additionally, there are concerns that e-cigarettes (which simulate smoking) could act as a gateway to future tobacco cigarette consumption. A model in 2015 concluded that for 2,070 adult smokers who had quit that year through vaping, more than 167,000 teenage and young adult vapers had made the transition from e-cigarettes to regular cigarettes. In some cases, however, people choose not to do either, deciding to dual instead, which refers to the use of e-cigarettes while continuing to smoke regular cigarettes at the same time. Dual use increases the risk for heart attack by five times.
Cigarette users looking to quit
Overall, vaping is less harmful than smoking, but not risk-free. There is still a lot that remains unknown about e-cigarettes, including their exact chemical content, and while their use shows potential in helping smoking cessation, smokers wanting to quit will need to use conventional smoking treatments as well to be truly free of smoke.
The safest health option is to not use e-cigarettes at all.
If you vape or smoke, it is important to have any lung or chest pain checked by a specialist. If you are experiencing symptoms associated with cigarette use, do not hesitate to make an appointment with a Top Doctors pulmonology and respiratory medicine expert today.
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