TMT presents two short articles on the topic of vaping. they provide different sides of the picture but we hope our Readers will find the information useful if they are smokers trying to quit, or thinking about taking up vaping.
In the first report, the US Military Health System talks about the dangers associated with their use that we do not fully understand. Recent studies in the UK indicate that these dangers are still being assessed, but that the use of an e-cigarette is a better bet for someone who used to smoke tobacco products and that it can help kick smoking altogether. Other reports suggest that vaping makes it easier for younger people to take up the habit and to develop a nicotine-addiction earlier in their lives than might have been the case with smoking traditional cigarettes. The UK NHS view is provided below the US piece.
Some believe that the UK is biased in favour of e-cigarettes to try to get traditional smokers off the habit, while others take the view that research efforts in the US are in the hands of the tobacco lobby who are trying to prevent e-cigarettes from stealing their markets. Hopefully the two sets of information below will help readers reach a balanced view – but it is likely that the debate will continue for some time.
A US view from Health.Mil, the official website of the US Military Health System
Cigarette smoking has been around since the ninth century. Today, many people are using battery-powered devices designed to mimic the habit while delivering fewer toxins. Experts, however, warn that regarding these devices as “natural” or “healthy” can be misleading.
“Many people think e-cigarettes are safe and without any sort of harm, because they’re not a conventional cigarette,” said Army Lt. Col. Sally DelVecchio, chief of Pulmonary Critical Care Service at Fort Belvoir Community Hospital in Northern Virginia. “While there may be fewer toxins in e-cigarettes, people should still be aware that there can be harmful toxins in the product liquid.”
Electronic nicotine delivery systems use noncombustible tobacco products and typically contain nicotine, flavorings, and other chemicals. They’re known as e-cigarettes, vaporizers, vape pens, hookah pens, and e-pipes. These devices can mimic traditional cigarettes and pipes, or they can look like everyday objects, such as pens or USB memory sticks.
In 2016, the Office of the U.S. Surgeon General released the first comprehensive report by a federal agency on e-cigarette use among older children and young adults. It said more than a quarter of students grades 6-12, and more than a third of young adults, have tried e-cigarettes, which is now the most common form of tobacco used by middle school and high school students in the United States.
In e-cigarettes, nicotine is delivered through a liquid called e-juice, which turns into vapor when using the devices. DelVecchio said the liquid can come in various flavors, which is attractive for the young population.
Regina Watson, health promotion program manager for the Air Force Medical Support Agency, warned that there are misconceptions about what’s in these products and the harm they can do. Some people may believe that e-cigarettes don’t contain nicotine, because they don’t have combustible tobacco, which is found in traditional cigarettes. But e-cigarettes are a nicotine product, Watson said.
“In some cases, it might have more [nicotine] than regular cigarettes, but it’s difficult to know, because it’s largely unregulated,” she said.
According to the Centers for Disease Control and Prevention, e-cigarette aerosol can include nicotine, cancer-causing chemicals, ultrafine particles, and heavy metals such as nickel, tin, and lead. It can also include flavourings like diacetyl, which is a chemical linked to serious lung disease.
E-cigarettes also increase the possibility of negatively affecting brain development and respiratory health, the OSG said. Nicotine affects the development of the brain’s reward system, which includes brain circuits that affect attention and learning. Other risks include mood disorders and permanent problems with impulse control.
DelVecchio warned that while more research needs to be done on the long-term health effects of e-cigarettes and vaping, bronchiolitis obliterans has been linked to these products. This disease occurs when e-cigarette use triggers an immune system response, causing inflammation in the lungs. It’s unknown whether the inflammation is long-term or if any additional damage disappears over time, DelVecchio said.
“I believe more and more places are starting to acknowledge that vaping and e-cigarettes are potentially just as harmful as secondhand smoke,” she said.
More than 460 different e-cigarette brands are available, according to the National Institute on Drug Abuse. Watson warned that many vaping products are not FDA-approved, since the contents, including chemicals and substances in flavouring, aren’t fully known, making the safety level difficult to determine.
According to NIDA, about 66 percent of teenagers who use e-cigarettes believe their products only contain flavouring, while nearly 14 percent report not knowing what’s in them, and only roughly 13 percent believe they contain nicotine. Although some e-cigarette brands are FDA-approved, other vaping products and e-cigarettes are not regulated. Long-term data on the safety of all of these products is not available, since they are still relatively new, DelVecchio said.
Research shows e-cigarette use among youth can lead to traditional tobacco use, which is known to cause disease and premature death, said Watson.
“Even though you may not feel like you’re smoking with an e-cigarette, you can be putting more harm in your body than you realise,” said Watson. “It’s important to stay informed and do your research.”
A UK view from Public Health England (PHE)
A new Public Health England (PHE) e-cigarette evidence review, undertaken by leading independent tobacco experts, provides an update on PHE’s 2015 review.
The report covers e-cigarette use among young people and adults, public attitudes, the impact on quitting smoking, an update on risks to health and the role of nicotine. It also reviews heated tobacco products.
The main findings of PHE’s evidence review are that:
- vaping poses only a small fraction of the risks of smoking and switching completely from smoking to vaping conveys substantial health benefits
- e-cigarettes could be contributing to at least 20,000 successful new quits per year and possibly many more
- e-cigarette use is associated with improved quit success rates over the last year and an accelerated drop in smoking rates across the country
- many thousands of smokers incorrectly believe that vaping is as harmful as smoking; around 40% of smokers have not even tried an e-cigarette
- there is much public misunderstanding about nicotine (less than 10% of adults understand that most of the harms to health from smoking are not caused by nicotine)
- the use of e-cigarettes in the UK has plateaued over the last few years at just under 3 million
- the evidence does not support the concern that e-cigarettes are a route into smoking among young people (youth smoking rates in the UK continue to decline, regular use is rare and is almost entirely confined to those who have smoked)
PHE’s evidence review comes just a few weeks after a US National Academies of Sciences, Engineering and Medicine report on e-cigarettes. Their conclusion on e-cigarette safety also finds that based on the available evidence ‘e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes.’
Professor John Newton, Director for Health Improvement at PHE said:
Every minute someone is admitted to hospital from smoking, with around 79,000 deaths a year in England alone.
Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95% less harmful, and of negligible risk to bystanders. Yet over half of smokers either falsely believe that vaping is as harmful as smoking or just don’t know.
It would be tragic if thousands of smokers who could quit with the help of an e-cigarette are being put off due to false fears about their safety.
Professor Ann McNeill, lead author and Professor of Tobacco Addiction at King’s College London said:
It’s of great concern that smokers still have such a poor understanding about what causes the harm from smoking. When people smoke tobacco cigarettes, they inhale a lethal mix of 7,000 smoke constituents, 70 of which are known to cause cancer.
People smoke for the nicotine, but contrary to what the vast majority believe, nicotine causes little if any of the harm. The toxic smoke is the culprit and is the overwhelming cause of all the tobacco-related disease and death. There are now a greater variety of alternative ways of getting nicotine than ever before, including nicotine gum, nasal spray, lozenges and e-cigarettes.
Professor Linda Bauld, author and Professor of Health Policy, University of Stirling and Chair in Behavioural Research for Cancer Prevention, Cancer Research UK said:
Concern has been expressed that e-cigarette use will lead young people into smoking. But in the UK, research clearly shows that regular use of e-cigarettes among young people who have never smoked remains negligible, less than 1%, and youth smoking continues to decline at an encouraging rate. We need to keep closely monitoring these trends, but so far the data suggest that e-cigarettes are not acting as a route into regular smoking amongst young people.
PHE is calling on smokers and a number of bodies to act on the evidence.
Anyone who has struggled to quit should try switching to an e-cigarette and get professional help. The greatest quit success is among those who combine using an e-cigarette with support from a local stop smoking service.
US article & image copyright US Military Health System
UK article and image Crown Copyright