Is Vaping Really Better Than Smoking?

Is Vaping Really Better Than Smoking?

E-cigarettes can leave carcinogens in your blood and may double your risk of heart attack.

Millions of Americans use e-cigarettes regularly, and more than 11 percent of high schoolers and 4 percent of middle-schoolers admit to using them in the past month, the Centers for Disease Control and Prevention (CDC) reports. But they’ve been controversial ever since they came to the United States in 2007, touted as a safe way to quit smoking.

Shortly after their arrival, the World Health Organization (WHO) announced that there was no evidence that e-cigs were safe or an effective way or stop using tobacco. And in 2016, the WHO officially recommended countries restrict their use. Still, there's confusion about e-cigs' general safety, as well as their efficacy as smoking cessation aids.

So, what are e-cigarettes exactly? The “e” stands for “electronic”—standard “e-cigs” run on a battery and have a chamber for storing liquid that usually contains nicotine. You don’t light them and they don’t produce smoke, the most dangerous aspect of ordinary smoking. Instead, when you puff on one, your lungs take in vapor, a heated mist, which is why smoking e-cigs is also referred to as "vaping." An e-cig can look like an ordinary cigarette, cigar or pipe, or like a pen or USB stick. It might be called an “e-hookah,” “mod,” “vape pen,” “vape,” “tank system” or “electronic nicotine delivery system (ENDS).”

How safe is vaping?  
Although vaping appears safer than smoking tobacco, experts don’t know as much about it. “It took generations to discover the full harm of combustible cigarettes. We may find something 30 years from now we don’t suspect in the e-cigarette,” says Norman H. Edelman, MD, Senior Scientific Advisor to the American Lung Association.

But experts do know there are some specific dangers now. “There’s no question that e-cigarettes cause inflammation of the airways and chronic bronchitis,” says Dr. Edelman. Most e-cigs contain nicotine, which is highly addictive, toxic to developing fetuses and can harm adolescent brain development, the CDC reports. Edelman adds that vaping nicotine increases blood pressure and, “there’s new data that nicotine promotes lung disease and lung cancer,” he says.

In addition to nicotine, e-cigs contain other chemicals, like kid-friendly flavoring and benzene, that may be dangerous. One 2018 study found higher levels of five cancer-causing toxins in the urine of 16-year-old e-cig users. Another 2018 study, presented at a conference hosted by the Society for Research on Nicotine & Tobacco, found people who vaped daily had almost double the risk of heart attack compared to those who didn’t vape. Other research suggests that vaping makes germs like staph more resistant to drugs.

How is vaping regulated?
Beginning in August 2016, the federal Food and Drug Administration (FDA) set a minimum legal sale age of 18 and forbid free e-cig samples, which were being distributed at music and sporting events. Other regulations will gradually go into effect; for example, as of August 2018, e-cigs containing nicotine must bear a warning that the compound is addictive. The FDA is also looking at limiting flavorings in tobacco, and several states and cities have already forbade sales to minors.

According to some, however, FDA regulators are moving too slowly. In March 2018, multiple major public health organizations, including the American Heart Association and American Academy of Pediatrics, sued the agency for delaying its safety review of e-cigarettes and cigars. Because of the lull, products appealing to young people—like chocolate-flavored e-cigarettes—are still available for purchase.

Some experts believe those products may lead those minors to regular smoking, and in 2018, two studies did find that teens move on from e-cigs to ordinary cigarettes—but Edelman thinks the question remains unresolved.  

Does vaping help smokers quit?
E-cigarettes are not an FDA-approved smoking cessation aid since the evidence on the issue is mixed. A 2017 CDC briefing concluded that smokers were more likely to swap in e-cigarettes rather than use a patch or gum, but most didn’t quit smoking entirely. Instead, they end up as “dual users.” In 2015, among US adult e-cigarette users, nearly 59 percent also regularly smoked. Only about 30 percent were former smokers.

Bottom line: it’s best to quit smoking entirely and e-cigs could make that harder. “Vaping actually makes it less likely that smokers will quit by about 27 percent,” says Stanton Glantz, Director of the University of California, San Francisco Center for Tobacco Control Research and Education.

Quit Smoking

Quit Smoking

Smoking tobacco products can lead to severe health problems and even death. While quitting smoking can be very difficult for some smokers, there are smoking cessation programs and medications that can help smokers quit. There are ...

many lifelong benefits of doing so, like increased lung function and decreased risk of heart disease and cancer. Understanding the importance of quitting smoking and all options available to help stop smoking is key to long-term success.