Vaping & Health
Smoking rates are falling as more people around the world embrace vaping. But which practice, if any, is better for you?
Electronic cigarettes for vaping are very different beasts from traditional cigarettes. They’re made up of three key parts: a battery, which is encased in a handset that’s connected to a tank. The tank is either pre-filled or fillable with vape juice, which is a mix of water and chemicals, often including nicotine and flavorings. The tank also contains a coil wrapped in cotton, which absorbs the vape juice. Once users switch their e-cigarettes on, the batteries activate and heat up the coil. When users take a drag, this hot coil vaporizes the vape juice for inhaling.
Traditional cigarettes are much simpler, just tobacco (usually with chemicals and fillers) rolled in thin paper. Users light one end of the cigarette, which makes the tobacco inside smolder, and inhale the smoke through the unlit end of the cigarette.
Image via Flickr by SmokeTastic
Vaping and smoking both transfer substances from cigarettes, whether they’re traditional ones or e-cigarettes, into the lungs. However, cigarettes ignite and burn at temperatures ranging from 600 to 800 degrees. This creates the smoke that smokers inhale. This smoke contains nicotine and roughly 7,000 other chemicals, according to the American Cancer Society.
E-cigarettes do not heat at such high temperatures. They release vapors, which are largely made up of harmless water vapor, rather than smoke.
Vaping is a relatively new phenomenon only introduced in the early 2000s, while we have decades of data on cigarette smoking. However, a 2014 review of more than 40 studies on e-cigarettes published in Therapeutic Advances in Drug Safety found vaping is “by far a less harmful alternative to smoking.” A 2015 report from Public Health England estimates vaping is 95 percent healthier than smoking.
Cigarette smoke contains far more chemicals than vapor. Cigarette giant Phillip Morris admitted, “It is these harmful chemicals — not the nicotine — in cigarette smoke that are the primary cause of smoking-related diseases.” Those smoking-related diseases are many, such as heart disease, stroke, lung disease, including asthma, and a range of cancers. Pregnant women are warned against smoking, as it can cause low birth weights, birth defects, and miscarriages.
It’s too early to examine the long-term effects of vaping. However, preliminary reports can help us assess the health risks. A study from the University of St. Andrews suggests vaping increases a person’s risk of getting cancer by less than 1 percent. This risk is comparable to wearing a nicotine patch or chewing nicotine gum.
E-cigarette vapor doesn’t contain carbon monoxide, the chemical most commonly linking smoking and heart disease. Other chemicals that may contribute to poor cardiovascular health also have a much lower concentration in e-cigarette vapor than cigarette smoke. Since the particles of e-cigarette vapor are liquid-based, they also don’t damage the heart as easily as solid cigarette smoke byproducts.
No evidence suggests vaping can trigger or worsen asthma symptoms or cause birth defects or miscarriages, as smoking can. In fact, some health experts, like Dr. Linda Bauld of Stirling University in the United Kingdom, advocate pregnant women switching to e-cigarettes to reduce the risks of harming their unborn babies.
Critics of vaping remind users that while propylene glycol has FDA approval for food stuffs, it creates formaldehyde when heated. However, cigarette smoke also contains this dangerous chemical, and at much higher levels.
The tasty flavorings in e-cigarettes have also concerned some health experts. Some flavors contain diacetyl, a chemical linked to scarring on the lungs. Cigarettes contain this chemical, too, and in much higher quantities.
Admittedly, some questions still exist about the health credentials of vaping, especially as it’s too early to assess its long-term health impact. However, when compared with smoking, experts agree that vaping is a much healthier choice. In fact, some believe that since vaping and smoking require similar actions, e-cigarettes could help smokers kick the habit more effectively than nicotine patches or going cold turkey. As the authors of the Therapeutic Advances in Drug Safety study said, “Due to their unique characteristics, e-cigarettes represent a historical opportunity to save millions of lives and significantly reduce the burden of smoking-related diseases worldwide.”
Early reports seem to support this claim, with a study published in British medical publication BMJ suggesting people who vape are nearly twice as likely to quit cigarettes than people who try quitting without vaping.
Another consideration is that the quality and ingredients in vape juice vary among manufacturers. However, new rules make e-cigarettes released after 2007 subject to U.S. Food and Drug Administration (FDA) safety and approval reviews. This legislation should make the e-cigarette market safer for all Americans.
People who smoke and vape with most e-cigarettes experience a pleasant nicotine rush. Nicotine is the addictive chemical which encourages people to reach for a cigarette time and time again. It’s also the chemical most people focus on when condemning smoking or vaping. Bodies used to nicotine feel deprived when they don’t get it regularly. This withdrawal can make users feel ill and cranky. Nicotine can also exacerbate heart problems, irritate arteries, reduce the brain’s capacity to recall facts and focus, and harm unborn babies. So how do the nicotine levels of cigarettes and e-cigarettes compare?
High-density e-cigarettes contain roughly 18 mg of nicotine, which is equivalent to full-strength cigarettes. There are low-density e-cigarettes with around 6 mg of nicotine, equivalent to lights or ultralights, and extra-high-density e-cigarettes which are like smoking unfiltered cigarettes, and various grades in between. However, it’s easy to leave an e-cigarette without finishing it, so many vapers find they consume less nicotine than they would while smoking.
Nicotine-free e-liquids which contain no nicotine at all are also available. In contrast, there are no nicotine-free cigarettes.
The immediate health impact of vaping and smoking on users tells only half the story. There is a raft of other considerations when comparing each practice’s safety credentials.
The danger of second-hand smoking has been a hot-button safety issue for decades. While the long-term effects of second-hand vaping are unknown, Public Health England reports “there have been no identified health risks of passive vaping to bystanders.”
The Centers for Disease Control and Prevention (CDC) tested the air quality inside a vape shop for diacetyl and pentanedione, two chemicals that concern health experts. The shop tested just 1.7 for diacetyl and 2.4 for pentanedione, well below the National Institute for Occupational Health and Safety’s permissible levels of 5 and 9.3, respectively.
In contrast, the U.S. Environmental Protection Agency, the U.S. Surgeon General, the U.S. National Toxicology Program, and the International Agency for Research on Cancer all classify second-hand smoke from cigarettes as a “known human carcinogen,” or cancer-causing agent. At least 69 chemicals in second-hand cigarette smoke can cause cancer.
Dr. Colin Mendelsohn, the chairman of the Australian Tobacco Harm Reduction Association and Associate Professor at the University of New South Wales’ School of Public Health and Community Medicine, told news.com.au that, since there’s no burning process releasing harmful chemicals, chemical levels in e-cigarette vapor are typically less than 1 percent of the levels in cigarette smoke.
Recently, the dangers of third-hand cigarette smoke that lingers on surfaces like clothes and furniture after a cigarette is extinguished have been under the spotlight. Dr. Yael Dubowsky, a senior lecturer at Technion-Israel Institute of Technology, says third-hand smoke can linger for months as ozone repeatedly lifts nicotine from surfaces and returns it to the air. Third-hand smoke can be absorbed through the skin, breathed into the lungs, and even ingested through food. It can cause similar complications to smoking, including birth defects, lung complaints, and cancer.
Unlike cigarette smoke, e-vapor does not linger in the air. As it’s liquid-based, it dissipates quickly, according to Dr. Mendelsohn.
The risk of fire associated with smoking is a potential safety hazard. Carelessly tossed cigarettes have caused house and forest fires. Lit cigarettes can also burn the skin. E-cigarettes don’t have a flame and the hot coil is contained, minimizing the risk of burns and starting fires.
However, caution should be exercised around e-cigarettes. While e-cigarette cases are made from solid substances like glass and plastic that should remain intact with regular usage, they can potentially break. Between 2009 and January 2016, there were 134 reports of e-cigarette batteries overheating and either igniting or exploding, according to FDA spokesperson Michael Felberbaum. Some of these incidents caused serious injuries.
While these numbers may seem alarming, they’re nothing compared to the more than 480,000 deaths the CDC attributes to cigarette smoking in the United States every year. The FDA guidelines also allow the official body to review e-cigarette batteries more closely to protect users.
Few things will withstand the efforts of a determined child, so even with these regulations, parents should monitor their kids closely. There have been reports of children breaking e-cigarettes, drinking the vape juice, and experiencing major health complications. High quantities of nicotine can be lethal when ingested or applied to the skin. Young children are especially susceptible to the ill effects of liquid nicotine. While this isn’t a concern with regular use of e-cigarettes, it’s something anyone who spends time with young children should be aware of. The FDA understands the risks and plans to introduce child-resistant packaging for all products containing e-liquid.
Vaping can be dangerous to people allergic to propylene glycol and vegetable glycerine, two common vape juice ingredients. Some vape juices also contain flavorings which can cause an allergic reaction in a small percentage of the population. If you have allergies, research your choice of vape juice carefully and avoid any that may be unsafe for you.
Since vape juice is made from humectants, which absorb moisture from the environment, vaping can dehydrate you. Smoking can also be dehydrating, but not to the same extent. This is a fairly minor safety concern which is easily mitigated by drinking water and staying alert to the symptoms of dehydration, including dry skin, mouth, and eyes, headaches, and coughing.
Vaping doesn’t carry some of the more unpleasant side effects that smoking can, like nausea, cold sweats, and insomnia.
Last year, big tobacco firms like Philip Morris and R.J. Reynolds Tobacco Co. increased the prices of key cigarette brands across their range, reported CS News. As smoking becomes more expensive, more smokers are considering cost-effective alternatives like vaping.
The average American smoker spends $2,569 every year on cigarettes. Vaping can offer significant savings, whether you’re using disposable or refillable e-cigarettes. On average, vapers using disposable e-cigarettes spend $1,387 annually on vaping.
Vapers who opt for refillable e-cigarettes can experience even more savings. A 30 mL bottle of e-liquid typically costs $16, and 2 mL of e-liquid is roughly equivalent to a pack of cigarettes, according to Fair Reporters. While a pack of cigarettes costs an average of $5.51 in the U.S., the equivalent amount of e-liquid costs just $1.06. In a typical year, a vaper who prefers refillable e-cigarettes might spend just $600.
While costs vary depending on how often people smoke or vape and the brands of cigarettes, e-cigarettes, or vape liquid they prefer, studies show vaping can be almost 80 percent cheaper than smoking cigarettes.
Just like smoking, vaping has its critics. Many are concerned that vaping technology is relatively new, so we are yet to see its long-term impact. However, the advantages we now know of vaping over smoking shouldn’t be overlooked. Vaping is healthier and safer than smoking, and the activity doesn’t put others around them at risk. The cost benefits to vapers also shouldn’t be overlooked.
Vaping is already considered better than smoking by many, but with the FDA taking more steps to regulate and improve the e-cigarette industry, the gulf between vaping and smoking should only widen over time.
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