As two more deaths in Britain are linked to e-cigarettes... Is vaping really much safer than cigarettes?
TOUTED as a harmless alternative to smoking, vape shops have even been opened in some NHS hospitals as part of efforts to eradicate smoking and the health risks associated with it.
Public Health England insists vaping is 95 per cent safer than using cigarettes. But as it soars in popularity — from 700,000 in 2012 to 3.6 million today in the UK, questions are being raised over whether smoking e- cigarettes poses health risks, too.
Last week, it was reported that UK watchdog the Medicines & Healthcare products Regulatory Agency (MHRA) is investigating two deaths in the past year potentially linked to e-cigarettes. It has also received 20 reports of serious adverse reactions to vaping.
Cigarettes involve burning tobacco — delivering addictive nicotine to the user and 4,000-plus chemicals, including tar which is known to be toxic to the human body. Meanwhile, e-cigarettes or vapes are devices that heat liquid in a refillable tank to generate a nicotine ‘vapour’, which comes in different flavours and is inhaled through a mouthpiece.
More than 20 countries have banned vaping and others have beefed up regulations. In the UK sale of vapes is permitted for over 18s; and the use of nicotine is limited to 20 milligrams per millilitre.
The first UK vaping fatality dates back to 2010, when Terry Miller, 57, of Gateshead, Tyne and Wear, swapped his 20-a-day smoking habit for e-cigarettes — only to die of the lung disease lipoid pneumonia (when fat particles enter the lungs) eight months later. Doctors discovered oil from vaping fluid on his lungs. A second UK death from vaping was reported last November.
Over the past five years, research has linked vaping to a rise in around 200 health problems in the UK, including pneumonia and heart disorders, according to a report filed to MHRA last year.
Yet statistics also suggest vaping has contributed to more than 20,000 successful cessations per year — the equivalent of preventing 10,000 premature deaths.
So, is vaping safer than smoking? Here, two leading experts give their views.
NO
VAPING appears to be harmless — even the word has a nebulous feel to it. Throw in nostalgic flavours such as bubble-gum and popcorn, which play to its childlike innocence, as well as the cartoon character advertising — Day-Glo colours and shiny posters — and it’s hard to peg this artfully advertised, burgeoning market as anything other than an innocuous past-time.
This is bolstered by assurances from Public Health England that it’s 95 per cent safer than smoking. But it’s this statistic which is the most dangerous — and potentially catastrophic — flaw in the ‘vaping is safe’ hypothesis.
For this vital figure isn’t based on scientific evidence. In fact there is very little research at all about vapes — including whether they are safe, which makes encouraging more people to opt for e-cigarettes rash.
As a professor of public health who has spent 30 years promoting people’s health, I am very concerned at the way we’re ignoring what could be a colossal health issue and using smoking as a relative marker for the safety of vapes and e-cigarettes.
What has given horsepower to consumer confidence is the fact that e-cigarettes don’t contain the typical carcinogens found in normal cigarettes. Yet, what an unsuspecting public may not realise is that it is the flavourings used in e- cigarettes and vapes that pose a potential danger.
Once heated, these substances break down into many chemicals such as acetaldehyde and formaldehyde, which are toxic. Some may even, research suggests, cause cancer.
Every new flavour is created by a cocktail of chemicals, each of which breaks down into potentially more harmful substances, about which little is known.
That’s why the 95 per cent safety assertion, and the research it is based on, are unreliable and out-dated.
My views are underpinned by a recent warning from leading experts at Virginia Commonwealth University who investigated the relative safety of vapes.
There are major concerns about the devices, too. Updated heating coils mean many of today’s e-cigarettes are ten to 20 times more powerful than most of the models that formed the basis of the safety information supported by Public Health England. This means more aerosol is produced, exposing users to increased levels of nicotine and other toxins.
We’ve been studying traditional cigarettes for the past 60 years but don’t yet have much data with regard to e-cigarettes. Yet already a number of studies confirm the harm they may pose to health.
Last year, researchers at Stanford University found that flavourings used in e-cigarettes damage blood vessels, potentially leading to heart disease or stroke.
Meanwhile, a study by Birmingham University last year found that vaporised e-liquid fluid has a similar effect on the lungs to that seen in regular cigarette smokers and patients with chronic lung disease.
And what of the idea that the amount of nicotine in vaping is harmless? Well, of course that varies depending on which brand, but there’s more than enough to make it addictive.
And with many youngsters drawn in by the colours, flavours and ease of purchase, this is particularly problematic.
The proportion of British 11 to 18- year- olds using vapes has doubled in the past five years. Other countries have tightened ecigarette regulations — some have even introduced a ban. Yet our Government seems almost supine in its approach.
The problem is vaping should be regarded as part of a quitting programme rather than an alternative to lighting up. We don’t seem to have got that message across.
Meanwhile, we’re left with the promise of vaping being safer than smoking. That is a blow for clinicians who remain anxious about the legacy vaping may leave.
YES
I’D BE the first to say that vaping isn’t risk-free — anything that exposes people to some form of chemical that could accumulate in the lungs has the potential to produce harmful side-effects.
But set against the staggering danger smoking poses to health, using e- cigarettes is considerably safer.
Regular tobacco cigarettes contain thousands of chemicals, many of which are toxic including arsenic and cyanide.
The exposure in e-cigarettes doesn’t compare. Little wonder they are endorsed by the NHS to help people stop smoking. And I’m not alone in thinking this: the Royal College of Physicians states that vaping is a ‘ substantially less harmful alternative to smoking’.
People who dismiss vaping as unsafe seem to be forgetting the colossal health issues smoking can cause — not least the fact it causes around seven in ten lung cancer cases in the UK, and is responsible for 83 per cent of deaths from chronic obstructive pulmonary disease (an umbrella term for chronic lung diseases including emphysema and chronic bronchitis).
There’s barely a part of the body that isn’t adversely affected by smoking cigarettes, from gum disease to eyesight.
Having spent more than 30 years studying drug and alcohol addiction, I’ve had countless opportunities to witness first-hand the damaging effects of smoking, including dealing with patients with terminal lung cancer.
BUT I’ve never seen anything to suggest vaping causes the same extent of damage. What’s more, the dangers of passive smoking are reduced when you vape. Second-hand smoke is responsible for an estimated 3,800 deaths a year in the UK, including, famously, entertainer Roy Castle.
E- cigarettes just release water vapour and don’t produce the tobacco smoke with its lethal cocktail of toxins, carcinogens and irritants that can lead to cancer in others over prolonged exposure.
But the biggest gain from vaping is its importance for smoking cessation. Vaping has contributed to the overall decline in the numbers of people smoking — and I’m not surprised the anti- smoking charity Action on Smoking calculated that it helped an extra 70,000 people to quit in 2017.
Of course, it’s vital that vaping is seen as a cessation tool rather than as a permanent substitute to cigarettes. Contrary to popular opinion, however, there’s no evidence e- cigarettes act as a gateway to smoking.
There are other net benefits, too. Although many people have now received the anti- smoking message, some parts of the population remain hard to engage — not least those with mental health problems who are known to smoke at higher rates. Vaping provides an alternative for people in places such as hospitals, prisons and hostels where smoking is banned, but vaping is permitted.
Yes, vaping devices need proper quality control. Regulations in the U.S. and UK are dramatically different, with American products more heavily nicotine-based and more aggressively advertised.
In contrast, all UK vapes are regulated stringently by the MHRA, as are all drugs.
Vaping is still relatively new — and there’s scope for more research into the implications for health if used long term. But at this point the balance of evidence is very much in their favour; there is simply no question that vaping is safer than lighting up.