I wish I could give people a straight up clear answer on this question, is vaping bad for you, but the answers aren’t quite that simple. Let me start from a place of is vaping better for you than never having smoked tobacco, the answer for that is no, compared to never smoking cigarettes, vaping nicotine products is bad for you. However almost all users of vaping devices have smoked cigarettes and when you ask the question, is vaping bad for you compared to cigarettes that gives a very different answer.
Is Vaping Harmful?
I am couching this as a conversation about the risks of vaping compared to the risks of smoking. Most studies show that the overall risk to health decreases when people start vaping instead of smoking. The toxins in vaping e-liquids are 9-450 times lower than what is found in cigarettes. Unfortunately, some of the most accessible vaping products, e-cigarettes, are the least safe. These devices found in bars, gas stations, and basically anywhere you purchase cigarettes are made by major Tobacco companies such as Blu, made by RJ Reynolds and Vuse by Imperial Tobacco. These highly available e-cigarettes are probably the worst as far as safety that the vaping market has to offer. Going to a vape pen or vape mod, usually means you have access to safer vaping products than using an e-cig. You will also usually find a wider variety of flavors and nicotine strengths when you upgrade from an e-cig to a vape mod, and you will usually have the ability to be more cautious and discerning about the ingredients in your vape e-juice.
non-nicotine E-Liquid that is otherwise safe has not been shown to be harmful, at all
If you are vaping nicotine, it is harmful, but smoking it is so much more harmful. The jury is still out if vaping non-nicotine products is harmful. I have a good friend who makes a vape e-liquid for when they have an upper respiratory illness like a cold or the flu. This magic stops the cough juice contains menthol and essential oils. My mom used to boil a pot of water, dissolve menthol crystals into it, add some eucalyptus, followed by a drop or two of peppermint essential oil and have me breathe that in when I got a cough, which was essentially a primitive form of vaping.
We slather babies with Vicks Mentholated Ointment, so it is quite possible that vaping non-nicotine mixtures could actually be helpful. However science hasn’t even started to look at vaping as a delivery system for these kinds of remedies, so I can’t say if it is harmful or not with any kind of certainty. I would caution anyone who vapes to study the ingredients in the e-juices they use and to watch out for anything that is harmful. I also caution that we need to hold manufacturers of vaping e-liquids to high standards when it comes to the ingredients they use. Having said all of that vaping a non-nicotine e-liquid that is otherwise safe has not been shown to be harmful, at all.
So back to the heart of the issue, and the heart is the issue, whenever you use nicotine it is bad for your heart. Nicotine in all of its forms has been shown to cause an increased risk for heart problems, period. Without flinching or pulling any punches, I will tell you the risk of vaping nicotine products is the risk of heart disease, or more precisely stiffening in the aorta. Research just presented by the Athens Medical School, shows that aorta hardening to occur regardless if nicotine was consumed by vaping or smoking. That is the bad news, vaping will not reduce this specific risk to your heart, but that does not mean that vaping is as bad as smoking.
The good news is that Public Health England claims that vaping is 95% safer than smoking. In the UK doctors are looking to prescribe vaping to patients who are trying to quit smoking because they see vaping as so much more safe and to have so many fewer risks than smoking.
What are the risks of Vaping?
Most of the risks of Vaping versus smoking risks seem to be based on unfounded hypotheses that aren’t really backed up by research, or has conflicting research. Most efforts to assign a heightened risk to vaping is based in the general premise that smoking is bad for you and by replacing smoking with something safer it disincentives people and they don’t make an effort to quit.
One of the big risks that gets thrown around is that people who start vaping don’t quit smoking. First off I want to state that smoking cessation programs fail a staggering 95% of the time. That doesn’t mean people don’t quit with smoking cessation programs but it is hard, and often you have to make multiple attempts; even then a very high number of people just can’t quit. With such a high failure rate I don’t think saying the only option is to quit is a very wise as a public health policy. It seems if you must use nicotine, use the safest form possible.
Most of the vaping versus smoking risks seem to be based on unfounded hypotheses that aren’t backed up by research
The reality is that we have ample evidence that many people are able to quit nicotine products by vaping. In fact it seems more people are able to quit using nicotine products with vaping than traditional smoking cessation programs. The American Journal of Preventive Medicine published some staggering results about people who quit smoking with e-cigarettes. 31% of the people they studied were able to completely stop using cigarettes after 6 months of vaping. Of those who stopped using cigarettes completely, 34.3% were able to stop using nicotine containing products completely. This suggests that the concern about people not being able to cease smoking is like making fun of an overweight person at the gym because being on the road to being healthier isn’t good enough.
Many who either can’t or chose not to quit actually reduce the amount of nicotine they consume by vaping. The best evidence for the fact that people reduce their reliance on nicotine is in the popularity of low nicotine and no nicotine products. If these products weren’t popular companies would not be making them and considering you can find low and no nicotine products even in the e-cig market demonstrate that people are choosing to lower their reliance on nicotine even if they continue to vape. Since we already discussed how nicotine is bad for heart health, reducing nicotine use is always a good thing.
Another concern thrown about around is that people who vape, still smoke. Yes about 70% of people who vape still also smoke cigarettes, but the evidence is they use cigarettes less often and significantly reduce their reliance on cigarettes. Again looking at the data you will find people who use nicotine gum and patches still light up, so this seems like another argument that is more about the morality of nicotine than the realities of how people use nicotine. Doctors know that simply reducing smoking can improve health and they have, for the most part, acknowledged the lower toxicity levels and harmful ingredients in vaping, so even if you are replacing some of your smoking with vaping, it is still a health win. It still isn’t the healthiest, but it is healthier, and the bar should not be set at perfection, but the bar should be set at anything that moves us towards better health.
One of the more interesting risks I have heard is that people who vape, will vape more than they smoke. Now I have seen this in my sister in law. She could go three to four hours between cigarettes, but now that she vapes, she does so every half hour to two hours, so she vapes more often. The difference is when she smoked cigarettes she smoked a whole cigarette every 4 hours, and sometimes if she thought she wouldn’t be able to smoke for a while, she would smoke whenever she could even if it was more often than her usual 4 hours.
With her vape mod she now takes one or two drags when she hits her vape and she doesn’t vape because she is afraid she won’t be able to get some nicotine when she needs it. The end result is that though she does use with more frequency, she uses less nicotine overall. She is not using the equivalent of a whole cigarette each time she vapes, and she does not vape when she isn’t craving it. You see this as very common amongst people who vape, which may be why even those who don’t quit nicotine products completely, often reduce how much nicotine they are consuming.
There is a risk to using any nicotine product while pregnant, and this does not change for vaping. Pregnant women have long been encouraged to quit smoking while pregnant. They have been offered smoking cessation products to step down off the nicotine to keep the physical stresses of withdrawal to a minimum. Since nicotine does have an effect on the heart and vascular systems, there is always a risk to using nicotine during pregnancy. With smoking, you have the added risks of inhaling toxins in the cigarette which poses additional risk to the developing baby. When it comes to nicotine use and pregnancy, it is always best, to be honest with your doctor about your use and talk to your doctor about what is safest for you and your baby.
With the evidence that people have more success stopping smoking and using nicotine products using a vape along with the reduction in exposure to other toxins[ many doctors are telling patients to switch to vaping and using that mechanism to step patients down in the amount of nicotine they use in a controlled manner. There is a lack of education in the medical community about how to use vaping devices to reduce and end dependence on nicotine use, so many doctors aren’t even aware of the option. You, as a patient, may have to bring your doctor information about vaping if you want to use vaping as a tool to reduce or end your reliance on nicotine while pregnant.
The one real risk with vaping is that we have teens who are trying vaping. Smoking in teens is down, way down, so the possibility that by making a safer option available, we might see a spike nicotine usage in teens is real. The good news is that teens who vape do use fewer nicotine products than teens who smoke. This suggests that vaping is more of a social thing for teens than a crippling addiction. We have also seen a drop in the rates of teens who vape over the past few years.
Some of the drop may be because of states making it illegal to sell e-cigarettes and vaping products to teens. Even when you add vaping teens into the overall number of tobacco using teens, the numbers are still dropping. I don’t think adults who vape want to see kids who have never smoked taking up the vaping of nicotine products, so we as a society must continue to make it not okay for teens to use any tobacco products. Social pressures to not use tobacco along with regulations that keep vaping products out of teen hands will go a long way to making sure that the positive trends we have seen continue.
anyone who uses a vape has to be vigilant about keeping these products away from children
The other real danger of vaping is children or toddlers getting into vaping juice or playing with vape devices. Just like anything else that is for adults only, anyone who uses a vape has to be vigilant about keeping these products away from infants, toddlers, and children. There is good news on this front is that the American Association of Poison Control Centers’ National Poison Data System has tracked a downward trend for reports of kids being exposed to nicotine, this decline has been attributed to both the increase in safety features on vaping products and an increased awareness of the risks amongst users. To put this in perspective in 2013 the National Poison Data System tracked 1,543 cases of nicotine poisoning from all forms of nicotine, compared to 196,183 cases of poisoning from cleaning products.
I have covered a lot of risks, but my final risk is one I kind of chuckle about as I write it. Some vaping devices have had battery failures that have been harmful. Okay as I say that I realize we have had the same failures in cell phone batteries. So we know we have had some cell phones with exploding batteries, but we haven’t banned cell phones. This just does not seem like a legit risk from vaping. I would like to note that I looked for instances in the news where a house fire was caused by an unattended vape unit and could not find any instances. I even read a report by the U.S. Fire Administration titled ‘Electronic Cigarette Fires and Explosions 2009 to 2016’.
This report noted that there have been no deaths caused by fires where a vaping unit was the cause of the fire and that only 10 fires in the 7 year period studied were major or considered to be room and contents fires. This is actually pretty good considering the number of appliances and household electronics that cause fires each year. It is also extremely good in comparison to the number of fires caused by cigarettes and lighters, which numbers over 100,000 each year. These fires account for 300 to 400 deaths each year, in the US alone.
Is Vaping Bad for Your Lungs?
Popcorn Lung is a theoretical possibility, has never shown up and no link has actually been established
Concerns about lung diseases and vaping have been discussed and researched, but really not supported. Popcorn Lung, which has been thought to be a theoretical possibility, hasn’t shown up and no link has actually been established, except a theoretical one. Vaping has only been popular for a little more than a decade, but in that decade we haven’t seen any sudden spike in lung diseases associated with vaping.
Recently I was in line at the grocery store, and somehow I ended up talking to the person who was checking me out about smoking. She was a smoker trying to quit and had tried several programs, had actually stopped for a while but was smoking again, I suggested vaping. She looked at me and said “I have thought about that, but I am worried about getting water in my lungs.” I had to make an effort not to laugh and looked at her and told her that water in the lungs from vaping wasn’t a real thing. I went on to explain that if water building up in our lungs from vapor was a problem we would not take hot steamy showers and people who worked around steam tables in restaurants would be getting sick. She thought about this and said, wait, isn’t there water vapor in the air. I confirmed that indeed lots of places had lots of water in the air (I was thinking about my years in Seattle), and that this whole water in the lungs thing was pretty much bogus.
I tell this anecdote because like so many of the possible lung problems you can have with vaping, they all are just theoretical and are often based on junk science and rumor. That isn’t to say that at some point in the future we won’t uncover some risk to the lungs we don’t know about today, but the evidence still all shows that the risk to the lungs is far less than smoking. If you are vaping a non-nicotine product, you might even find there are benefits.
This is where I circle back to vaping as a delivery system for medicines or even as a portable vaporizer for people with respiratory illnesses. It is possible we could find vaping when inhaling medicines and other remedies, could have a real benefit. Vaping, as in the inhalation of vaporized water, is not harmful; it is the e-liquids used in vaping that can cause harm. So as a consumer that is where you come in to demand that vaping products not just be safer than cigarettes, but as safe as possible. This means reading ingredient lists, asking questions, and holding manufacturers accountable for the products they put out on the market. Vaping is a grassroots industry, and the consumer has a lot of power, what people don’t want to see happen with vaping is what we saw with tobacco, where manufactures purposefully added harmful and even cancer-causing ingredients to make the product more addictive. With consumers that are vigilant, we can prevent this and expect that the safety of vaping products gets better and better.
Are Vapes Bad for You?
I feel like I am beating a dead horse because vaping isn’t bad, it is the substances you are vaping that can be harmful. I think the real question here is the second-hand vaping question. There isn’t a lot of studies on how vaping affects the quality of air others breathe, and many people believe there is no harm to others from vaping. Recent research suggests this might not be a reality.
The International Journal of Hygiene and Environmental health published a report that links the use of e-cigarettes to lowered indoor air quality. The main problem seemed to be with e-cigs that contained nicotine, which did increase the nicotine, and other particulates including aluminum, in the air when used. Their data confirmed that e-cigarettes did have emissions other than water vapor. Though this research did include non-nicotine and nicotine vaping liquids, it seems that the liquids that contained nicotine were what they were concerned with. This study did not do a side by side comparison of the toxins put into the air by other everyday things like cars or factories, or even by cigarettes, so this is really a study meant to find if vaping does have some sort of emission.
Since vaping does produce some emissions, the takeaway is that in the interest of keeping nicotine out of the environment of non-nicotine users, there needs to be some restrictions on where people can vape. As a community vapers might decide to err on the side of caution and respect the wishes of non-vapers not to be exposed to second-hand vape.
Second-hand vape is categorically safer and better than smoking, but I think some sensitivity to the sensibilities of others will go a long way in making it so that vaping doesn’t get the bad reputation that smoking currently has. It also should be noted that some of the ingredients in vaping e-liquids can be an irritant to people with asthma and other lung issues. Perfumes, hair products, and other items we use daily are also irritants to people with asthma and some other sensitivities; however, society has pretty much accepted that since almost everyone uses these products, those with sensitivities have to put up with it. Vaping doesn’t get that kind of pass, so practicing consideration and politeness will go a long way to keep there from being pressure to create sweeping regulation that bans vaping from public spaces.
Cigarettes contain more toxins and harmful substances than vaping liquids do
The Final Analysis
Vaping in and of itself has no inherent danger. It is the vaping liquids and juices that have possible risks. It is possible that vaping some substances could actually be beneficial, but we need a lot more research before the medical and regulatory bodies are onboard with that idea. Vaping nicotine is far better and less risky than smoking. Nicotine does have real health risks, so reducing nicotine is beneficial. Cigarettes contain more toxins and harmful substances than vaping liquids do, therefore vaping is a better choice for people’s health than smoking. People who vape will need to continue to be vigilant and hold manufacturers accountable to make sure products are just safer than cigarettes, but as safe as they can be.
One Final Note
As I read through research and scholarly articles, I keep getting hit with something, that those who make the regulations don’t like vaping because it makes it hard to tell if people are using legal nicotine and other products or illegal marijuana substances. As more states legalize marijuana, this may become less of an objection, and we might see more research that is done out of a real desire for information instead of out of fear and prejudice.
It is a hurdle unique to the vaping industry; that the delivery device could be used for both legal and illegal substances and it can be difficult without analyzing the vape e-liquids to determine if a vape device is being used for marijuana. Sure needles can be used for both legal and illegal substances, but because needles were used in the medical profession first, there is more validation for them as a medical device first.
I think what is more disturbing is that some politicians, scientists, and health organizations are ready to demonize vaping even though we don’t even have the science yet to tell us if the other things vape devices could be used for are beneficial or not. A lot of the concerns about vaping have nothing to do with the science but really are about our deeply ingrained views on marijuana that have been instilled through the war on drugs. So as you read studies and information about vaping, make sure you fact check and see if all the studies on a particular aspect of vaping actually agree. Also, try to look past the biases about vaping to make sure you are getting real and accurate information. Not only do people in the vape community need to hold the manufacturer’s to high standards, we must also hold the science to high standards and call attention to science that is junk, does not use good methodology and that takes shortcuts to get the answers the sponsors of the research wants instead of being impartial.