The use of electronic nicotine delivery systems (ENDS), also known as ecigarettes or vaping, has rapidly risen across the globe. In recent years, adolescents seem to be taking up the habit at alarming rates. Many claim that the additive flavorings are a big reason teens are drawn to these devices. Much debate exists around the use of ecigarettes, or vaping. Many claim that it is safe, while others say at least safer than traditional cigarettes. Still others argue that vaping can be a gateway to smoking cessation. But, what does the science show? As doctors, we are expected to practice evidence-based medicine (no hidden conspiracies with tobacco companies here).
Smoking Cessation
While it is true that vaping has helped some smokers quit, researcher published in July showed that only 10% of nearly 1,300 former smokers who turned to vaping to help quit were successful in doing so. In the study, smokers who switched from smoking to vaping were followed for 1 year. The study authors “found no evidence that ENDS use, within context of the 2015–2016 US regulatory and tobacco/vaping market landscape, helped adult smokers quit at rates higher than smokers who did not use these products. Absent any meaningful changes, ENDS use among adult smokers is unlikely to be a sufficient solution to obtaining a meaningful increase in population quit rates.” Another study, published in August, investigated the smoking/vaping trajectories and quit-smoking success rates of smokers deciding to start vaping for the first time and buying their e-cigarette in brick-and-mortar vape shops in Belgium. The study found that “around one in five smoking customers buying their first e-cigarette in a brick-and-mortar vape shop had quit smoking completely after 6 months.” Many studies replicate these findings.
eCigarette Ingredients
While we may not know the full extent of the dangers ENDS pose, the research clearly demonstrates there are a multitude of harmful effects that come along with vaping. The flavoring additives, so popular with teenagers, have come under scrutiny. Study findings published in July in an American Heart Association journal suggest that e-cigarette flavorings may damage blood vessels and the heart. One study quantified six different pyrazine additives in ecigarettes. Pyrazines have previously been found to have synergistic effects on nicotine addiction by increasing appeal, easing smoking initiation, and discouraging cessation. Also, they are known as potentially toxic to the reproductive tract. It has also been demonstrated that fruit flavorings and other additives are frequently used by teens and young adults who vape, potentially putting them at risk.
Among the toxic chemicals found in ecigarettes are aldehydes. One study looked at the respiratory uptake of formaldehyde and acetaldehyde specifically. The results showed that both were increased during vaping.
Many harmful trace metals have also been discovered in ecigarettes. Nickel, chromium, cadium, tin, aluminum, and lead have all been observed and are potential carcinogens, leading to both lung and sinonasal cancer and potentially oral cancer.
Nicotine
While many argue that vaping is not addictive like smoking regular cigarettes, they fail to acknowledge that the same addictive ingredient is present in both: nicotine. In fact, it’s possible that higher levels of nicotine are present in the serum of vapers. This in turn increases cancer risks by stimulating nicotinic acetylcholine receptors (nAchRs).
And while many may claim ecigarettes don’t contain nicotine, the truth is that virtually all contain some amount, with high-nicotine ecigarettes flooding the US market. In one randomized, single blind, 3-period crossover design study, researchers found that vaping products that contained nicotine impaired acetylcholine mediated vasodilatation, increased indices of arterial stiffness, increased both diastolic and systolic blood pressure as well as heart rate, and raised plasma myeloperoxidase. Another study demonstrated changes in peripheral and central blood pressure as well as heart rate and pulse rate velocity in those who vaped products containing nicotine. Other research found “a single session of e-cig use, approximating nicotine exposure of one tobacco cigarette, induces significant inhibition of cough reflex sensitivity. Exploratory analysis of a subgroup of subjects suggests that nicotine is responsible for this observation. Our data, consistent with previous studies of nicotine effect, suggest a dual action of nicotine: an immediate, peripheral protussive effect and a delayed central antitussive effect.”
Other Affects on the Lungs
The pro-inflammatory effects smoking can play on the endothelium in the lungs, leading to a host of pulmonary diseases, have long been known. While ecigarette liquid (ECL) is not cytotoxic by itself, it becomes so once it is vaped. It appears vaped ECL is toxic to alveolar macrophage function. It creates excessive amounts of reactive oxygen species, inflammatory cytokines, and chemokines, leading to an inflammatory state in the alveolar macrophages. It has further observed that there is a nicotine-dependent inhibition of phagocytosis, suggesting that vapers may suffer an inhibited clearance of bacteria that places them at risk of lung infections. One interesting case showed lipoid pneumonia caused by vaping.
There are many case studies in the literature showing ecigarettes causing bronchiectasis, eosinophilic pneumonia, pleural effusion, and possible hypersensitivity pneumonia. In another case, a young man suffered subacute respiratory failure due to diffuse alveolar hemorrhage caused by vaping.
While it is clear from these studies that much more research needs to be done, there is enough science to be concerned that ecigarettes are not safe like many claim. In fact, they appear to have many hazards that are still being discovered. Are they safer than cigarettes? That remains to be determined. No one can make that claim without more large-scale clinical trials. Until that time, hedge your bets where you will.
UPDATES SINCE THE ABOVE WAS WRITTEN:
Vaping impacts blood vessels, even without nicotine
MRI Shows Vaping Has Transient Impact on Vascular Function
Cases of Severe Lung Injury After Vaping Reported in Three States
Teen vaping tied to marijuana use
Vaping Likely to Blame for 14 Hospitalizations in Two States
Vaping may aid smoking cessation but also boost relapse risk
Flavored tobacco use rising in U.S. kids as vaping takes off
PWeekly
The truth is being revealed! E-cigarettes are heavily marketed to high schoolers. Let that sink in as you go about your day. http://www.fmtrialattorneys.com/2019/06/the-manufacturers-and-distributors-of-e-cigarettes-know-their-products-are-dangerous-do-you/
I smoked for 30 years. Tried many times to quit and failed. Due to a new work environment, I decided to try vaping. My wife did so as well. Five years without a cigarette for both of us in August. We are at the lowest nicotine level we can get from our local vape shop that has a lab close by that mixes everything. Local folks we trust. Now vaping is frowned on at work so I leave it at home. Your mileage may vary.
For the record I do not smoke or vape. I have considered vaping.
What I wish studies and doctors would address is whether or not the act of vaping itself is safe. I enjoyed your article on Diffuse Alveolar Hemorrhage Induced by Vaping, but the study is very limited and draws broad conclusions that point more to the oils being used than the act of vaping itself. The first patient cited in the study is a direct result of the oil that was used.
I think its really important to separate out the risks so that neither side of the argument can conflate the issues.
1. What is the risk associated with the act of vaping itself irrespective of the oil used?
2. What if anything can be vaped with with minimized risk?
E-Cig Oils recently came under intense scrutiny and regulation due to poor quality control an oversight. Because of this it is very easy to the pro-vape argument to attribute and write off any previous health concerns. People want honest information to make a decision on.
You’re generalizing oils ,it is specifically vegetable glycerin. does it get poisonous at 450 degrees F. That is the first question to ask. Next address this polypropylene glycol. What happens to it at 450 degrees F.
Let me help, this is from Wikipedia:
Propylene glycol is a compound which is generally recognized as safe (GRAS) by the U.S. Food and Drug Administration (FDA) under 21 CFR x184.1666 and is also approved by FDA for certain uses as an indirect food additive. Propylene glycol is approved and used as a vehicle for topical, oral and some intravenous pharmaceutical preparations in U.S. and in Europe.
Glycerol
From Wikipedia, the free encyclopedia
(Redirected from Vegetable Glycerin)
Glycerol (/ˈɡlɪsərɒl/;[5] also called glycerine or glycerin; see spelling differences) is a simple polyol compound. It is a colorless, odorless, viscous liquid that is sweet-tasting and non-toxic. The glycerol backbone is found in many lipids which are known as glycerides. It is widely used in the food industry as a sweetener and humectant in pharmaceutical formulations. Glycerol has three hydroxyl groups that are responsible for its solubility in water and its hygroscopic nature.[6]
Looks pretty safe to me.
This is article is so full of malarkey and no science to back the claims . I have common sense on my side too many people buy into hysteria. WAKE UP MILLENNIALS.
My god don’t start an addiction. Use that thing on your shoulders for more than a hat rack.
It helped me quit cigarettes. Since I started vaping I haven’t smoked for 2-3 years now
First you say 10%, then you cite a different study that says 1 in 5 which is 20%. Make up your mind. I have been tobacco free for 3 weeks after starting to vape and plan to continue this road. I have tried multiple methods and multiple times before and it didn’t work. Vaping is working. It is people like you that are causing more harm than good.
Going on 3 years
Nancy Reagan talking about drug, I felt she was lying about MJ being addictive. Made me mistrust medical information
Lots of things are addictive
Much of the noise against vaping I fear is out of dislike of smoking
It’s tough to tell the truth
Noel bravo for you.follow the money.
Would vaporizing herbs with beneficial elements be better for your general health rather than vaping e-liquids?
They need to look into the effects of vaping the separate components in e-liquid. It’s made out of propylene glycol and vegetable glycerin, both of which are generally recognized as safe by the FDA. They need to figure out what’s in those flavorings and if it’s causing some of those chemicals to be produced. Every study I’ve seen hasn’t made a distinction and they definitely need to be. Propylene glycol is used in fog machines so if vaping is bad so are fog machines. They need to study and find out what is causing those chemicals so that they can focus on harm reduction and not just blindly attack vaping.
I have noticed this too.
I went to my doctor and I mentioned that I vape, and she responded ” You know vaping is very bad for you because of the nicotine”(she referred to Juulin). I smoke 0mg nic, and told her this. Does that mean my vape is okay? My doctor responded “oh I didn’t know you could get no nicotine juice”.
In my opinion, it shows how limited vape research is, and all of the misinformation currently in the medical field. Obviously I can make my own life decisions to vape (safe) no nicotine vegetable glycerin juice. But when my health insurance rates can be affected by medical opinion rather than fact, then I have a problem!
A lot of professional organizations blanket attack all vaping methods without making distinctions about the different methods and ingredients in vape juice. It’s like saying “all fast food is bad” based on the existence of the Big Mac (1200 cal+) without doing any studies on the hundreds of types of fast food, lifestyles of people that eat, etc.
The blanket attack on vaping only solidifies false ideas and de-legitimizes the possible benefits of vaping (stress relief, quit smoking, cost effective, etc)
The thing people are failing to grasp is that things that are approved, or safe, to ingest does not mean your can inhale it This is where the public is so lost. Your airways are designed to eliminate “trash” because we inhale dust and various things in the air and our lungs work to eliminate those via a layer of mucus that is in constant motion to bring it to the surface. Once we start inhaling things that affect this process it is only a matter of time before we begin seeing health related issues. Take some time to study the history of smoking and you will see the exact same thing that is happening with Vaping & Juuling. There are so many unknowns and yet so many are jumping on the bandwagon. If there is the potential for harm and there is, then why would you do it. It has been proven that when Propylene glycol is heated it can change to a irritant for the lungs as well. On top of this is the nicotine content which does not help you with the original addiction so there is not end to this.
As a respiratory therapist I saw this problem coming over 5 years ago and I hate to say it but I was right. It has gotten out of hand as as predicted this is not used for nicotine replacement alone.
The day the doctors office phoned and said I had the beginnings of COPD, I quit cigarettes and started vaping. I’ve been stepping down the nicotine content, and right now I’m mixing the 3 mg with 0 mg. There’s still the habit of the hand/mouth thing, but by breaking away from the nicotine, I think I can throw away the vape pen soon. Good luck to all those trying to quit nicotine!
Vaping helps to quit cigarette but in the end, it is up to the person how he/she is willing to quit cigarette. E-cigarettes is less dangerous than smoking because it has less nicotine than a cigarette. nothing is going to happen immediately, it will take some time. Keep sharing!
I’ve been vaping for a while and I picked up my cigarette habit from my parents and grandparents when I was at the tender age of 7. Yes, you read that right. I was 7 years old when i started smoking cigarettes. I was for a while smoking and vaping, but it gave me headaches and a sore throat after a while; so I decided to only use my vape if I didnt have cigarettes. May 21st 2019 I decided to try…once again to give up smoking. So far so good. I havent wanted a traditional cigarette for a whole almost 48 hours. They say the first 3 days are the worst, although the vape oil I use right now is 18mg nicotine. I plan to move down in nicotine ranks and hope to be able to quit smoking/vaping altogether. I figure its 2019 time for a change. When you quit you will smell better, look better, feel a helluva lot better ANNDDD you’ll ACTUALLY be able to once again taste your food the way it’s supposed to taste, everything I eat is still really bland tasting and I’m sick of having to use hella Cheyenne pepper in all my food just for it to taste half way decent to me. That, and the fact I have 3 children; 7, 5 and 6 months and cant afford to be sick all the time from this crap, cant afford to be broke all the time and beyond sick of not being able to breathe properly. I also have asthma and shouldn’t be smoking ANYTHING anyway, but I’m a stubborn, bullheaded woman who has always believed I know what’s best for myself and everyone I come into contact with. Like I said, it’s now the year 2019 time for a change, and a major one at that.
I smoked cigarettes for 20 years , even being pregnant with my first child I just couldn’t quit , I thing helped patches pills gum tried it all , my daughter had gotten very sick , after a series of times before this was the worst , when taken in the doctors asked if anyone smokes in the house and I hated that question it just seemed like it was an easy out on blaming that , so I looked into alternatives yet again just Incase I was the cause , christmas 2014 was approaching and my Bf at the time bought me a vape , I remember thinking Oh No now I’m obligated to use this thing , to my surprise I used it all day christmas and only smoked one real cigarette when I was over a pack a day before, I put that one out and told myself I’m going to carry around one and every time I want a drag I can take one , I smoked 5-6 drags before I couldn’t stand the smell that first week , I’ve been vaping ever since , unbelievably my daughter wasn’t sick all the time no more emergency visits , I hate that I was most likely the cause of this , but she is 10 and healthy now, it said only 10% of people quit which truly surprised me , I guess I lucked out then I’m feeling better my smell came back , that wasn’t necessarily a good thing , everything had to be washed or tossed out because it smelled so bad of cigarettes, I don’t know the long term effects but I feel great 5 yrs later I can breathe better , I’m not always the first one to get sick anymore , I believe vaping was a positive in my life
If it safe then why does it cause me to have asthma attack when around someone vaping? Why does it kill birds and some lizards in doors. I mean we used to put birds inside mines for air quality and when they died they would evacuate the mine. All I have to do is smell those scented vapes and I cant breath something is really off about them.
If you light a candle next to some birds they die. Are candles bad for you?
As from my point of view electronic cigarette is an effective way to quit smoking as electronic cigarette is the alternate practice of tobacco smoking and it is also less harmful in properties and substances it contains. Make sure you don’t increase the intake of electronic smoking as well. To get the vape related products, buy from best vape shop in Fort Mill in South Carolina.
The only difference I see with the e-cigs is the fact that most people don’t smoke them like they would an actual cigarette. So to me if there is harm that would be one of the things that should be studied as well. Some smoke them on a pretty repetitive basis. In their vehicles or homes for possibly hours at a time verses getting up and going outside to smoke or pulling over to smoke etc. so I think that would be worth looking into and doing a study on as well. I have one I’m not saying they are bad etc. I just notice a difference in the way they are treated vrs an actual cigarette. I actually still go outside to smoke my e-cigarettes like I would a regular cigarette. Now if I’m watching tv Like a movie or something, I’ll wait till commercial breaks or what would be one to smoke it. I do smoke it in my car however but since I had such a routine with actual cigarettes I got used to that and that’s how often I smoke it in the car. If I’m around people who don’t smoke or like the smell of my juice etc. I won’t smoke it around then I’ll wait till they get out of the car or leave my location or I leave. So technically I feel like the less it’s smoked the less risk!harmful it could possibly be?… maybe… I know the idea is to help quit as well so that’s another reason I try to treat it like a real one in ways too. I have noticed the smell of cigs suck now except when one is first light. I also noticed they taste like cardboard smells or licking a postage (old here sorry) lol. But I have gotten stronger especially now that I’ve spent less on repairing it and what not. I did notice with some flavors I’d get headaches real bad and others would make me feel like I hadn’t eaten in days. So once you find that flavor and a level that you think you can handle and see nothing happen I think it’s worth it. It’s just like buying certain things you have to play with the buttons and settings till you find the right fit etc. at least at this time that’s my opinion. Well hope this possibly helps with a new study on these as well as other viewers. I have completely quit for almost a month now for my second time hopefully my last. As long as nothing happens to my mod like the last few I had that upset me so bad I gave up on trying due to my job making it hard to make them last longer than a day.. week…
The industry will grow and consolidate, meanwhile making lots of people rich. And 20 years from now, long after strong evidence shows the negative health effects, illness, and death, the vaping industry will have their lobbyists scurrying about the halls of congress to ensure that Americans and others have access to their nicotine one way or the other.
I have been vaping for 4 years, it has helped me quit smoking all together for those 4 years. physically I feel 100 times better. my wallet feels heavier. I do not hack and cough daily. Even if there is some dangers involved, it clearly seems much better than smoking
Late 40s, quit smoking for the first time in 28 years when I switched to vaping. Within 3 days of vaping (using the Juul) i haven’t turned back to the dreaded cigarettes…don’t care about them at all. Feel so much better. Smell is back, breathing is so much better, jogging again, allergies are gone, blood pressure is low; I can’t say enough other than i have had no negative side effects, lots of positive improvements and it was EASY! I knew cigarettes would eventually be my downfall so I will take my chances that vaping is better. whether the studies agree is yet to be determined but I feel better and I recommend switching from cigs to vaping to any smoker.
Nicotine is no more harmful than caffine. Its the burning and other additives in smokes that cause the cancer. Please stop with the false info and fear mongering. Vaping saved my life and Im 45 and flavors are important. Want to help vaping rights? Join safata or casaa to help!
I have been vaping for five years and have not had one smoke since I quit. The info here is not correct for one nicotine does not cause cancer matter of fact its no more harmful than caffine. Its everything but the nicotine being burned that causes cancer with smokes. The EU has done studies on vaping unlike the fda unfortunatley and determined that vaping is in fact 95% safer than vaping. The fear mongering of this life saving device must stop. Want to help join CASAA or SAFATA to help fight for the right to vape. Vaping and flavors saved my life and I should not have to go back to smokes because kids are vaping in epidimic proportions. The law is you must be 18 even 21 in some states to buy these devices. I dont see anyone worried about fruit flavors in the alcohol that kids get a hold of and alcohol deffinatley kills especially from drunk driving. Please do your own research before judging this life saving device.
im a licensed funeral director. Keep vaping, a lot of these symptoms are from the vaping formaldehyde. Go ahead and support it. Your making my job easier since your internally embalming yourself. For those that are against it, its no different than the big companies early on( including doctors that said smoking cigarettes wasn’t harmful.) For all those who argue for it, go ahead and be just as ignorant as millions of people that believed that cigarettes weren’t bad for you.
I initially tried to give up smoking by switching to e-cigarettes in 2008. That lasted a few days, then I went back to smoking. I tried earnestly a few more times over the years using gum, patches, or the new and improved ecig pens, until in September 2018, after doing lots of research and buying several different types of e-juice to sample, I took the plunge once again. That was 10 weeks ago, and I have not had a traditional cigarette since. I was initially thrilled with this outcome because for the first time in 40 years of smoking, I was successfully able to quit.
Well…
For the first month I didn’t really have any issues at all. I learned to tweak the wattage on my mod, determine which flavors worked best for me, adjust airflow rate, etc. I was perfectly giddy with excitement that I was free of those blasted cigarettes.
After about six weeks, I began to notice some really odd symptoms. I had a harsh soreness in my throat. Simultaneously, I developed intermittent pain coming from an area where I had surgery four years earlier (one of my sub-mandibular salivary glands was removed due to a gland stone, w/o subsequent complications). I came down with cold sores back to back. Oddly, I developed some weird pain in my right hip, and also my groin. My head would feel light, and full, stuffy. I felt like I was coming down with a flu or pneumonia. This scared me. I found these symptoms very disturbing because I have no health issues at all. None.
So, I started taking Zicam to help stave off what felt like the early onset of a cold. About two days later came an even bigger shocker. My gums began to swell to the point that they were putting pressure on my teeth, causing them to hurt. Then…the blood. My gums would bleed profusely after flossing and brushing, or even after eating something like an apple, or a celery stick, or even chicken or steak. And I mean lots of blood. This was also very scary because I have always enjoyed excellent oral health. Never an issue since childhood.
Right around this time, I called to make an appointment with my physician because the onset of these symptoms were fairly acute. While it crossed my mind that somehow vaping might be associated w/ the symptoms, I discredited that idea because I’d not had any of these symptoms for the first six weeks of vaping. I was almost prepared to be told that I had come down with a major illness.
Upon meeting with my physician and explaining to her all my symptoms, and explaining that the only thing I was doing differently was using the vape, she simply advised me to stop vaping for 24 hours to see if the symptoms subsided; outside of the inflammation in the suspect areas, there were no other indicators (I did have a low level fever). By the next afternoon, all my symptoms were mostly gone. Within 36 hours, they had completely subsided. So, for me, it appears the vaping of these aerosols was causing the issues.
While glad to know that I didn’t have any major medical issue going on, I was very disheartened to face the prospect that I would have to give up vaping – which was the only method that aided me in successfully quitting cigarettes.
That’s when I started searching the internet for more information on possible side effects from vaping, and that’s what let me to this and other websites to learn as much as I could. I figured I’d post about my experiences because surely I’m not the only one.
Having said all this, I am not going back to smoking cigarettes. I might try to use a higher VG and lower nicotine juice to see if that helps (as I’ve read elsewhere that it may). Ultimately, though, I’m thinking this episode will represent the end of my relationship with tobacco and alternative nicotine delivery systems, which was my goal to begin with.
I just don’t trust vaping as being safe. Instead, I see it for what it is. This will become the predominant mode of nicotine consumption. Proponents will argue its a safer alternative to smoking. Public health, medical, and research communities will warn – to no affect – that we just don’t know the long term harm. Hardware and ejuice websites, shops, and wholesalers will market their goods. The industry will grow and consolidate, meanwhile making lots of people rich. And 20 years from now, long after strong evidence shows the negative health effects, illness, and death, the vaping industry will have their lobbyists scurrying about the halls of congress to ensure that Americans and others have access to their nicotine one way or the other. You heard it here first.
I wish I felt differently about vaping being a viable alternative to smoking, or that I had a different experience with the method – but I don’t, and I didn’t. So that’s that.
I have Vaped for four years. Previously I had smoked cigarettes for 18 years. I feel better smell better and have no problems whatsoever with coughing mucus sickness Etc. So what is the problem with vaping again?
I haven’t smoked in 4 years thanks to vaping. Previously I had smoked cigarettes for 18 years. I feel better smell better have less allergies no coughing no mucus Etc. What is the problem with vaping again?
was the first comment suppose to be funny?
I want to know what dangers vaping present to older middle-aged people. Decreasing the amount of nicotine gradually seems much like the gradual decrease of caffeine. When studies are more definitive, please let me know.
Unsafe? You mean like the pesticides, herbicides, high fructose corn syrup and other treats colorfully and expensively foisted on children and other humans by government subsidized big agriculture and big food? The hypocrisy is mind bending.
I wonder: have you ever had a patient who quit smoking thanks to vaping? What do you say to the many ex-smokers who say they quit thanks to vaping? Do you reject them as ‘anecdotal evidence’? What do you say to professor Ken Warner who just published a study where he thinks the health benefits of vaping are higher than the eventual risks?
They won’t say that because they have a political addenda to fulfill.