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E-cigarettes And Vaping: Safe or Not?

Medically reviewed by Carmen Fookes, BPharm. Last updated on Sep 30, 2022.

The History Of The Electronic Cigarette

In 1963, Herbert A. Gilbert invented the first electronic cigarette (EC) and took it to market. His business wasn't successful - he was in an era when smoking was well accepted and not considered dangerous in any way. It took forty years before time caught up with Gilbert's idea, when Chinese pharmacist Han Lik developed another device that transformed liquid nicotine into a vapor, enabling smokers to satisfy their addiction without smoke or tobacco; eliminating the hundreds of other chemicals that make up cigarettes.

ECs (or vapes as they are more commonly known today) first hit the American market in 2007, although they could be purchased in Europe several years before they were sold here.

Authorities couldn't decide initially what these devices were. Were they technically a medical product, a form of tobacco, or a drug delivery device? No formal classification meant they sat outside FDA regulations for years, and it was left to individual states or businesses to propose their own restrictions.

An explosion in the Marketing of Vapes

Few products have undergone such a remarkable transformation in such a short space of time as vapes.

Initially made to look and feel like a conventional cigarette or pipe, they are now small, discreet, and easy to hide in the palm of your hand. They usually contain a cartridge filled with a liquid mixture of propylene glycol, glycerin, water, nicotine, and sometimes flavorings. A small heated coil inside the EC heats up the liquid and delivers it to the user as an aerosol mist, which is then inhaled.

The FDA classifies all vaporizers, vape pens, hookah pens, ECs, and e-pipes as an Electronic Nicotine Delivery System (ENDS).

Lack Of Regulation Meant Lack Of Control

In 2016, nationwide tobacco regulations were extended to allow the FDA to regulate ALL nicotine and tobacco-related substances and devices. This was arguably considered a win for both pro-smoking lobbyists and anti-smoking groups.

Prior to 2016, the industry was one for cowboys. There was no need to standardize concentrations of nicotine in each product because nobody was policing this. As such, levels of nicotine could vary markedly between companies and even within the same company's product. Mislabeling was common - that is, if there was actually even a label on the canister - or provided only limited information, meaning that nobody really knew what was actually contained inside.

Because of FDA regulations, all new ENDS are reviewed prior to coming on the market for misleading claims. In addition, all product ingredients are fully evaluated and warnings about the potential risks involved with vaping must be clearly visible.

Are Vapes Less Harmful Than Cigarette Smoking?

Henry Lik's incentive for the development of the EC was his father's death from lung cancer. Because his father was an avid smoker, Lik wondered if things would've been different if a smoke-free device was available to satisfy his nicotine cravings.

Although vaping is less harmful than smoking, it is not harmless. Toxic substances, such as nitrosamines, carbon monoxide and volatile organic compounds, can still be detected in people who vape, although levels tend to be lower than those who smoke conventional cigarettes. The FDA does not recognize vapes as a stop-smoking aid, although some experts confirm they may be useful for this purpose.

Any product that contains nicotine is potentially highly addictive. Nicotine also reduces blood flow, and using products that contain nicotine may be detrimental prior to surgery.

Do Vapes Help You To Quit Smoking?

This is a controversial topic because although vapes are not as toxic as cigarettes, there is substanial evidence that they are a gateway to youth smoking with traditional cigarettes.

The FDA has not declared vaping to be a way of quitting smoking and recommends people wanting to quit smoking ring 1-800-QUITNOW for advice and use proven methods. The American Lung Association is extremely troubled about the rapid rise of young adults using these products and have been urging the FDA to crack down on unproven claims by the e-cigarette industry that their products are a way to quit smoking.

However, other expert organizations claim there is growing evidence that vapes can be effective. Vaping can help reduce nicotine cravings because it replaces addictive nicotine in tobacco and people can control the quantity of nicotine in their vape and reduce it over time. Research has also shown that people who switch completely from smoking to vaping dramatically reduce the risk to their health and that vaping to quit is more successful when combined with support from a stop smoking service.

A Cochrane review found with moderate-certainty that ECs and vapes do help smokers to stop smoking in the long-term compared with placebo ECs and nicotine replacement therapy. Further larger trials are underway which will be added to the review once their results have been published.

Several well-respected professional bodies, such as the Royal College of Physicians, state that vaping is far less harmful than smoking tobacco with health hazards from ECs unlikely to exceed 5% of the harm from smoking tobacco.

The World Health Organization remains closed to the idea of vaping saying both tobacco products and ENDS pose risks to health and the safest approach is not to use either.

Are Vapes A Gateway To Smoking In Teenagers?

Yes, they are. Research has shown that more than 30% of teens who vape begin smoking traditional tobacco products within six months. Young people are four times more likely to try cigarettes and three times more likely to smoke regularly if they have already used vaping products.

The 2019 Monitoring the Future College and Young Adults Survey showed that 22% of college students and 18% of non-college students now vape, compared with only 6% and 8% respectively in 2017. Cannabis vaping also increased substantially with 14% of college students and 17% of non-college students using cannabis vapes, compared to only 5% and 8% respectively in 2017.

Parents should be concerned about their teenagers vaping. One in 5 high school students now vape and most vaping devices contain nicotine, although two-thirds of teenagers that vape are oblivious to the fact that they might be addicted to nicotine, and that this addiction is potentially life-long.

Look for telltale signs that your teen is vaping which may include fruit or candylike smells, trouble breathing, unexplained cough, mouth sores, nosebleeds, mood swings, and irritability. Although vaping is less harmful than smoking cigarettes, the aerosol from vaping is not harmless. Vaping has also been linked to an increased risk of COVID-19 infection.

All Products Containing Nicotine Are Poisonous To Children And Pets

Vapes contain concentrated liquid nicotine and should be treated like any other poison in your home.

Calls to poison centers about e-cigarettes and liquid nicotine products began in 2011, around the same time these products were introduced to the U.S, which coincides with the initial period where these products reached the U.S. market. Children and pets who come into contact with these products can become very ill, with nausea and vomiting being the most significant symptoms. In the eight months to August 31st 2022, 4197 calls about vapes and other nicotine products were reported to poison centers. The year before, over 5000 calls were received.

Young children are particularly at risk of nicotine poisoning. Symptoms include abdominal cramps, agitation, difficulty breathing, drooling, rapid heartbeat, vomiting, and in some cases, death.

All vaping supplies should be kept out of reach of children, preferably in a locked cupboard. This applies to both full and empty refills, as well as the actual device. Kids (and even pets) can be attracted to the smell and color of vapes, so they should not be left lying around on a coffee table or in the car. Drinking, sniffing, or even accidentally touching the liquid in vapes can cause poisoning.

If you suspect your child has been exposed to liquid nicotine, call the Poison Help Line immediately, at 1-800-222-1222.

Explosions in Your Pocket: Hopefully Your Device Will No Longer Go Up In Smoke!

Luckily, explosions involving ECs have become a thing of the past. At one time, lithium batteries contained in ECs were nicknamed the "mini-bomb in your pocket" because more than 200 separate incidents of exploding ECs were reported soon after the devices first came onto the market. 62% of these occurred when the EC was either in somebody's pocket or in use.

But the TSA still treats them as threats. Vaping devices like vape mods and vape pens with lithium batteries must go in carry-on luggage or in your pockets; never in checked luggage. That’s for any kind of vapes that have lithium batteries. Nicotine e-liquid or extra pods can be packed in checked bags but federally controlled substances like cannabis products are prohibited on most United States flights.

If you’re traveling to an unfamiliar country, you should also check the local vaping laws before you depart. Some countries have outright vape bans.

Finished: E-cigarettes And Vaping: Safe or Not?

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.