Vaping vs. Smoking – lesser of two evils?
A study conducted by YouGov on behalf of Action on Smoking and Health (ASH) last year shows an estimated 2.9 million adults in Great Britain are using electronic cigarettes (also known as e-cigs or vapes). But is vaping worse than smoking?
What is vaping?
Vaping involves the insertion of an e-liquid, usually containing nicotine and several flavourings, into an electronic cigarette, powered by a re-chargeable battery. The liquid then becomes a vapour that people breathe in, as they would smoke from a tobacco cigarette. Vapes give smokers the nicotine hit they need to help beat their cravings. Unlike cigarettes, vapes do not contain the same harmful combination of chemicals found in tobacco smoke.
Like all new trends influencing public health, vaping has been the subject of intense international debate among researchers and health professionals. However, unlike the dangers of smoking cigarettes (which have been well publicised for many years) the potential health risks of vaping are still not fully known.
What the headlines say:
“Vaping causes cancer, new study warns…” – Daily Mail Jan 2018
The infamous Daily Mail reported earlier this year that “Vaping causes cancer, new study warns”. This headline was based on a widely criticised study on the effects of e-cigarette vapour on mice and human cells tested in a lab.
The study found that e-cig vapour raised levels of DNA damage in the lungs, bladders and hearts of mice as well as damage to the DNA inside those lab-grown human lung and bladder cells. They found that these cells were less able to repair this damage and were then more susceptible to further genetic faults that could give them properties like those of cancer cells.
However, animal studies and laboratory tests on cells do not tell us about the effects of inhaling e-cigarette vapour on humans and we also don’t know whether the DNA damage in the mice would have led to cancer if the experiments had run for longer. Most importantly, no direct comparisons were made with tobacco smoke.
“Misinformation and scaremongering could still be putting people off switching” – The Guardian Dec 2017
The Guardian reported that, “Misinformation and scaremongering could still be putting people off switching” and it is true that much of the information published online regarding vaping is false, or misleading.
So what can we believe?
A study funded by Cancer Research UK which involved UCL in London and the Centers For Disease Control And Prevention (CDC) in the US found that the risks of vaping paled in comparison to the carcinogenic cocktail people ingest every time they smoke a cigarette.
Vaping was found to be useful in helping smokers give up harmful tobacco and reduce their risk of contracting chronic or terminal diseases over the course of their lives. This study is considered so influential, that it is published on the NHS website.
Similarly, Public Health England carried out an independent evidence review of e-cigarettes and concluded that vaping was 95% less harmful than smoking. This study noted that the idea of vaping being as, or if not more, harmful than cigarettes was a common misconception among smokers. Although 40% of smokers had never tried an e-cigarette, the study found that at least 20,000 people were switching from cigarettes to vapes, and consequently giving up smoking each year.
This year additional organisations, such as the Royal College of General Practitioners and the British Medical Association, also published reports suggesting e-cigarettes can be a useful tool for smokers trying to quit. And for the first time, Public Health England included e-cigarettes in its advertising for ‘Stoptober’.
Vaping as a ‘gateway’ to smoking?
“E-cigarettes ARE a gateway to teenage tobacco smoking…” – MailOnline Oct 2017
It has been argued that vaping is a ‘gateway’ to smoking, especially in young people. In 2017, the notorious MailOnline published an article with the headline, “E-cigarettes ARE a gateway to teenage tobacco smoking…” based on a US study of around 300 adolescents who had never smoked tobacco. The study found that 16 months later, those that had smoked e-cigarettes were six times more likely to have started smoking tobacco.
However, various media outlets as long as NHS choices have criticised the validity of the study arguing, “those who experimented with e-cigarettes would have probably ended up trying cigarettes anyway, regardless of whether or not e-cigarettes existed.”
NHS choices also goes on to say that the increasing use of vapes hasn’t had any impact on the declining rate of young smokers – at least for now.
Additionally, a survey of British 11- to 16-year-olds in August 2017 argued that experimentation with vaping devices did not translate into regular use.
So does this mean we should we all start vaping?
No, this doesn’t mean vaping is harmless. Although a vape does not contain any tobacco, it still contains nicotine which is the addictive substance found in cigarettes, which drives smokers to buy packet after packet of them. Research suggests that nicotine in liquid form as part of a vape, can be absorbed rapidly into the blood stream, through the skin, and cause nausea, vomiting and diarrhoea.
That said, nicotine’s biggest risk to health is as an accessory to the damaging carcinogens found in tar. On its own, nicotine does not cause cancer. Like all addictive substances, nicotine can affect an individual’s heart rate. Then again, so can caffeine, yet many people drink several cups of coffee every day without considering the health ramifications of their favourite beverage.
But more importantly…
The biggest problem with vaping is that the long-term effects of are for now unknown. Longitudinal studies on the effects of vaping to our health are yet to be conducted. In 50 years time studies may reveal devastating effects of vaping but the truth is for now we just don’t know. Lack of research not only makes it impossible to comment on the long-term effects of vaping, it also makes it difficult to argue that vaping is more dangerous than smoking. There is now an overwhelming amount of evidence proving that smoking is bad for our health compared to next to no research about vaping and health.
With 79,000 people dying every year across the UK because of smoking, combined with speculation that cigarette prices are to rise again and the proposed ban on menthol cigarettes, as well as a lack of evidence concerning the long-term effects of vaping, we can only hope people will be encouraged kick both habits – both of which are potentially dangerous to our health.
This blog has been co-created by Medstars’ Demi Sanders and Thomas O’Brien.
For help quitting smoking, consult one of our GPs below.
For respiratory problems, visit our consultant in respiratory medicine, Dr Brian O’Connor.
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