Is vaping really safe?

Experts are concerned that vapes could create a new generation of nicotine addicts.

Cutting-Edge Technology

In 1965, Herbert Gilbert was awarded the world’s first patent for a smokeless, tobacco-free cigarette, claiming that his invention would provide a "safe and harmless way to smoke." However, over 60 years later, the modern version of Gilbert’s invention — the vape — has sparked controversy in the public health community.

Vapes have gained increasing popularity in recent years as a tool to help people quit smoking. By quitting smoking, the risk of lung cancer and other diseases can be significantly reduced. The question is whether the potential benefits of vapes in helping people quit outweigh the health risks they might pose.

Question 1: Can They Really Help People Quit Smoking?

The mechanism of a traditional cigarette is straightforward: when tobacco is lit, it combines with oxygen to produce inhalable smoke. Vapes, on the other hand, work by heating a liquid in the vape cartridge — the liquid typically contains nicotine and flavorings — to create an aerosol that can be inhaled. Therefore, vapes provide nicotine to users without the tar and other harmful substances produced by combustion, theoretically offering a healthier alternative to smoking.

This seems like a win-win situation. However, in practice, scientists have not reached a consensus on whether vapes effectively help smokers quit. While vapes contain fewer carcinogenic chemicals than traditional cigarettes, such as arsenic, benzene, and formaldehyde, there is still insufficient data to assess their long-term health impact.

Additionally, although vapes are designed for adults and legally restricted to adult users, they have become extremely popular among teenagers. Experts are concerned that vapes may be cultivating a new generation of nicotine-dependent individuals.

Are They Effective? The WHO Takes a Cautious Stance

The long-term effects of using vapes are not the only unknowns. Scientists are still unsure whether vapes truly help smokers quit. Some studies, supported by evidence from a large user base, suggest that vapes make it easier for people to quit smoking; yet, other studies show the opposite: vapes may actually increase the likelihood of continued smoking because they provide addictive nicotine.

Vapes are not approved by the U.S. Centers for Disease Control and Prevention (CDC) as smoking cessation tools, and manufacturers are prohibited from advertising them as health products. As such, vapes are generally referred to as cigarette alternatives for adult smokers. In the U.S., Juul is the most popular vape brand, and CDC data shows that in 2017, Juul sold 16.2 million vapes, a 641% increase from the previous year. However, many vape users do not completely quit smoking. A CDC study found that in 2015, approximately 59% of adults who used vapes were still smoking. A recent study by Rand Corporation also found that teenagers who use vapes are more likely to take up smoking than their peers who don't.

Some public health officials, such as those in the UK, strongly support vapes, and Dr. Scott Gottlieb, the commissioner of the U.S. Food and Drug Administration (FDA), also believes that although vapes "are not without risks," they provide an alternative that could reduce the incidence of lung cancer and improve overall respiratory health for adults trying to quit smoking, benefiting public health. "If we could get all adult smokers to fully switch to vape products, it would have a huge impact on public health," he said.

However, the World Health Organization (WHO) has adopted a more cautious stance on vapes, and some researchers remain skeptical. They argue that there is insufficient evidence to suggest that vapes help adults quit smoking, and an increasing body of research indicates that vapes may harm health, including raising the risk of heart disease and respiratory illnesses. "What would happen if a user vapes 200 puffs a day for 20 years?" asked Dr. Eisenberg, director of the Tobacco Products Research Center at Virginia Commonwealth University. "Anyone who claims to know the answer to this question must provide data."

Question 2: Are They Just As Harmful to Health?

Although vapes contain far fewer carcinogens than cigarettes and the levels of these substances are lower, there is no evidence to suggest that vapes are carcinogenic. However, scientists remain uncertain about the long-term health effects of using vapes. Part of the issue is that vapes have not been around long enough for rigorous studies to be conducted.

Some research indicates that dual use of cigarettes and vapes may be more harmful than either product used alone. A study published in the American Journal of Preventive Medicine in August found that smoking and vaping both carry a high risk of heart attack, and that using both together increases the risk even further.

Additionally, while vapes are often compared to cigarettes, they are actually very different products.

 

As vapes become more widespread globally, public and scientific concern about their potential health impacts continues to grow. In addition to the lack of clear conclusions regarding the long-term health effects, the quality and ingredients of vape products have also become a new focus of discussion. Some vape products have been found to have inaccurate labeling, with nicotine and other harmful chemicals present in higher concentrations than advertised. Moreover, the constant emergence of new vape products, such as those with adjustable nicotine levels and various flavors, complicates their safety and health risks.

 

On the other hand, the effectiveness of vapes as a smoking cessation tool has been questioned by different studies. While some research suggests that vapes can help reduce smoking among traditional smokers in the short term, the long-term effects on quitting smoking remain unclear. Some experts believe that vapes may only "reduce harm" but do not address the underlying health issues caused by smoking behavior. As governments, public health organizations, and academic institutions continue their research, the future development of vapes and their impact on public health will remain a focal point of global attention.

 

Vapes Cause DNA Damage in Mice

"When you study the chemicals present in both cigarettes and vapes, you can compare them. But if you consider the mixture in vapes on its own, along with how all the different compounds and chemicals interact, that raises a different question," said Sylvia Balbo, assistant professor of Environmental Health Sciences at the University of Minnesota’s School of Public Health.

Although research in this area is still in its early stages, some studies suggest that vapes may pose health risks. In one small study earlier this year, Balbo and her colleagues found that chemicals produced by heating vapes for 15 minutes could damage the DNA in the mouths of vape users. This study only involved five participants and did not track their health outcomes. However, Balbo said the DNA changes they observed could be linked to several types of cancer, including oral and lung cancers.

Other early studies have reached similar conclusions. A paper published in the Proceedings of the National Academy of Sciences this year found that vape aerosols can cause DNA damage in mice. A study published in Scientific Reports in May found that vapes contain more formaldehyde, a potential carcinogen, than previously estimated.

There are also other potential lung-related issues. Diacetyl, a chemical commonly found in flavored vape liquids, is linked to respiratory diseases. A study presented at the American Thoracic Society’s international conference in May found that vaping may contribute to the development of chronic obstructive pulmonary disease (COPD) and bronchitis.

Of course, some experts are cautious about these findings, arguing that banning vapes due to unknown health risks would be "throwing the baby out with the bathwater." Michael Siegel, a professor at Boston University School of Public Health, is dedicated to reducing tobacco use. "We know the harms of smoking. Of course, in an ideal world, a smoker wanting to quit would completely give up nicotine, but that’s hard to do. Vapes can provide a transition for quitting," he said.

Key Issue: Preventing Teenagers from Using Vapes

The FDA’s primary concern is preventing teenagers from using vapes. Federal data shows that the number of teenagers using vapes has surged, with vapes being more popular than cigarettes among high school students.

In September, the FDA strengthened its regulations on vapes, requiring vape companies to find ways to prevent minors from accessing their products. The agency warned that failure to do so could result in a ban on flavored vapes, which accounted for 60% of the vape market in 2016.

Siegel believes that reducing teen vape use should be a top priority and suggests that this can be achieved through regulating the sale of vapes and controlling the nicotine content in vape products. However, he also warned that removing vapes from the market could harm adult users, as smokers in the process of quitting might be tempted to return to cigarettes if appealing vapes are no longer available.

How governments will address the issue of vapes remains to be seen, but one thing is certain as research continues and teen usage rises: the debate over vapes is only just beginning.