Vaping, also known as electronic nicotine delivery systems (ENDs) or e-cigarettes, emerged in the early 2000s as an alternative to traditional tobacco products. These pocket-sized devices deliver nicotine through an aerosol that resembles water vapor. However, the question remains: Are vape pens healthier than cigarettes?
The answer to this question is not straightforward. According to experts interviewed by Live Science, vaping poses only a fraction of the risks associated with smoking. Nonetheless, it is crucial to acknowledge that vape pens are not entirely safe, and the long-term effects of e-cigarette use are not yet fully understood.
It took several decades of research to uncover the dangers of smoking. Cigarettes, introduced in the early 19th century, were linked to lung cancer and other diseases in the 1940s and 1950s. In comparison, vape pens have been available for less than 20 years, and certain vape liquids and types of ENDs may be more harmful than others, further complicating the situation.
To assess the potential health effects of vaping, it is essential to consider the composition of cigarettes and e-cigarettes.
Cigarettes contain tobacco leaves, as well as various additives such as flavorings and preservatives. When burned, they release approximately 7,000 different chemicals, including hydrogen cyanide, arsenic, lead, and carbon monoxide, according to the American Cancer Society (ACS).
Many of these chemicals are carcinogens, substances that can cause cancer. Most carcinogens in cigarettes originate from the tobacco leaves themselves rather than the additives. Smoking cigarettes not only increases the risk of various types of cancer but also contributes to lung and heart disease. In contrast, nicotine, the addictive chemical in tobacco leaves, is not considered a cancer-causing agent by the World Health Organization (WHO). However, nicotine can have other detrimental effects on the body besides being highly addictive.
Vape pens come in different shapes and sizes, but they all operate on the same principle. A battery-powered core heats and rapidly cools a vape liquid, also known as e-liquid or vape juice, creating a smoke-free aerosol that users inhale, or "vape." Vape juice can contain either synthetic nicotine or nicotine derived from tobacco, but it does not include tobacco leaves or other chemicals found in the plant.
Switching entirely from smoking to vaping typically results in lower exposure to toxic substances for individuals. Dr. Alayna Tackett, an assistant professor at the Ohio State University Wexner Medical Center, explained that the absence of smoke and tobacco in e-cigarettes contributes to this reduced exposure. However, it is important to note that vape pen liquids can contain other substances that may form carcinogenic compounds when heated.
Most e-liquids primarily consist of nicotine, flavorings, and solvents. These ingredients generate vapor and maintain a suspension. However, the specific composition of an e-liquid can vary significantly depending on the brand's manufacturing process, making it challenging to assess their toxicity accurately.
The most common solvents used in e-liquids are propylene glycol and glycerol, which are generally recognized as safe for human consumption by the Food and Drug Administration (FDA). Nevertheless, the 2021 review published in the journal Pharmacology & Therapeutics suggests that these solvents may not be safe to inhale. They can act as airway irritants, causing inflammation and other adverse reactions in the respiratory system.
Flavorings used in e-liquids are considered safe for consumption but have not been proven safe for inhalation as aerosols. Some flavorings may even be dangerous to inhale. For instance, diacetyl, a compound responsible for a buttery flavor, was linked to a severe respiratory disease known as bronchiolitis obliterans or "popcorn lung." Workers at a microwave popcorn factory developed this condition after inhaling diacetyl.
Both solvents and flavoring agents have the potential to generate toxic byproducts, including formaldehyde, a substance classified as a probable human carcinogen. Inhaling high doses of formaldehyde can be harmful, and a 2017 study published in the journal PLOS One found that concentrations of formaldehyde from heated vape liquid solvents may exceed the acceptable limits established by the U.S. Environmental Protection Agency. While this theoretically suggests a higher cancer risk for ENDS users, further research is needed to establish a clear link.
Most e-liquids contain varying levels of nicotine. Traditional tobacco smoke has a relatively low nicotine concentration and is harsh on the lungs, making it difficult to overdose on the addictive chemical when smoking cigarettes. Vape pens, on the other hand, can contain high concentrations of nicotine, and users can adjust the amount delivered in a single puff.
As a result, vaping may increase the risk of nicotine overdose. Symptoms of nicotine overdose, or nicotine poisoning, include muscle twitching, fainting, vomiting, heart palpitations, seizures, and difficulty breathing. Severe cases of nicotine poisoning can even be fatal, as reported by Mount Sinai.
According to a 2014 study conducted by the Centers for Disease Control and Prevention (CDC), there was a significant increase in nicotine vape pen-related calls to poison control centers. The number of calls surged from one per month in September 2010 to 215 per month in February 2014. In contrast, calls related to cigarettes remained relatively steady during that period.
Vape pens themselves can contaminate e-liquids. Repeated heating of the device's core can introduce metals such as nickel, copper, iron, and others into the aerosol. Inhaling these metals may increase the risk of cancer, kidney damage, heart disease, and neurological disorders, as highlighted by the Pharmacology & Therapeutics review.
The risk of metal contamination may be higher in closed pod ENDs, which have replaceable e-liquid cartridges, compared to disposable vape pens designed for single use. Furthermore, a 2023 study in the journal Toxics found that the concentration of hazardous metals in the vapor from pod-type e-cigarettes increases as the device is used for a longer duration.
In addition, black-market vaping products that contain THC, the psychoactive ingredient in marijuana, have been found to be sometimes contaminated with vitamin E acetate, a synthetic form of vitamin E. Vitamin E acetate was likely added by manufacturers as a way to dilute the THC content of vape juice. In 2019, it was associated with a significant outbreak of vaping-related illness in the United States.
While vaping may pose fewer risks compared to smoking, it is crucial to recognize that it is not without its own dangers. The long-term effects of e-cigarette use are still unknown, and certain vape liquids and types of ENDs can be more harmful than others. The composition of e-liquids, potential metal contamination, and the risk of nicotine overdose all contribute to the complex nature of the health effects associated with vaping.
To make informed decisions, individuals should stay up to date with the latest research and consult healthcare professionals. It is essential to consider the potential risks and carefully evaluate the available information before deciding whether to vape or smoke.
1. Is vaping completely safe?
No, vaping is not entirely safe. While it poses fewer risks than smoking, it is not without its own health concerns. More research is needed to fully understand the long-term effects of e-cigarette use.
2. Can vaping cause cancer?
The direct link between vaping and cancer is not yet fully established. However, certain substances found in vape liquids, when heated, can potentially form carcinogenic compounds. Further research is required to determine the extent of the cancer risk associated with vaping.
3. Are the flavorings in e-liquids safe to inhale?
While flavorings used in e-liquids are considered safe for consumption, their safety when inhaled as aerosols is not yet confirmed. Some flavorings may have harmful effects on the respiratory system.
4. Can you overdose on nicotine from vaping?
Yes, it is possible to overdose on nicotine from vaping. Vape pens can contain high concentrations of nicotine, and users can adjust the amount delivered in a single puff. Nicotine overdose can lead to severe symptoms and, in some cases, be fatal.
5. Are there risks associated with metal contamination in vape pens?
Yes, repetitive heating of vape pens can cause metals such as nickel, copper, and iron to enter the aerosol. Inhaling these metals may increase the risk of various health issues, including cancer, kidney damage, heart disease, and neurological disorders.