The use of e-cigarettes has become wildly popular, and it can be called a trend of some kind. Vapes still have a lot of disadvantages. The user base of e-cigarettes mainly consists of smokers or those who have quit smoking. However, is vaping actually safer than smoking or even an effective way to succeed in quitting smoking?
Electric and smokeless cigarette replacement
An electronic cigarette, or vape, is a battery-powered device that imitates a combustible cigarette, which is used to heat the liquid in the tank into vapor and inhale it into the lungs. The devices are currently available in both easy-to-use basic models and more functional models with different adjustment possibilities, for example in relation to the efficiency of the device.
The user base of e-cigarettes mainly consists of smokers or those who quit smoking. Also the inventor of the device, the Chinese pharmacist Hon Lik, longed for a way to stop his heavy smoking and in 2003 created a device that represents today’s modern electronic cigarette. E-cigarettes do not contain tobacco, and their use does not involve a combustion reaction like a regular cigarette, which would generate carbon monoxide and tar. According to current research data, the adverse effects of electronic smoking are less than those of smoking cigarettes.
Evidence of short-term adverse effects of e-cigarettes
E-cigarettes have only been on the market for a good 10 years, so their long-term effects on health have not yet been studied. However, in various human and animal studies, evidence of their health harm has been obtained. Harmfulness can also be assessed using safety limits for the risk of exposure to chemicals, as is the case with other internally administered preparations.
The harmful health effects of e-cigarettes are influenced by, among other things
- device and its power
- components of the smoke fluid
- mixing liquids by the user
- the pH value of the acidity of the nicotine liquid
- the composition of the vapor formed from the liquid
- the manner and frequency of use of the device.
The compositions of e-cigarette liquids are questionable
There are many different types of e-liquids, and users can also mix the combinations they want. Liquids usually consist of four ingredients:
- vegetable glycerin (VG = vegetable glycerin)
- propyleeniglykoli (PG = propylene glycol)
Liquids partly contain the same harmful substances as cigarettes. Some of these are cytotoxic, i.e. dangerous to cells, and some predispose to cancer. Small particles harmful to the lungs, i.e. nanoparticles, have been found in the steam. The concentrations of the substances are mainly lower compared to cigarettes, but depend on the way and power of the e-cigarette, as well as the composition of the liquids. When vaporizing at high temperatures, the concentrations of harmful substances increase considerably. The combination of liquid ingredients can result in unforeseen side effects that would not occur from individual substances.
Evaporation increases the amount of harmful substances
A combination of vegetable glycerol and propylene glycol is used as the base liquid for electronic cigarettes. Adding vegetable glycerol makes the liquid thicker and produces more vapor. Propylene glycol gives the liquid a more tobacco-like feel. When these substances vaporize, they can form cancer-causing formaldehyde, depending on the device, even more than when smoking ordinary cigarettes.
In addition, other harmful substances have been found in the liquids, such as residues of plant poisons and heavy metals. In general, different flavors and additives in liquids can be harmless, but the effects become harmful when they vaporize. In particular, the sweet flavors of liquids irritate the lung passages and increase the risk of inflammation and the risk of dangerous lung reactions. Only unflavored or tobacco-flavored liquids may be sold in Finland.
Nicotine causes many harms in vapes as well
Nicotine is a highly addictive substance. Like smoking, when using e-cigarettes, nicotine is quickly absorbed from the lungs into the bloodstream. Among other things, it constricts blood vessels, weakens oxygen supply, raises blood pressure and accelerates the heart rate, i.e. it causes many kinds of adverse effects on the cardiovascular system and exposes them to diseases. Nicotine use during pregnancy has the same adverse effect on the unborn child and increases the risk of miscarriage. In addition, it weakens both men’s and women’s fertility and causes erectile problems.
E-cigarette liquids for sale are available in nicotine-free versions as well. In e-cigarette liquids sold in EU countries, nicotine may not exceed 20 mg/ml, as defined in the Tobacco Act. In the end, you can get even more nicotine from e-cigarettes than from cigarettes. This is affected by the nicotine content of the ready-made liquid or the liquid combination mixed by the user, as well as the frequency of use of the e-cigarette. According to estimates, 13 puffs of 18 mg/ml nicotine liquid is equivalent to the amount of nicotine obtained from one cigarette. There are also liquids on the market to which nicotine salt has been added to facilitate the use of stronger nicotine liquids. Nicotine salt is created by mixing nicotine with acids, such as benzoic acid, which results in a lower pH value.
Vapes have adverse effects, especially on lung function
The health hazards of e-cigarettes have been studied with the help of human and animal studies. Most of the harms are the same as in traditional smoking. Disadvantages of electronic smoking have been found, among other things
- respiratory irritation symptoms and cough
- weakening of lung and blood vessel function
- increase in blood pressure and heart rate
- weakening of the body’s defenses
- risk of cardiovascular disease
- COPD risk and typical symptoms
- weakening of the defense mechanism of lung cells
- cell changes related to the development of cancer (e.g. lung cancer).
E-cigarette vapor increases the risk of infections and weakens the effectiveness of antibiotics. Taste liquids have a negative effect on oral health and lung function. Chronic cough, wheezing, bronchitis and asthma in young adults have been found to be connected to e-cigarettes and it worsens the already existing symptoms.
E-cigarette smokers themselves have also noticed increased heart rate, irritation of the pharynx and mouth, nausea and headache as symptoms. Some have also reported that their health has improved by switching from cigarettes to e-cigarettes. However, these subjective experiences are not yet generally considered reliable information.
The varying legislation on e-cigarettes can be seen in the morbidity statistics
Poisonings and deaths
The quality of e-cigarette liquids varies greatly, and flaws have been found in the devices and packaging labels. Quality control works mainly on the basis of the compositions declared by the importers of the liquids. Nicotine poisoning and even death have been reported from abuse of the liquids. A defective device or part of it can cause liquid to run into the mouth and throat, and children and young people are especially at risk of nicotine poisoning and death. For this reason, devices and liquids should only be purchased from a reliable source that has a sales license in accordance with the Tobacco Act.
In 2019, more than 2,000 people got sick and at least 39 died in the United States from lung disease caused by e-cigarettes. The cause was found to be vitamin E acetate, which has been in the cannabis liquids used in e-cigarettes. Vitamin E acetate is used in cosmetics and food, but when vaporized and inhaled, it causes a disturbance in lung function. In the United States, there were not many restrictions on e-cigarettes, but after the cases, the law was tightened and some e-cigarette products were banned.
Europeans use of e-cigarettes is restricted by the Tobacco Act
There have also been cases of nicotine poisoning in Europe but not to the extent of the United States. This is affected by the Europe Tobacco Act, which was set to also apply to e-cigarettes in 2016. Curious children can become interested in the candy-scented substance and end up in the hospital for nicotine poisoning. In Europe, efforts have been made to reduce the appeal of products, especially to children and young people, and only unsweetened or tobacco-flavored liquids are allowed to be sold.
The Tobacco Act also says the following about e-cigarettes and liquids:
- The age limit for sale, purchase and use is 18 years.
- E-cigarettes are generally prohibited where smoking is prohibited.
- E-cigarettes and nicotine liquids may not be sold remotely (for example online or over the phone) inside or across the borders of Finland.
- An individual may bring a maximum of 10 milliliters of nicotine liquid into the country.
- As a general rule, liquids with a nicotine content of more than 20 mg/ml may not be brought to Europe or received by mail from outside of Europe.
The Tobacco Act also applies to nicotine-free liquids, and this can be seen, for example, in their taxation, as a tax of up to 30 cents per milliliter is paid on liquids. However, you can order nicotine-free liquids from home and abroad.
There is no research evidence for the benefits of e-cigarettes in quitting smoking
Many switch from smoking to e-cigarettes in their quest to become smoke-free. However, no clear scientific evidence has been obtained about the functionality of e-cigarettes for this purpose, which is why they cannot be defined as detoxification products either. Some have managed to quit using them, but the majority continue to smoke after at least six months, use both products, or continue to use e-cigarettes. Even the inventor Hon Lik himself failed to quit and ended up not only smoking cigarettes but also using e-cigarettes.
Based on current research, e-cigarettes have quite similar disadvantages as smoking, and its long-term effects on health will only be seen years or tens of years from now. E-smoking, especially with nicotine-free or deliciously flavored liquids, may sound harmless, but you may have to pay a heavy price when the contents of the liquids vaporize and form surprising and dangerous substances in your body. It is clear, therefore, that for the treatment of nicotine addiction, it is recommended to use official nicotine replacement therapy products, which have evidence of their effectiveness.