Vaping: A Healthier Alternative to Smoking or Gateway Drug for the Younger Generation?

The verdict on smoking was much clearer in the past few decades: do not smoke cigarettes – they will kill you. Now, with the growing popularity of electronic cigarettes (e-cigs) and vaporizers (vapes), health policy makers and scientists alike are struggling to determine the health effects of smoking these new, “safer” alternatives. There is no surprise that in the smoking industry, an industry with a long history of misleading advertisements that rely on uninformed or misinformed consumers, there is a shortage of scientifically backed data on the safety of such alternatives. So, while the Food and Drug Administration (FDA) has not yet passed federal regulations on e-cigs or vaporizers, there are a few things important to know before trying one yourself.

E-cigs and vaporizers are very similar in that they both produce vapor instead of smoke, meaning that users do not inhale the carcinogen filled tar and tobacco found in conventional cigarettes. Instead, the vapor is a vegetable glycerin based liquid that usually comes in different flavors ranging from vanilla to rainbow custard. The liquids can contain varying amounts of nicotine, making e-cigs and vapes good alternatives for people trying to quit smoking. The small difference between the two is that e-cigs use a battery to directly heat the liquid to vapor, while vaporizers heat the liquid with a flow of warm air, leading to slightly different results in the way that the user experiences the vapor.

Within the last five years, the act of using a vaporizer or e-cig, “vaping”, has seen an extraordinary increase in popularity. What was barely an industry five years ago has grown to be worth $3.5 billion in 2015, according to Wells Fargo security analyst, Bonnie Herzog. In fact, Business Intelligence and Strategy (BIS), a global market research firm, estimates that the global electronic cigarette industry will reach a total market value of $50 billion by 2025 as “innovative product launches” and improvements that enhance “the quality and level of customization in the products” spur its growth. A large part of the growth can be attributed to the change in public perception towards vaping. Boston University’s pulmonary care physician and School of Medicine professor, Avrum Spira, put it best when he says, “in theory—and how they’re marketed—e-cigarettes are a safer product because they don’t have tobacco, which has known carcinogens. The question is: does safer mean safe?”

In fact, the sudden rise in popularity of vaping has come at a very controversial time. According to the Center for Disease Control and Prevention (CDC) cigarette usage is at an all time low –just under 17 percent of U.S. adults smoke. Furthermore, the CDC found that 48 percent of the adults who have tried an e-cig are current smokers, and 55 percent of smokers have attempted to quit smoking in the past year. Distinguishing by age, 22 percent of 18-24 year-olds have tried an e-cig, while 17 percent and 10 percent of 25-44 and 44-64 year olds, respectively, have tried an e-cig. On one hand, a large percentage of current cigarette users, especially those who are trying to quit, have tried e-cigs as possibly a way to quit smoking. Yet, a growing number of young adults aged 18-24 are starting to try them as well. Thus, e-cigs and vaporizers could either be the agent that finally eliminates smoking by helping long time smokers break their addiction, or be the catalyst that reintroduces excessive nicotine use and possibly lead to a resurgence of smoking cigarettes. The consequences of vaping will likely boil down to the extent to which consumers are educated about the positives and negatives of e-cigs and vapes.

So what are the health affects of e-cigs and vaporizers? Although not much research analyzing the effects of vapor has been conducted, studies that exist point to many possible negative effects. Nicotine is in both traditional cigarettes as well as in vape liquids, and, according to the CDC, nicotine is “as addictive as heroin, cocaine, and alcohol…[and] causes blood vessels to constrict, raises blood pressure, and can trigger abnormal heart rhythms”. Furthermore, researchers at the National Center for Biotechnological Information found evidence that suggests a “causal relations between nicotine exposure during adolescence and cognitive deficits in later life”, an indication that nicotine, although less harmful than tobacco, could still have negative effects. Moreover, a study by the Harvard T.H. Chan School of Public Health found that 75 percent of vapor flavors tested contained Diacetyl, a compound linked to severe respiratory diseases. As if the toxins were not enough, researchers at Johns Hopkins University recently discovered that vapor in the lungs also weakens the immune system against bacteria and viruses in that region and leads to an increased susceptibility to influenza. Still, even with the plethora of negative effects researchers are beginning to find associated with vaping, electronic cigarettes still have fewer toxic chemicals and carcinogens than traditional tobacco cigarettes, making them a favored method of trying to quit smoking.

Another factor that could potential make e-cigs a strong contender for the best method to quit smoking is the fact that e-cigs mimic smoking’s gestures and “throat hit” feeling, making them a potentially better alternative to traditional forms of nicotine. This very same argument, however, can be looked at in reverse as the similarities that vaping has to smoking may lead users that had not smoked previously to try smoking. Researchers at Dartmouth-Hitchcock Norris Cotton Cancer Center examined this possibility and found that of a national sample of nearly 700 16-26 years-olds, 38 percent of e-cig users began to smoke traditional cigarettes, while only 10 percent of non e-cig users began. The 28 percent increase suggests that e-cigs can in fact serve as a gateway drug for young adults and teenagers to start smoking. In fact, much of the advertising done by e-cigs companies are aimed towards younger children who are more susceptible to start using and possibly later move on to traditional cigarettes. And considering that many of the giant tobacco companies are scooping up the newer e-cig companies, this almost seems like the industry’s plan.

The smoking industry is at a fork, and the e-cig and vape industry will be the navigator that decides in which direction it goes, towards death or towards rebirth. Studies have shown that e-cigs and vapes do have harmful effects, and thus the question arises whether its potential power in helping long time smokers quit outweighs its disadvantages. In the end, the answer will lie in federal regulation and consumer knowledge. Currently, the FDA and activist groups have done an excellent job in educating the younger generation about the dangers of smoking, yet another battle is afoot. The big tobacco companies have already started targeting youth with advertisements that claim e-cigs and vapes are completely safe when in fact there is substantial evidence that they are not. The FDA and federal government need to quickly pass regulations on e-cig distribution and implement procedures that dissuade children from starting to use e-cigs. Yet, if the last fifty years of smoking have shown anything, it is that regulation alone will not enough to curb vaping, and that widespread knowledge on the effects of vaping will be a much stronger tool in the fight against drugs. Before vaping becomes ubiquitous in society, people, especially children, need to know that safer does not in fact mean safe.