Are e-cigarettes a safe method to help a tobacco user quit? Or are they the gateway for kids to get hooked on smoking? With all we know about how smoking can lead to cancer, heart disease, lung disease, and a host of other health issues, are they worth that risk?
With “vapor shops” showing up on every corner these days, they certainly aren’t hard to find. But with new regulations and rules that went into effect across the country this past summer, will it slow down the booming growth of e-cigarettes?
And e-cigarette looks like a real cigarette but is battery-operated instead of being lit by a lighter or match. There are several different brands and styles of these devices, each having it’s own “look” with the refillable tanks. What they have in common is they are intended to take care of your nicotine habit without the known dangers of traditional cigarettes. And they all work in the same basic manner:
- There is a container, aka tank, that are filled with liquid that contains flavoring, nicotine and other chemicals.
- There is a heating device that works from the battery and vaporizes the liquid which is inhaled.
Are They Safe?
Most of the e-cigarettes contain a nicotine, which is the same addictive substance found in traditional cigarettes. When a person quits using e-cigarettes, they can experience depression and withdrawal, become irritable. Anyone that has known heart or lung problems should not vape any more than they should use traditional cigarettes. E-cigarettes can also damage a child’s brain development, affecting their attention span and memory. An expecting mother should avoid them as any other tobacco to avoid damaging her unborn baby.
But nicotine isn’t the only concern about e-cigarettes. Some e-cigarettes contain chemicals like formaldehyde, a substance used in construction materials. There are similar ingredients in e-cigarettes that is in antifreeze as well, a cancer-causing agent.
E-cigarette flavors also are a concern such as those that have a buttery-taste created by using diacetyl, a chemical found in popcorn and other foods. In the form of food, it isn’t as dangerous as when it is being inhaled. It has been linked with lung disease, aka ‘popcorn lung.’
While e-cigarettes aren’t considered 100% safe, it is the opinion of most experts that they aren’t as dangerous as traditional cigarettes., says Neal Benowitz, MD, a nicotine researcher at the University of California at San Francisco. Cigarette smoking kills almost half a million people a year in the United States. Most of the harm comes from the thousands of chemicals that are burned and inhaled in the smoke, he explains.
E-cigs don’t burn, so people aren’t as exposed to those toxins. A 2015 expert review from Public Health England estimated e-cigs are 95% less harmful than the real thing.
That figure is controversial and might be a little high, says Kenneth Warner, a tobacco policy researcher at the University of Michigan. But, he adds, “The worst critics of e-cigarettes would probably argue they’re a half to two-thirds less dangerous. But from a practical view, they’re probably on the order of 80% to 85% less dangerous, at least.”
Some states and communities that ban smoking in public places also ban vaping. But, Warner says, while the danger from secondhand vapor isn’t zero, “it’s probably very low.”
Do They Help Smokers Quit?
“We don’t have the definitive study on that,” Warner says. “My reading of the evidence is that it is quite convincing that e-cigarettes are helping some people quit smoking.”
Caren Kagan Evans, 56, of Washington DC, is one of those people. She started smoking when she was 13-years-old. Over the years, Evans tried to quit by using the nicotine patch, gum, and even hypnosis.
Vaping worked in a month, and she’s been off cigarettes for more than two years. “I’m breathing, sleeping, and eating much better since I started vaping. My ‘smoker’s laugh’ went away, and I no longer smell like an ashtray.”
But Evans’ story is the exception, not the rule.
“If there was good evidence that people were using e-cigarettes just to quit smoking, there would be wide support,” Benowitz says. “The problem is most of the e-cigarette use in the U.S. is dual use with cigarettes.” People use e-cigs in places or situations where they can’t smoke, like in a restaurant, but continue lighting up when they can, he explains.
Sward points out that according to the FDA, there’s no evidence any e-cigarette is safe and effective at helping smokers quit. She suggests talking to your doctor about medications and other strategies that are proven stop-smoking tools.
The American Heart Association says e-cigs should only be used as a last resort way to quit.
Do They Lead Kids to Smoke?
Critics of e-cigarettes fear that vaping will get kids hooked on nicotine and that they’ll “graduate” to cigarettes when they want a bigger kick, Warner says.
Two recent studies suggest a link.
A 2016 study in the journal Pediatrics found that teens that never smoked but used e-cigs were six times more likely to try cigarettes compared to kids who don’t vape.
A study in the Journal of the American Medical Association in 2015 found a connection too. Researchers surveyed 2,500 Los Angeles high school students who had never smoked. They found that kids who used e-cigs were more likely than non-users to smoke cigarettes or other tobacco products over the next year.
But, CDC stats on teen smoking show that while use of e-cigs went up to 24% in 2015, cigarette smoking dropped to an historic low — to just under 11%.
The trend is reassuring, Benowitz says.
The FDA is regulating e-cigarettes and tobacco products such as hookah tobacco and cigars in the same way as cigarettes and smokeless tobacco. Key rules include:
- No one under age 18 can purchase them — in stores or online.
- Sellers will need to check ID of anyone under 27 years of age.
- The products can’t be sold in vending machines, except for in adult-only facilities.
- Free samples are banned.
E-cigarettes placed on the market after 2007 have to go through an FDA safety and approval review to enter or stay on the market. That could take years, but products can be sold while they wait for approval.
Critics say the rules will crush small makers of e-cigs because they can’t afford the time and lawyer fees to get through the process.
The American Academy of Pediatrics and the American Lung Association are glad to have the rules. But, Sward adds, “We certainly thought [the FDA] should have gone farther — ending the sale of flavored products.” Some come in candy and fruity flavors that appeal to kids and teens.
What Else You Should Know About E-Cigs
They can blow up. There were 134 reports of e-cigarette batteries overheating, catching fire, or exploding between 2009 and January 2016, according to Michael Felberbaum, an FDA spokesperson. Some people were seriously hurt. The new rules will allow FDA to review the safety of batteries and eventually take action to protect the public.
They can poison people. Liquid nicotine is especially dangerous to young kids. Reports of poisonings are on the rise. Keep all e-cigarettes out of reach of little ones.
The FDA plans on future rules that will require nicotine warnings and child-resistant packaging for products with e-liquids, Felberbaum says.