By now, you’ve probably seen people puffing on all sorts of odd-looking devices, walked through clouds of vapour on the street, and maybe even tried an e-cigarette yourself. It’s pretty safe to say—e-cigs are officially a thing.
So what are e-cigarettes anyway, and what do we know—and not know—about the risks?
First, let’s clear up a quick misconception: College and university students may not be using e-cigs as often as you think. In a 2016 nationwide survey, students thought that only 15 percent of their peers had never tried an e-cig. The reality? Eighty-six percent of students say they’ve never puffed on one (American College Health Association, National College Health Assessment, Canadian Reference Group, Fall 2016).
But even if our perception of how many students are smoking e-cigs is off, that doesn’t mean they’re not a problem. According to the 2013–2014 National Adult Tobacco Survey, 14 percent of young adults (ages 18–24) are using e-cigarettes compared to only 6 percent of those 25 and older.
E-cigarettes, vapourizers, and ENDS
There’s a lot of lingo associated with e-cigarettes and vaping, and trying to follow it can get a little confusing.
- Any device that lets you inhale an aerosol of chemicals (usually including nicotine) is considered an e-cigarette, according to the Heart and Stroke Foundation of Canada.
- Some e-cigarettes look like regular cigarettes. Others, called vapourizers, don’t. Yup, file this under the confusing part. There are also e-hookahs, e-cigars, and e-pens. All of these are known as electronic nicotine delivery systems (ENDS).
- Vapourizers and e-cigarettes have a tank that holds liquid chemicals. There’s a heating element—usually a battery—that turns the liquid into an aerosol that is then inhaled.
- The liquid is called e-liquid or e-juice. The e-liquid in e-cigarettes and vapourizers often (though not always) contains nicotine (in varying amounts), flavours, and other chemicals.
What do experts say about vaping?
Vaping is widely thought to be safer than smoking, but that doesn’t mean it’s risk-free, says Dr. Hayden McRobbie, a professor and researcher in the Tobacco Dependence Research Unit at the Wolfson Institute of Preventive Medicine at Queen Mary University of London. Many e-cig products contain nicotine, which is highly addictive and has been shown to harm the developing brain of young adults, according to the US Surgeon General. The US Food and Drug Administration (FDA) has also found a number of cancer-causing chemicals in vaping products.
E-cigarettes with nicotine are not approved by Health Canada for sale in Canada, but are still widely available, says Renee O’Leary, PhD candidate at the Centre for Addictions Research of British Columbia at University of Victoria. “They’re regulated as consumer products, and some provinces have enacted other restrictions on them.” Research on long-term risks is limited, which might in turn limit the regulations that federal and provincial governments place on them. There are other variables at play, too.
“There are many models of e-cigarettes and vapourizers, including homemade products,” says Dr. Jean-Francois Etter, a professor of public health at the Faculty of Medicine of the University of Geneva in Switzerland and an expert in tobacco dependence. Little-known fact #1: There are more than 460 different e-cigs on the market today. Little-known fact #2: They’re so varied—from the number of puffs to the types of liquids to the depth of inhalation—that it’s difficult to assess their risk, Dr. Etter says.
We don’t know yet how e-cigs can affect our health in the long run, but we do know some interesting facts about them.
5 lesser-known facts about vaping and e-cigs
1. Everything is made of chemicals. E-cigarettes have some funky ones.
The chemicals in e-cigarettes have yet to be evaluated to determine how safe they are. What does that mean for you vapers out there? You have no idea what you’re smoking and neither do we. Many vaping products contain nicotine, which we know is addictive and harmful, and also affects attention and memory in developing brains, according to the Canadian Lung Association. Other ingredients often found in vaping products include propylene glycol, a chemical that helps make smoke, and glycerin, a byproduct created when soap is made. Interestingly enough, glycerin can be found in materials ranging from toothpaste to brake fluid—you probably don’t want to be inhaling either of those.
2. Vapourizer batteries can explode.
We’re willing to bet that no one likes exploding electronics. (Anyone remember the Samsung Note 7 debacle?) While vape battery explosions appear to be rare (Although there is no current data available in Canada, only about 25 were reported in the media in a five-year span, according to the US Fire Administration), they can obviously be dangerous and probably pretty terrifying. If you use battery-powered vaping products, here’s how to reduce your battery explosion risk:
- No charger swapping. Only use the charger your vape came with.
- Daytime charging only. Don’t charge your vape at night while you’re sleeping.
- Drop your vape into your reusable water bottle? Replace the batteries anytime they get wet.
- Don’t let the batteries come into contact with anything metal.
- Look for e-cigarettes with safety features, like an automatic shutoff feature when the battery is fully charged.
3. Vaping may increase the likelihood of using traditional tobacco products later on.
Early research suggests that using e-cigs may increase the chances of young people moving on to cigarettes and other traditional tobacco products later on, according to the National Institute on Drug Abuse. An analysis of more than 17,000 14- to 30-year-olds found that those who had ever tried vaping were 3.6 times more likely to start smoking traditional cigarettes than those who had never tried it, while those who had vaped in the past 30 days were more than 4 times more likely than non-vapers to turn to cigarettes (JAMA Pediatrics, 2017). As we know from decades of research, using traditional tobacco products can lead to a host of not-so-fun health issues, such as cancer, heart disease, erectile dysfunction, and emphysema.
4. Dripping can boost your exposure to toxic chemicals.
What’s dripping, you ask? It’s a process of directly inhaling heated e-cig liquid at a higher temperature in order to produce a more concentrated vapour. “The bad news is that [dripping] substantially increases the production of toxins,” says O’Leary. Preliminary research suggests that doing this may increase the user’s exposure to toxic chemicals such as formaldehyde (a known carcinogen used in glues, adhesives, and embalming fluids), acetaldehyde (a chemical found in cigarettes and in some foods), and acetone (the active ingredient in nail polish remover) (Pediatrics, 2017). A tip for vapers and probably the rest of us: Avoid dripping.
5. Big tobacco is now playing the vaping game.
The popularity of vaping hasn’t gone unnoticed by big tobacco companies. Tobacco conglomerates started buying up popular e-cigarette companies back in 2012, and they’ve also started making their own e-cig products, according to a 2016 Newsweek special edition. Philip Morris recently filed an application to market a kind of cigarette that heats, rather than burns, tobacco and hopes to advertise it as “less harmful than traditional cigarettes,” according to Reuters.
Look out for anything tobacco companies tout as safe: In the 1920s–1950s, tobacco companies used ads featuring doctors, babies, and even Santa Claus to encourage smoking. The tobacco industry is also known for manipulating data and funding research that supports their best interests (read: making money), according to a 2017 editorial published in Public Health Ethics.
The risk of e-cigarettes: TBD
The dangers of traditional tobacco products are many and known; the dangers of e-cigarettes are still being determined. That leaves plenty of unknowns for students mulling whether to vape or not.
“I think that any substance that you’re inhaling into your lungs isn’t healthy and should be avoided, at least until more research is done.”
—Jessica W., first-year graduate student, University of New Brunswick
“It’s a risky habit to start, considering that we don’t know the long-term effects. On the other hand, if the person is a smoker, vaping could be a better option since the negative effects of tobacco are already well known and may outweigh the potential negative effects of vaping.”
—Gillian T., second-year graduate student, Queen’s University, Ontario
Research published in BMC Medicine in 2015 found that e-cigarettes appear to be less harmful than traditional cigarettes. The researchers also noted that smokers who switched to vaping saw improvements in their respiratory health. That said, “better than” isn’t the same as “safe,” and it will likely be decades before the risks of e-cigarettes are fully understood.
What about for people trying to quit traditional tobacco?
For people looking to cut down their cigarette habit, vaping may be a useful tool—though the results of recent studies are mixed. Let’s take a closer look: A study including more than 2,000 smokers found that those who also used e-cigarettes were more likely to cut their cigarette use in half than were those who only smoked traditional cigarettes (Addiction, 2017). However, the Public Health Agency of Canada recommends a combination of counselling and nicotine replacement medication (such as the nicotine patch) as one of the most effective methods for quitting smoking.
In this context, it may be reasonable to try e-cigarettes as a smoking cessation aid—with caution. “By providing the nicotine that smokers need or want without the dirty delivery system of the cigarette, vaping [could] be an effective way for many people to quit smoking [traditional cigarettes],” says David Sweanor, Adjunct Professor of Law at the University of Ottawa in Ontario, who focuses on smoking cessation and anti-tobacco policy.
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Fifth-year undergraduate, University of Victoria, British Columbia
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Smokers helpline: Canadian Cancer Society
Jean-Francois Etter, PhD, Professor of Public Health, Faculty of Medicine, University of Geneva, Switzerland.
Hayden McRobbie, MB, ChB, PhD, Tobacco Dependence Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom.
Renee O’Leary, PhD candidate, Centre for Addictions Research of British Columbia, University of Victoria, British Columbia.
David Sweanor, Adjunct Professor, Faculty of Law, University of Ottawa, Ontario.
American College Health Association. (2016). American College Health Association-National College Health Assessment II: Canadian Reference Group Executive Summary. Retrieved from http://www.acha-ncha.org/docs/NCHA-II%20SPRING%202016%20CANADIAN%20REFERENCE%20GROUP%20EXECUTIVE%20SUMMARY.pdf
Agency for Toxic Substances and Disease Registry. (2015, January 21). Public health statement for propylene glycol. Retrieved from https://www.atsdr.cdc.gov/phs/phs.asp?id=1120&tid=240
American Lung Association. (2016, December 8). E-cigarettes and lung health. Retrieved from http://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html
Brownson, E. G., Thompson, C. M., Goldsberry, S., Chong, J. H., et al. (2016). Explosion injuries from e-cigarettes. New England Journal of Medicine, 375(14), 1400–1402. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMc1608478
Dawson, A., & Verweij, M. (2017). No smoke without fire: Harm reduction, e-cigarettes and the smoking endgame. Public Health Ethics, 10(1), 1–4. Retrieved from https://academic.oup.com/phe/article/10/1/1/3100270/No-Smoke-Without-Fire-Harm-Reduction-E-Cigarettes
Elliot, S. (2008, October 6). When doctors, and even Santa, endorsed tobacco. New York Times. Retrieved from http://www.nytimes.com/2008/10/07/business/media/07adco.html
Ellis, J. (2016, April 24). Vaping: Big Tobacco’s big gamble on the future. Newsweek. Retrieved from http://www.newsweek.com/vaping-big-tobacco-big-gamble-future-451074
Environmental Working Group. (n.d.). Glycerin. Retrieved from https://www.ewg.org/skindeep/ingredient/702620/GLYCERIN/#
Hammond, D; White, CM; Czoli, CD; Martin, CL; Magennis, P; Shiplo, S (9 October 2015). Retail availability and marketing of electronic cigarettes in Canada. Canadian Journal of Public Health. 106 (6): e408–12. PMID 26680433. doi:10.17269/cjph.106.5105. http://davidhammond.ca/wp-content/uploads/2014/12/2015-Ecig-Retail-in-Canada-CJPH-Hammond.pdf
Heydari, G., Ahmady, A. E., Chamyani, F., Masjedi, M., et al. (2017). Electronic cigarette, effective or harmful for quitting smoking and respiratory health: A quantitative review papers. Lung India, 34(1), 25–28. http://doi.org/10.4103/0970-2113.197119
Krishnan-Sarin S., Morean, M., Kong, G., Bold, K. W., et al. (2017). E-cigarettes and “dripping” among high-school youth. Pediatrics, 139(3). Retrieved from http://pediatrics.aappublications.org/content/pediatrics/early/2017/02/02/peds.2016-3224.full.pdf
MedlinePlus. (2015, August 29). Risks of tobacco. Retrieved from https://medlineplus.gov/ency/article/002032.htm
Pasquereau, A., Guignard, R., Andler, R., & Nguyen-Thanh, V. (2017). Electronic cigarettes, quit attempts and smoking cessation: A six-month follow-up. Addiction, 112(9), 1620–1628.
Polosa, R. (2015). Electronic cigarette use and harm reversal: Emerging evidence in the lung. BMC Medicine, 13(54). Retrieved from https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-015-0298-3?site=bmcmedicine.biomedcentral.com
Reuters. (2016, December 6). Philip Morris seeks US approval to market alternative cigarette. Retrieved from http://www.reuters.com/article/us-pmi-fda-idUSKBN13V2EP
Soneji, S., Barrington-Trimis, J. L., & Wills, T. A. (2017, June 26). Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults. JAMA Pediatrics, 171(8), 788–797. Retrieved from http://jamanetwork.com/journals/jamapediatrics/fullarticle/2634377
US Centers for Disease Control and Prevention (CDC). (2016, December 1). Current cigarette smoking among adults in the United States. Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm
US Centers for Disease Control and Prevention (CDC). (2017, June 15). Tobacco use among middle and high school students—United States (2011–2016). Retrieved from https://www.cdc.gov/mmwr/volumes/66/wr/mm6623a1.htm?s_cid=mm6623a1_w
US Department of Health and Human Services. (2016). E-cigarette use among youth and young adults: A report of the Surgeon General. Retrieved from https://e-cigarettes.surgeongeneral.gov/documents/2016_sgr_full_report_non-508.pdf
US Department of Health and Human Services. (n.d.). Electronic cigarettes. Retrieved from https://betobaccofree.hhs.gov/about-tobacco/Electronic-Cigarettes/index.html
US Fire Administration. (2014, October). Electronic cigarette fires and explosions. Retrieved from https://www.usfa.fema.gov/downloads/pdf/publications/electronic_cigarettes.pdf
US Food and Drug Administration. (2017, May 30). Tips to help avoid “vape” battery explosions. Retrieved from https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm539362.htm
US Food and Drug Administration. (2017, April 18). Vaporizers, e-cigarettes, and other electronic nicotine delivery systems (ENDS). Retrieved from https://www.fda.gov/tobaccoproducts/labeling/productsingredientscomponents/ucm456610.htm
US National Institute on Drug Abuse. (2017, June). Electronic cigarettes (e-cigarettes). Retrieved from https://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes