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When e-cigarettes hit the market 10 years ago, no one knew what to make of them. They’re designed to look similar to traditional cigarettes, and you inhale them like cigarettes—are they actually less harmful than cigarettes?
E-cigarettes are battery-powered devices that contain a liquid cartridge. When heated, the cartridge releases a vapor that the user inhales. Besides e-cigarettes, you might see vaping products called ecigs, vapes, vape pens, hookah pens, mods, personal vaporizers, and PVs. They all operate in the same basic way.
Because vaping is so new and different, it’s taking time for scientists to catch up and figure out what impact these products may have. While fewer health risks are associated with vaping than smoking traditional cigarettes, they do carry some health risks of their own. Scientists and federal regulators are still figuring out how to deal with e-cigs, and the research is in its early stages. Here’s what we know so far.
Here’s what the vapor contains:
- Nicotine (usually—some vaping products do not contain this)
- Propylene glycol, a synthetic chemical that’s also found in anti-freeze, some foods and toiletries, and other chemicals
- Flavorings and coloring; these vary by brand
Here’s what the vapor does not contain:
The Food and Drug Administration (FDA) has only just started the process of regulating e-cigarettes and vaping products, so manufacturers have been operating without much oversight. This means that some products may still contain higher nicotine doses than it says on their packaging. The FDA has not approved e-cigarettes as a smoking cessation aid.
Click below to get answers to your vaping questions
Most teens aren’t vaping. According to national studies, less than a quarter of teens (16–24 percent) have used e-cigarettes in the past 30 days. And vaping among high school students may be on the decline. The number of teens who say they vaped in the past 30 days dropped in 2016 compared with 2015, according to the most recent Monitoring the Future survey.
Note: In most states you must be at least 18 to purchase e-cigarettes or vaping products. Some states, such as California, require purchasers to be 21 or older.
At this point, researchers are sounding reasonably confident that e-cigarettes are less harmful than traditional smoking—but the research is far from complete. And e-cigarettes are unlikely to be completely safe.
“A lot of the harm from cigarettes comes from the chemicals that are produced through combustion (lighting the tobacco on fire), and there’s no combustion (lighting on fire) when vaping,” says Dr. Jessica K. Pepper, social scientist at the Center for Health Policy Science & Tobacco Research in North Carolina . “But even though e-cigarettes are probably less harmful than cigarettes, they are not free of harm.”
In people who would not otherwise smoke, using e-cigarettes could potentially contribute to health problems, researchers acknowledged in a Nicotine & Tobacco Research study.
The nicotine in some e-cigs has the potential to harm brain development in people in their early 20s, according to the World Health Organization. Vaping can also aggravate respiratory diseases, such as asthma and bronchitis.
Many teens who vape opt for fruity flavors, without the nicotine, according to the Monitoring the Future survey. Out of 15,000 eighth-, tenth-, and twelfth-graders who say they vape, more than half said they’d only ever vaped flavoring.
“Even if you’re using a vaping product without nicotine, there are still risks from the flavors and chemicals in e-liquid,” says Dr. Pepper. “For example, some people think that flavorings in e-liquid are safe because the government has approved them for use in food. But the reality is that they’re approved for eating, not approved for heating into a vapor and then inhaling.”
Note: Don’t be fooled by all the different names vaping has. No matter what it’s called, each device operates in the same basic way and all have potential risks.
“Some kids think that ‘e-cigarettes’ are harmful because they’re like cigarettes, but that ‘hookah pens’ aren’t because they just have flavor and water—that’s not the case,” says Dr. Pepper. These two products are closely related—both are used to vaporize flavored liquid—though an e-cigarette is more likely to contain nicotine.
This is a point of controversy among health professionals.
Vaping may be helpful in smoking cessation (quitting smoking) in adults
Researchers are trying to figure out whether or not these devices can help people who smoke traditional cigarettes quit smoking altogether. The current evidence is mixed. E-cigs containing nicotine may be more effective for quitting smoking than a nicotine patch, according to a 2014 study published in Addiction. A 2016 analysis of multiple studies, however, found that e-cigarettes are not leading people to quit smoking (The Lancet Respiratory Medicine).
What about teens?
There isn’t any research about whether e-cigs can help teenagers quit smoking traditional cigarettes. “Teens and adults have different patterns of cigarette smoking and may respond differently to smoking cessation methods [ways to quit smoking], so even if e-cigarettes can help adults—which is a still very much a ‘maybe’—we have no idea if that translates to teenagers,” says Dr. Pepper.
In recent years, the amount of teens who smoke cigarettes has gone down and the amount of teens who vape has gone up—but the evidence is mixed on whether and how these two things are connected.
“Some studies show that kids who try vaping are more likely to smoke cigarettes in the future, and thus vaping creates new smokers. Other studies suggest that those same kids who try vaping would have ended up smoking cigarettes anyway, even if they hadn’t tried vaping,” says Dr. Pepper.
Nicotine is a highly addictive substance, whether you find it in traditional cigarettes or when vaping. The amount of nicotine in vaping products can vary by product and manufacturer.
“Most vaping products contain nicotine, and any product with nicotine is addictive,” Dr. Pepper says.
E-cigarettes don’t contain smoke, but they do create secondhand emissions. It’s still unknown what effect these emissions may have. If you’re using an e-cigarette that contains nicotine, people around you can breathe in that nicotine and other dangerous chemicals—but research is mixed about which chemicals people are breathing in and in what amounts.
“It’s a myth that the only thing that comes out of an e-cigarette is water vapor,” says Dr. Pepper. “In actuality, what the user inhales is an aerosol with many chemical components. We know for sure that at least some of those chemical components are harmful.”
“If there is a ‘secondhand vapor’ effect, it’s likely to be relatively mild compared with that of secondhand smoke,” says Dr. Abigail S. Friedman, assistant professor in the department of health policy and management at Yale School of Public Health in New Haven, Connecticut. “There’s much less concern about the vapor causing harm to nonvapers here than with conventional cigarette smoke. “
Vaping hasn’t been around long enough for us to see its long-term effects. If e-cigarettes can potentially contribute to serious illnesses—such as cancer, lung disease, or heart disease—we won’t see that for years. Researchers can study how e-cigarette vapors affect the cells of lab animals, which may offer some insight but can’t show us exactly how vaping affects people in the long term.
In 2016, the Food and Drug Administration (FDA) began regulating all e-cigarette products that are on the market, including manufacturing, importing, packaging, advertising and more.
Ready to quit? You can do this
If you smoke or vape and you’re trying to quit, the easiest way is to come up with a plan and a way to cope with cravings. You’re more likely to succeed with a structured approach, according to Smokefree.gov, a governmental resource for all things tobacco-free. Ask your health care provider for tools and strategies that have been evaluated in studies and shown to be successful.
Principles for successfully quitting
Steps to eliminate smoking/vaping altogether include:
- Choosing the date you’re ridding yourself of e-cigarettes or tobacco.
- Telling friends and family about it for support and to make you accountable.
- Giving your environment a makeover: Get rid of any hookah pens, e-cigarettes, or other vaping products, and throw away extra cigarettes or ashtrays.
- Find alternatives to help you replace the habit, especially when you have cravings (e.g., healthy snack food, such as carrots or popcorn, or an assortment of delicious teas).
To quit permanently, your strategy has to be sustainable:
- Look for life changes that you can live with; for ideas, check out former smokers’ strategies.
- Make a list of things that are important to you and aim to keep doing them after quitting. This might mean spending more time with friends or pursuing your own goals, like joining the track team.
Find helpful tools for quitting by clicking “Get help or find out more” below.
Tobacco QuitLine: American Lung Association
Abigail S. Friedman, PhD, assistant professor, department of health policy and management, Yale School of Public Health, New Haven, Connecticut.
Jessica K. Pepper, PhD, social scientist, Center for Health Policy Science & Tobacco Research, North Carolina.
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