But there is a lot of confusion over whether these smoking alternatives are better, worse, or the same for your health as the kind of cigarettes that famously dangled from the lips of smokers from James Dean to Leonardo DiCaprio. Because the devices are so new, researchers are still in the process of discovering the long-term health effects of this high-tech habit, but here’s what we know right now:
First of all, what is vaping?
There are several different types of e-cigarettes, including vape pens, tanks, and the extremely popular JUUL, which looks like a flash drive, making it easy to hide from unsuspecting parents and teachers. What they all have in common is a battery-powered heating element; when you add a liquid containing nicotine, flavorings, and other chemicals, the heat converts the liquid into an aerosol or “vapor” (hence the name vaping), which is then inhaled directly into the lungs. Though Christy Sadreameli, MD, a pediatric pulmonologist at Johns Hopkins University School of Medicine and a spokesperson for the American Lung Association, takes issue with the very name vaping. “People hear that it’s a vapor and they think of water vapor,” she says. “But water vapor is benign, and we don't think that the vapor from these products is benign.”
Is vaping healthier than smoking regular cigarettes?
This is a somewhat loaded question: For adults who are already addicted to cigarettes, switching to vaping can be a healthier move, says Vaughan W. Rees, PhD, director of the Center for Global Tobacco Control at the Harvard T.H. Chan School of Public Health — though of course it is far less healthy than not smoking at all. “We want to try to prevent the use by young people, while also allowing adult smokers the ability to switch to e-cigarettes, which will create better health outcomes,” he explains.
Let’s start off with the fact that smoking traditional cigarettes is one of the most dangerous things you can do to your body — one large study showed that regular cigarette smoking chops an entire decade off your life expectancy by increasing your risk for cancer, cardiovascular disease, and respiratory disease. And though e-cigarettes are too new to have any long-term health data, they do seem to be less deadly than a regular old pack of Marlboros.
The difference is in how the tobacco is converted to an product that can be inhaled, says Dr. Rees. “Cigarettes are harmful when the tobacco is combusted,” he explains. When you light a match and set fire to tobacco, “there is a mix of thousands of toxic chemicals, including at least 60 known carcinogens, that you inhale deeply into the lungs, which increases your risk of cardiovascular disease and respiratory problems and does damage throughout all the organs.”
Vaping products, on the other hand, don’t contain the byproducts of combustion, Dr. Rees adds. “They’re not free of health risks,” he warns. “But the risks are greatly reduced.”
Of course, vaping has created a whole set of alarming, previously unseen risks: Thousands of people have become seriously ill because of vaping, and dozens have died from what is now being called e-cigarette, or vaping, product use associated lung injury (EVALI).
The more we learn about e-cigarettes, the more risks we discover. The aerosol that gets inhaled so deeply into your lungs (where it then enters the bloodstream and travels to the brain) contains a whole slew of substances in addition to nicotine, including volatile organic compounds such as benzene, formaldehyde and acetaldehyde, which can cause lung disease, plus ultra-fine particles and heavy metals including nickel, lead, and tin, says Dr. Sadreameli.
Even the flavors — think pineapple, watermelon, mango, and other kid-friendly choices — may cause damage to an extent as yet unknown, says Dr. Sadreameli. “People are inhaling these flavors in very high concentrations, and in many ways it’s unprecedented,” she explains. One study found that a chemical called diacetyl was present in 39 out of 51 e-cigarette flavorings that were tested. Diacetyl has been linked to a serious lung disease called bronchiolitis obliterans, also known as “popcorn lung” because it was found in workers who inhaled butter flavoring in a factory that produces microwave popcorn. While these chemicals are considered safe when eaten, they are not meant to be inhaled into the lungs, Dr. Sadreameli explains.
Recent studies have also shown that e-cigarettes almost double your risk of a heart attack (when compared with non-smokers), as well as increasing inflammation of the lungs and bronchitis-like symptoms. And then there are the risks that are unique to the battery-heated-liquid devices: There have been several reported cases of e-cigarettes exploding, causing severe burns and facial damage. In addition, if those fruity-flavored liquids are swallowed — a particular risk if small children find them — they can cause nicotine poisoning, which can lead to nausea, vomiting, seizures, and even death.
Another danger:
The main concern about vaping, and specifically about JUULing, is that it is a trend that has spread like wildfire among young people, says Dr. Sadreameli. A recent study in the New England Journal of Medicine found that vaping is now the single most popular form of tobacco use among adolescents. In fact 25% of high school seniors reported vaping in the past month, along with 20% of 10th graders, and nearly 10% of 8th graders.
Not only are these kids dealing with the risks of vaping at a very crucial time in their development, but there is concern that they will move on to smoking traditional cigarettes. A study in Pediatrics found that kids aged 12 to 17 who used e-cigarettes were more than twice as likely to move on to smoking old-school combustible cigarettes as kids who never vaped.
The bottom line: If you’re addicted to nicotine and are looking for a way to step down from the massive health risk of combustible cigarettes — and you’re not pregnant — vaping is a viable alternative. But better yet, look here for ways to quit smoking altogether. But if you are just curious about vaping, consider this: Nicotine is a highly addictive substance, and once you start vaping, you may start looking for other ways to get that buzz; even if you just stick with e-cigs, you will be putting your health at greater risk than not smoking or vaping at all. All bad habits are hard to break, so why even start?