Looking at the Research into the Long-Term Effects Of E-Cigarettes
Since the introduction of e-cigarettes, vaping has been surrounded by a cloud of misinformation. One of the biggest claims made by the anti-vaping lobby is that e-cigarettes are harmful to our health, and even that they are equally as harmful as smoking cigarettes.
However, recent months have seen growing recognition that e cigarettes should be looked on as a viable alternative to tobacco cigarettes. Last month, a group of UK MPs publicly advocated for the allowance of vaping in public spaces. Another manifestation of this can be in the recent relaxing of advertising restrictions around e-cigarettes.
In this article we examine the research and studies which have been conducted into the impacts of e-cigarettes and what evidence there is for any long-term, harmful effects of vaping when compared to combustible cigarettes.
No Conclusive Evidence
As a relatively new product on the market, it has been difficult to establish the long-term effects of e-cigarettes to date. E-cigarettes were invented in China in 2003 and introduced commercially into Europe and the UK in 2005. As a product which has only been used in the UK for a little over a decade, the long-term effects have not been seen by those who use them.
In recent years, however, scientific and medical studies have been conducted into the health impacts of vaping.
In early 2018 the US National Academy of Sciences released a report which looks at long-term health effects associated with vaping.
- The report stated that there is conclusive evidence that completely substituting e-cigarettes for combustible tobacco cigarettes reduces users’ exposure to numerous toxicants and carcinogens present in combustible tobacco cigarettes
- There is moderate evidence that second-hand exposure to nicotine and particulates is lower from e-cigarettes compared with combustible tobacco cigarettes.
- There is substantial evidence that except for nicotine, under typical conditions of use, exposure to potentially toxic substances from e-cigarettes is significantly lower compared with combustible tobacco cigarettes.
- There is moderate evidence that risk and severity of dependence are lower for e-cigarettes than combustible tobacco cigarettes.
- There is substantial evidence that completely switching from regular use of combustible tobacco cigarettes to e-cigarettes results in reduced short-term adverse health outcomes in several organ systems.
- While the overall evidence from observational trials is mixed, there is moderate evidence from observational studies that more frequent use of e-cigarettes is associated with an increased likelihood of cessation.
The full report can be found here.
A Healthier Alternative Than Smoking
Additional reputable studies from major institutions have shown that e-cigarettes are indeed a good alternative when compared to smoking tobacco.
UK government agency Public Health England released a review in 2015 which showed that e-cigarettes are 95% less harmful than tobacco products. Furthermore, the review recommended that the National Health Service (NHS) should consider prescribing e-cigarettes as a way to help smokers to help.
Another study, published in 2017 in the peer reviewed journal, the Annals of Internal Medicine compared smokers and ex-smokers who were now using e-cigarettes. The study showed that those who were no longer smoking cigarettes but now using e-cigarettes tested for significantly lower levels of toxic chemicals and carcinogens.
The results came from tests of breath, saliva and urine samples from 181 participants, and compared levels of harmful chemicals for current smokers who had smoked an average of five or more cigarettes per day for at least six months, with former smokers who had ceased smoking tobacco at least six months prior.
The study found that former smokers using e-cigarettes only showed much lower levels of the two main carcinogenic chemicals found in cigarette smoke, TSNAs and VOCs. This group also showed a 97% reduction in the toxic chemical NNAL (a by-product of exposure to TSNAs) compared to the cigarette smokers.
Controls and Regulations
There have been concerns expressed by experts of the chemicals which may be emitted from e-cigarette vapour, depending on the composition of the e-liquid.
Standard e-liquid is composed of Vegetable Glycerine (VG), Propylene Glycol (PG) and Nicotine. VG in a non-toxic liquid commonly found in foods as a sweetener, preservative or thickening agent, which turns into vapour when heated in the e-cigarette.
PG is commonly used as a vaporiser in products such as inhalers.
The concern with harmful chemicals in e-liquid is linked to the potential presence of other chemicals in vaping liquid. In the UK, vaping products are governed by the Tobacco Products Directive (TPD), meaning consumers can be confident in the quality and purity of the e-liquid they vape.
The TPD regulations protect consumers with a range of enforceable guidelines relating to the production and sale of e-cigarettes and accessories, including specifics such as e-liquid composition.
E-cigarettes are a relatively new product, and therefore information and evidence is still emerging when it comes to long-term health effects.
While it cannot be said e cigarettes are without health risks recent studies from well-regarded institutions have consistently shown that they are far less harmful than tobacco products.