SWISS MEDICAL EXPERTISE: MALLORCA, ZURICH, LONDON, OFFSHORE

14 Minutes

Edited & medically reviewed by THE BALANCE Team
Fact checked

Vaping in the UK has become a topic of significant public health interest, with debates oscillating between its efficacy as a smoking cessation tool and concerns about its potential health risks. 

E-cigarettes, commonly known as vapes, are devices that heat a liquid into a vapour, which is then inhaled. The liquid usually contains nicotine, flavourings, and other chemicals. While e-cigarettes don’t contain tobacco—the primary carcinogen in traditional cigarettes—they are not free from harmful substances. 

Various studies and health organisations, including Cancer Research UK, have pointed out that, although vaping is considerably less harmful than smoking, it is not devoid of risks. Vaping devices are known to contain potentially harmful chemicals, albeit in levels generally lower than those found in tobacco cigarettes. These substances can cause side effects like throat and mouth irritation, coughing, headache, and nausea. Importantly, the long-term health effects of vaping are still under investigation, emphasising a cautious approach to their use, especially among non-smokers and young people.

Vaping, the act of inhaling vapour produced by an e-cigarette or similar device, has emerged as a popular alternative to smoking traditional tobacco cigarettes. These devices work by heating a liquid, which typically contains nicotine, propylene glycol, glycerin, and flavourings, to create an aerosol that the user inhales. Despite being marketed as a healthier option than smoking tobacco cigarettes due to the absence of tobacco smoke, vaping is not without its dangers and health risks.

E-cigarettes have been touted as tools to help quit smoking, appealing to those looking to stop smoking tobacco cigarettes. While they contain fewer toxic substances compared to the 7,000 chemicals found in tobacco smoke, they are not risk-free. Vaping still introduces the user to nicotine, a highly addictive substance also found in traditional cigarettes, along with a range of potentially harmful substances including carcinogens like acetaldehyde and formaldehyde, lung disease-causing chemicals such as acrolein, diacetyl, and diethylene glycol, as well as heavy metals like nickel, tin, lead, and cadmium.

The health risks associated with vaping include:

  • Lung and organ damage
  • Breathing problems
  • Addiction

Nicotine, whether inhaled from tobacco smoke or e-cigarette vapour, raises blood pressure and spikes adrenaline, which can increase the risk of having a heart attack. Furthermore, vaping has been linked to chronic lung diseases, asthma, cardiovascular disease, and other severe conditions.

Does vaping help with stopping smoking?

The FDA has not approved e-cigarettes as smoking cessation devices, and studies indicate that individuals who use e-cigarettes to quit smoking often end up using both e-cigarettes and tobacco cigarettes. Moreover, there is concern about e-cigarettes potentially leading non-smokers, particularly youth, to nicotine addiction and subsequently to smoking tobacco cigarettes.

Research is ongoing to fully understand the long-term health effects of vaping. While some studies suggest that vaping might be less harmful than combustible cigarettes for individuals who switch completely from tobacco smoking, nicotine in any form is addictive and can prime the brain’s reward system, increasing the risk of addiction to other drugs. Additionally, vaping exposes the lungs to a variety of chemicals, some of which are known carcinogens and toxic chemicals.

Given the addictive nature of nicotine and the health risks associated with vaping, individuals who do not currently use tobacco products are advised against starting to vape. For those looking to quit smoking, proven smoking cessation methods recommended by health authorities should be considered.

One of the major concerns with vaping is the exposure to potentially harmful chemicals. Research has identified the presence of carcinogens like acetaldehyde and formaldehyde, lung disease-causing agents such as acrolein, diacetyl, and diethylene glycol, and heavy metals like nickel, tin, lead, and cadmium in e-cigarette vapour. Diacetyl, for instance, is linked to a condition known as “popcorn lung” (bronchiolitis obliterans), which causes permanent scarring of the lung’s tiny airways, leading to breathing difficulties.

Moreover, vaping can cause lung and organ damage, breathing problems, and conditions like EVALI (e-cigarette, or vaping, product use-associated lung injury), a severe lung condition that has caused numerous hospitalizations and fatalities. 

Symptoms of EVALI include:

  • Coughing
  • Shortness of breath
  • Chest pain
  • More severe outcomes like lung collapse and cancer

Recent statistics indicate a significant uptick in vaping among the youth. 

  • In 2023, 20.5% of children aged 11-17 had tried vaping, marking a considerable increase from 15.8% in 2022. 
  • The rise in vaping experimentation among children (those trying once or twice) surged by 50% year-on-year, from 7.7% in 2022 to 11.6% in 2023.
  • Adult vaping prevalence in England also reflects this trend, with data showing an increase to 8.3% in 2022. 
  • The increase in vaping is not isolated to any specific demographic but is evident across various age groups and socio-economic statuses. Despite the higher smoking prevalence among adults from more disadvantaged groups, vaping prevalence appears to be lower than smoking across all demographics. Tank models remain the most popular vaping device among adult users.

The health implications of vaping have been extensively reviewed, with findings suggesting that vaping poses a small fraction of the risks of conventional smoking in the short to medium term. However, vaping is not risk-free, particularly for those who have never smoked. The most robust evidence comes from biomarkers of exposure, showing significantly lower exposure to harmful substances from vaping compared to smoking. Despite this, the public perception of vaping’s harm relative to smoking has not fully aligned with scientific findings, highlighting a need for continued education and awareness.

Efforts to address vaping, especially among young people, include enforcing age-of-sale regulations for vaping products and cigarettes. Additionally, the increasing popularity of disposable vaping products among the youth calls for improved regulatory oversight and investigation into the marketing strategies targeting this demographic.

Overall, while vaping offers a less harmful alternative for adult smokers looking to quit smoking, the public health community remains vigilant about the potential risks associated with vaping, especially among young people and non-smokers. Continuous monitoring, research, and regulation are essential to mitigate these risks and prevent the renormalization of smoking behaviours.

Serious concerns have been raised regarding the long-term health effects of vaping. Research links vaping to heart, lung, and neurological injuries, which could cause long-term problems. For instance, chronic users of e-cigarettes may experience impaired blood vessel function, potentially increasing their risk for heart disease. This risk is compounded for individuals who use both e-cigarettes and traditional cigarettes.

As mentioned, one of the most severe vaping-related conditions identified is EVALI (e-cigarette or vaping product use-associated lung injury), characterised by symptoms that can mimic the flu or other respiratory conditions. Patients may require mechanical ventilation to breathe, and there have been fatalities associated with this condition. While the incidence of EVALI peaked in 2019, healthcare providers remain vigilant.

The use of e-cigarettes, particularly among youth, has surged, with flavoured e-cigarette products being particularly appealing. This rise in “youth vaping” has led to concerns about renormalising smoking behaviours and establishing new nicotine dependencies among a demographic that might not otherwise have engaged with tobacco products. The potential for vaping to lead to other serious illnesses, similar to those associated with traditional smoking, won’t be fully understood for decades due to the relatively recent introduction of e-cigarettes into the market.

Ultimately, while vaping may offer a reduction in exposure to the tar and carbon monoxide found in cigarette smoke, it introduces its own set of risks and health effects, including potential damage to the heart, lungs, and blood vessels. Public and healthcare professionals are urged to consider these factors and continue supporting research into the long-term impacts of vaping products.

People vape for a variety of reasons, ranging from attempting to quit smoking to being drawn to the social and competitive aspects of vaping culture. Here are the primary reasons:

  • The belief that vaping is a safer alternative to smoking tobacco (due to absence of harmful chemicals produced by burning tobacco in cigarettes)
  • The wide array of e-liquid flavours available is another significant draw for many vapers.This variety not only helps ex-smokers transition away from tobacco but also caters to broad tastes.
  • Vaping is seen as a way to reduce exposure to harmful chemicals found in cigarette smoke, potentially lowering the risk of developing related health problems. Some people who switch to vaping report improved senses of smell and taste, further enhancing their quality of life. 
  • In the long term, vaping can be more cost-effective than smoking, appealing to those looking to save money.

However, there risks associated with vaping outweigh the costs, including health risks like lung damage and other respiratory problems. The devices’ batteries can be volatile, posing a risk of exploding and causing injury. Moreover, e-cigarettes contain nicotine, an addictive substance that can lead to dependency, whether users are transitioning from smoking or starting fresh with vaping. The lack of regulation in the vaping industry adds another layer of potential harm, with the possibility of harmful chemicals present in some products.

It’s clear that informed choices are crucial. Understanding the potential harm and benefits can help individuals make decisions that best suit their health and lifestyle needs. Whether used as a tool to quit smoking or for recreational purposes, vaping is a complex phenomenon that requires careful consideration of its effects on health and wellbeing.

The symptoms of nicotine addiction from vaping are primarily physical and emotional.

Withdrawal symptoms 

These are a key aspect of nicotine addiction and can vary widely among individuals. Common symptoms include:

  • Irritability
  • Restlessness
  • Sadness
  • Anxiety
  • Difficulty concentrating
  • Intense cravings for e-cigarettes

Physical symptoms

Individuals may experience:

  • Headaches
  • Fatigue
  • Trouble sleeping
  • Increased hunger

The severity and combination of these symptoms can make the process of quitting vaping particularly challenging.

Managing nicotine withdrawal requires seeking help from healthcare professionals, staying hydrated, prioritising sleep, and reaching out for support from friends and family.

For those looking to quit, local stop smoking services offer resources and support tailored to help manage the unique challenges posed by vaping and nicotine dependence.

Treatment options for nicotine addiction focus on reducing withdrawal symptoms and helping individuals quit vaping and smoking. These treatments are vital, especially considering the health risks associated with smoking, such as chronic obstructive pulmonary disease, lung cancer, cardiovascular disease, and the harmful chemicals found in tobacco smoke and e-cigarette vapour. 

Nicotine Replacement Therapy (NRT)

This is widely used and includes products like gums, patches, inhalers, and lozenges. These products supply the body with nicotine at lower doses than cigarettes, aiming to ease the process of quitting by reducing cravings and withdrawal symptoms. 

Prescription medications

Medications such as Bupropion and Varenicline offer additional options. Bupropion works by lowering the brain’s absorption of dopamine and norepinephrine, helping to reduce cravings and the pleasurable effects of nicotine. Varenicline targets nicotine receptors in the brain, reducing cravings and the rewarding effects of smoking. Some studies have found Varenicline to be more effective than NRTs.

Behavioural therapies

These are often recommended alongside NRTs and medications. 

Cognitive Behavioral Therapy (CBT): This helps individuals identify triggers and develop coping strategies.

Motivational Interviewing (MI): This addresses ambivalence about quitting, and mindfulness techniques can help manage cravings and emotional responses without relying on nicotine. 

Other valuable resources for people trying to quit vaping include: 

  • Support groups
  • Quit lines
  • Mobile apps 

While these treatments can significantly aid in quitting nicotine, it’s crucial to consult with healthcare providers to determine the most appropriate strategy based on individual needs and health conditions. Support from family, friends, and local stop smoking services can also play a crucial role in successfully quitting nicotine.

Each treatment option has potential side effects, and it’s important to discuss these with healthcare providers. For example, NRTs can cause skin irritation, sleep disturbances, and gastrointestinal issues, among others. Being informed and prepared for these possibilities can help individuals manage their nicotine dependence more effectively.

In conclusion, a combination of NRTs, prescription medications, and behavioural therapies offers a comprehensive approach to treating nicotine addiction. By understanding the available treatments and seeking professional guidance, individuals can find the support they need to quit smoking and vaping, significantly improving their health and quality of life.

Vaping has been surrounded by myths and misconceptions, particularly regarding its comparison with conventional smoking and its health implications. 

“Vaping is just as harmful as smoking”

UK experts in 2022 reviewed international evidence and found that vaping poses only a small fraction of the risks of smoking. Unlike cigarettes, which release thousands of harmful chemicals, including tar and carbon monoxide, most of these chemicals are not present in vape aerosol. People who switch from smoking to vaping significantly reduce their exposure to toxins associated with cancer, lung disease, heart disease, and stroke.

“Nicotine, the addictive substance in e-cigarettes, is very harmful to health.” 

While nicotine is indeed addictive, it’s relatively harmless in terms of causing diseases like cancer, lung disease, heart disease, or stroke. It’s the other toxic chemicals in tobacco smoke that cause the vast majority of harm from smoking.

“Vaping is a smoking cessation tool” 

Another myth is that vaping is the best option for those looking to quit smoking. While some find vaping helpful due to its similarity to the act of smoking, health experts suggest exploring all options, including FDA-approved cessation aids, as e-cigarettes have not been approved as smoking cessation devices by the FDA. Studies show mixed results regarding their effectiveness in helping smokers quit, with some people continuing to use both traditional and e-cigarettes.

“Vaping is completely safe and e-liquids are well-regulated”

Although vaping is considered less harmful than smoking, it is not without risk. The inhalation of propylene glycol and vegetable glycerin, common bases for e-liquids, is generally safe for ingestion but their effects when inhaled are not fully understood. Additionally, some flavourings used in e-liquids are harmful when inhaled, and the industry lacks comprehensive regulations on e-liquid contents, leading to potential exposure to contaminants.

“Vaping is not as appealing to young people as smoking is”

The belief that vaping is not as appealing or harmful to youth is incorrect. E-cigarettes are more popular among youth than traditional tobacco products, with a significant number using flavoured e-cigarettes. This has led to concerns about a new generation becoming addicted to nicotine, which could potentially lead them to traditional tobacco use later on.

“Vaping has no health risks”

Despite some beliefs to the contrary, vaping poses several health risks. It can exacerbate asthma and lead to lung conditions like bronchiolitis obliterans (popcorn lung), caused by certain chemicals in flavourings. Nicotine and other substances in e-liquids can also harm the heart and brain, and there’s a risk of developing EVALI (e-cigarette or vaping product use-associated lung injury), a serious condition linked to vaping.

“E-cigarettes do not contain much nicotine”

Many people underestimate the amount of nicotine in vape products. The nicotine in one small vaping pod can be as much as a whole pack of cigarettes or more, posing a significant risk of nicotine addiction and associated health issues.

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