Cigarettes, along with processed foods, water treatments, and pesticides used in farming, represent a massive leap of faith by the public, both in governments and in the industries surrounding the chemicals we ingest or inhale. Chemical compounds in these products and their effects are often unknown to us or not fully understood — and most of us use, eat, drink, or smoke these products hoping that our ignorance won’t kill us more quickly than curiosity killed the cat. Cigarettes are the most infamous in this list of dubious ingestibles and combustibles for their detrimental and sometimes deadly effects, but are e-cigarettes — and specifically e-liquids used in vaping — any safer than cigarettes?
Compared to some other products we use or consume regularly, the main ingredients in e-liquids, the mystical mist that vapers inhale and exhale, are better understood — but that’s assuming we know the true ingredients. For example, according to the CDC, some e-liquids which have been labeled and sold as 0 mg nicotine have been found to contain nicotine. It’s plausible that some liberties are taken in labeling by some e-liquid manufacturers and that some quality control issues may exist. Of course, recipes used to create unique flavors are trade secrets, so the exact ingredients and concentrations used in flavorings becomes a cloudy topic. However, flavorings are a small part of e-liquid. Most of the content in e-liquid is the unflavored base, a mix of Vegetable Glycerin (VG) and/or Propylene Glycol (PG).
What’s Diacetlyl, and Should I Care?
Among the most mentioned concerns in e-liquid ingredients is diacetyl, a flavoring agent used in foods which along with acetyl propionyl, another flavoring agent, is safe to ingest — but may pose risks if inhaled. In 2002, the CDC documented cases of 8 workers in a microwave popcorn plant who contracted a lung condition due to inhaling massive quantities of diacetyl which was used in powder form to flavor the popcorn.
While it’s likely safer to avoid inhaling diacetyl and similar agents altogether, in any form, it’s worth noting that according to industry sources, cigarettes contain over 100 times the amount of diacetyl found in e-liquid.
Is Vaping Safer than Smoking?
We all know prolonged smoking is unhealthy and sometimes deadly. Cigarette smoking is responsible for nearly half a million deaths each year in the U.S. — one in five deaths. In fact, smoking can be a contributing factor in four of the top five causes of death, including heart disease, cancer, lung disease, and strokes. Figures from the CDC indicate that over 40,000 deaths per year are due to secondhand smoke, included in the half million annual deaths attributed to smoking.
Vaping, being just over a decade old in its modern e-cig incarnation, doesn’t yet register on the death toll richter scale — perhaps because vaping is too new to have caused many deaths, or perhaps because it just doesn’t cause many deaths — or any at all. The long-term health effects of vaping aren’t yet fully known and early reports, while many are promising, seem to create more confusion than clarity because they aren’t always in agreement or are reported in a way that promotes the agenda of an individual or group.
Wait, Don’t E-Cigs Explode?
While the type of heart and respiratory health concerns seen with cigarette smoking aren’t evident with vaping yet, there have been some well-publicized injuries due to exploding vape mods. In many of these cases, a damaged battery or a short circuit in an unregulated device without adequate venting — or a device modified by the user — has been blamed for the explosive mishaps. Similar battery overheating occurrences have happened with popular cell phones, like Samsung’s Note 7, or with laptops.
Unlike phones and computers, which are usually well-vented, the big danger presented by some vaping devices is poor ventilation, meaning that a short circuit that causes battery overheating leaving building heat and pressure no quick way to escape. As pressure builds inside the battery chamber, the risk of catastrophic device failure and its resulting injuries becomes more likely. Hands and faces tend to take the brunt of injuries because the device is being held near the mouth and the pressed fire button is triggering the short. Regulated devices, which have circuitry to automatically prevent the device from firing if there is a short, help to reduce the risks more commonly found with unregulated devices, essentially a battery in a metal tube with a switch.
There are safety risks with any electronic device, a fact we tend to forget as we press phones to our ears and peck away at laptops or tablets sitting on out laps or held in our hands. Putting electronic risks aside to look at other health considerations, a new study documented by The National Center for Biotechnology Information supports the assertion in a separate report published in 2015 by Public Health England, which states that e-cigs are 95% less harmful than tobacco. The 2015 report from Public Health England measured toxic chemicals found in atomized e-liquids, finding considerably fewer toxic chemicals and carcinogens and much lower concentrations than found in cigarettes. It’s important to note that while lower risks were found, risks may still exist because of the presence of toxic chemicals.
Health concerns about secondhand vapor begin to safely dissipate, according a study crowdfunded by The Consumer Advocates for Smoke-free Alternatives Association (CASAA). Vapor exhaled by vapers does have harmful components, but in concentrations so small that they are benign. Of greater concern to the vaping community is the consideration of the community itself toward others. Non-vapers generally don’t want to walk through clouds of vapor or have it breathed in their faces. Because exhaled vapor is usually much thicker than cigarette smoke, the clouds caused by vaping continue to be irksome to many, likely adding to vaping’s difficulty in gaining wide public acceptance.
Another study looked at the effects of vaping when compared to smoking for asthma sufferers. The study found improved lung function in patients who switched from smoking to vaping or who reduced smoking to favor vaping. However, the study did call for additional controlled trials to expand and confirm its observations, which it called preliminary.
The Smell of Formaldehyde in the Morning
Vaping safety alarms sounded in the press when a report published by The New England Journal of Medicine (NEJM) in 2015 pointed to formaldehyde in e-liquid vapor, stating propylene glycol, a common base in e-liquids and liquid flavorings could degrade to formaldehyde when a exposed to heat. A group of 40 academics quickly responded with a letter to the NEJM asking for a retraction of the published report, citing unrealistic laboratory conditions, including temperatures not reached by e-cig vaporizers and which would cause the device to fail instantly, producing little or no vapor.
Public perception of vaping continues to be a challenge, with government agencies making new laws to curb or regulate the poorly-understood activity faster than e-liquid and hardware manufacturers can invent new flavors and vaping products. Among the most ominous of these regulatory efforts were the rules introduced by the FDA in 2016 which subjected all new vaping products and e-liquids to the same lengthy approval times as regular cigarettes, a move that threatened to kill the fledgling vaping industry and which created confusion for customers and retailers alike. In July of 2017, the FDA shifted its stance, loosening some restrictions and choosing to focus its efforts on reducing the use of combustible cigarettes and tobacco.
Vaping has proven to be a viable alternative for smokers wanting to kick the cigarette habit, sometimes referred to by ex-smokers as “stinkies”, due to the strong, acrid odor of cigarettes which becomes more noticeable after quitting smoking. With the long-term effects of smoking well known and its cost measured in both dollars and lives, vaping is becoming a refuge for ex-smokers seeking a safer way to find the pleasure they experienced from smoking without all the known health risks. The risks of vaping itself are still not fully understood, but early studies suggest vaping is much safer than smoking. As interest in vaping continues to grow, more data points and additional studies will help to clear the lingering fog surrounding vaping safety.