This story was originally published by Knowable Magazine
By Viviane Callier
They’re less toxic than traditional cigarettes but still addictive and not without their own health risks. Researchers disagree on whether vaping can help or harm efforts to reduce tobacco use.
In 2003, Chinese pharmacist Hon Lik created the first commercially successful electronic cigarette. Motivated by the death of his father, who was a heavy smoker and died of lung cancer, Lik had a simple concept: to separate nicotine delivery from the carcinogens in cigarettes. Instead of burning tobacco, his device vaporized a nicotine-containing liquid, thus creating smoke-like vapor that could be inhaled.
In 2006, e-cigarettes were introduced in Europe and the US. Uptake has been rapid among adults and youth alike. According to the Centers for Disease Control and Prevention, in 2016, more than 2 million US middle and high school students had used e-cigarettes in a 30-day period, and 3.2 percent of US adults (approximately 10.4 million) were current users. Because e-cigarettes don’t burn tobacco, but simply heat a liquid until it vaporizes, users refer to “vaping” rather than “smoking,” and there is a widespread perception that e-cigarettes are less damaging to users’ health than conventional cigarettes. But are they right?
Early on, in the absence of any scientific studies of e-cigarettes’ potential harm, some scientists and advocates adhered to the “precautionary principle” — that is, “until we have more science, we don’t know what to do about this and we ought to be very careful because it’s got nicotine in it and we don’t know what harm the aerosol has,” says clinical health psychologist David Abrams of the New York University College of Global Public Health. That, he believes, is no longer the case today.
The body of research on the safety and public health impacts of e-cigarettes has grown substantially in recent years, but important questions have yet to be answered. In fact, two very different interpretations have emerged among the scientists who study e-cigarette use.
On the one hand, some researchers argue that e-cigarettes are an obvious win for public health. “The e-cigarette is just the beginning of a proof of principle of what I regard as a potential disruptive technology that literally could make cigarettes obsolete and save lives,” by helping smokers quit, says Abrams.
On the other hand, studies suggest that e-cigarettes may be depressing quitting rates and creating a gateway to traditional cigarettes, especially among young people. For these reasons, “we would be way better off if they didn’t exist,” says tobacco control scientist Stanton Glantz of the University of California, San Francisco.
The controversy is based on three principal issues: whether e-cigarettes are safe; whether they help or undermine attempts to quit; and whether they expand the nicotine market by attracting youth who otherwise might not ever light up, thus functioning as a gateway to traditional cigarettes.
Fewer carcinogens doesn’t mean safe
Because e-cigarettes don’t deliver the tar and carcinogens that traditional cigarettes do, users largely believe that they are a much safer nicotine delivery product. Indeed, studies show that e-cigarettes release fewer harmful chemicals, such as hydrogen cyanide and carbon monoxide (two of the more than 7,000 chemicals in tobacco smoke). So they may be a more effective way to reduce tobacco use — and prevent lung cancer — than current quitting aids.