Smoking cigarettes has known life-threatening health risks from lung cancer to throat cancer. Now, a growing number of people are taking up e-cigarettes, or vapes.
Is vaping less harmful than smoking? Or are we seeing the beginnings of a trend which might reveal negative effects in the decades to come?
The Cosmos team recently launched in its Debunks podcast a four-part series about vices. In Episode 2, “Is vaping better for you than cigarettes?” it spoke to experts and health professionals to help us understand the problems with vaping.
What is vaping?
“A vape is a device that creates a vapor out of a solution,” Professor Matthew Peters, a respiratory medicine expert from Macquarie University Hospital, tells Cosmos.
“They all contain vegetable glycerin and propylene glycol in a slightly variable combination. The majority contain nicotine in relatively high concentrations. In addition, there are a range of flavours and other additives designed to make it more pleasant to inhale the stuff.
“When the solution is standing still, there are reactions between the constituents.
“They generate compounds such as formaldehyde and other toxic aldehydes. That’s even before it gets into the mouth of a user. Then that whole solution with the original constituents, the altered constituents, and whatever flavours and other things are superheated. It’s the superheated mix which is exposed deeply to the lung of the user.”
Vaping vs. smoking
According to government statistics, the proportion of Australians over the age of 14 who smoke daily has more than halved in the last 30 years. It was 24% in 1991 and about 12% in 2023.
E-cigarettes are often marketed as way to help smokers quit. The majority of vapers are smokers. But it’s not just smokers and ex-smokers developing a vaping habit.
Rates of vaping among 14- to 17-year-olds are rising rapidly. Research published in the Medical Journal of Australia in 2023 indicates more than a quarter of teens have tried e cigarettes, up from 10% in 2019. About 6% say they are regular users.
Smoking rates in the same cohort are up too – rising to 13% in 2023 from 3% in 2019. With dual use – vaping and smoking – common among teens.
So, is there any evidence to suggest vaping can help end a smoking habit?
“There’s a lot of hype, often put around by people trying to sell these products, that it’s a game changer, that it’s just a revolutionary way of getting off smoking,” says Simon Chapman, a professor of public health at the University of Sydney.
“Randomised control trials show about 90% of people who are vaping are still smoking 6 to 12 months later. Real world results are even worse than that.”
Chapman says the method for quitting smoking which has the highest success rate is going “cold turkey.”
A cautionary tale
Matthew Peters says the chemicals in vapes may be doing harm to our bodies.
“Some are known toxins. And there’s almost an infinitely variable range of compounds that end up in vaping solutions. It’s the totality of the mix which is significant,” he says.
Both Peters and Chapman highlight the history of tobacco smoking as a word of warning.
“We can go back to the times when smoking really took off at the beginning of last century,” Chapman says. “We didn’t see any evidence of diseases like lung cancer in any significant numbers until 30, 40 years later.”
“Vaping has only been around in large numbers for not even 10 years. So, when someone says nobody has ever died from vaping, they’re displaying their ignorance about the epidemiology of chronic diseases. You don’t get chronic disease like respiratory disease, cardiovascular or cancer the next day, week, month, or even the next year. It starts manifesting decades later in serious ways. That’s what we may be looking at with vaping.”
Is vaping safe?
“I will not tell you whether vaping is safer, more dangerous, or the same thing. I will not tell you whether vaping is just as risky as smoking is safer, or is more hazardous? Because I don’t know. I would contend now that nobody knows,” Peters says.
But he suggests that advances in modern medicine should allow us to make decisions on vaping before it becomes a serious public health problem.
“There are clearly some emerging risks, unknown harms, but we have a wealth of basic science information. We should take advantage of that knowledge, not wait 20- or 30-years’ time, to have what we know now from basic science confirmed by people dying. It’s got to take something more insightful than watching our body count.”