The Three Big Questions About E-Cigarettes

The Three Big Questions About E-Cigarettes
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The rapid rise of e-cigarettes has left many worried vaping will rewind society's progress against the public health dangers of smoking. Underlying these concerns are three key questions. Today, we answer them:

1. Are E-cigarettes safer than normal cigarettes?

Yes. After years of research, there's little doubt that e-cigarettes are far safer than normal cigarettes. Joining the consensus are organizations like the National Academies of Sciences, Engineering, and Medicine, Cancer Research UK, and the British Medical Association. By replacing combustion of tobacco with vaporization of nicotine salts and chemical flavoring, long-term health risks are greatly reduced. Cancer risk from vaping could be as little as one percent of the cancer risk from smoking. Passive exposure to e-cigarette vapor is far less harmful than secondhand smoke. One study found that 3.5 years of daily e-cigarette use did not appear to damage the lungs of vapers in their twenties and thirties.

While e-cigarettes are unquestionably safer than cigarettes, they are not without health risks. Potential side effects include coughing, dehydration, sore throat, headaches, nausea, stomachaches, and, of course, nicotine addiction. Regular nicotine use can hinder brain development in adolescents and is especially harmful to developing fetuses.

2. Can E-cigarettes help people quit smoking?

Probably. There aren't a lot of randomized, controlled trials to evaluate thus far, but those that have been conducted show vaping to be an effective way for smokers to quit tobacco and transition to a far safer product. One study found e-cigs to be at least 1.6 times more effective than over-the-counter nicotine replacement therapies at getting smokers to quit. Moreover, in a large survey commissioned by e-cig maker JUUL of their online buyers, half who admitted to being daily or non-daily smokers prior to purchase reported that they had quit smoking completely as a result of vaping. However, this intriguing result is likely affected by sampling bias. The Food and Drug Administration now recognizes that e-cigs can "provide a potentially less harmful alternative for currently addicted individual adult smokers who still want to get access to satisfying levels of nicotine without many of the harmful effects that come with the combustion of tobacco."

3. Are E-cigarettes a gateway to smoking for teens?

Maybe. Reviews show that teens who've vaped are more inclined to try normal cigarettes, but it remains to be seen if they actually are more likely to become long-term users of tobacco products. A large survey of teenagers in the UK found that "most e-cigarette experimentation does not turn into regular use."

Per the Centers for Disease Control, the rates of high schoolers smoking cigarettes or using any smoking product – including e-cigarettes – are at their lowest levels ever recorded. Fewer than eight percent of high school students smoked cigarettes in 2016, down from a high of 36.4% in 1997! Roughly one out of nine high schoolers have tried e-cigs, and that proportion has remained steady for the past few years. If vaping is a gateway to smoking, it doesn't seem – thus far – to be a very good one, but the data could change quickly as the market takes off.

Teenagers are not permitted to purchase e-cigarettes or normal cigarettes. Retailers and e-cig makers should be required to institute measures to prevent teens from acquiring their products. Still, many kids invariably get their hands on the products anyway. The situation recently prompted citizens of San Francisco to vote to ban the sale of flavored vaping liquids and tobacco products so that teens would be less tempted to try them. It remains to be seen if the ban will be effective.

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