Knowing whether smoking electronic cigarettes −better known as vapes− is better than smoking traditional tobacco cigarettes is the focus of researchers around the world who seek to understand if there are health damages associated with using these devices.

There are different models of vapes, but the fundamental difference between these and traditional cigarettes is that they do not burn the substance directly but rather have an atomizer and a battery to heat up and vaporize a liquid solution. Instead of smoking, consumers inhale aerosol or vapor.

The solutions generally contain nicotine, propylene glycol -an organic compound in the form of an oily liquid- glycerin, and different flavorings.

“In recent years, they have become very popular because they have different flavors, and you can inhale nicotine without the inconvenience of the aroma of a cigarette,” says Francisco Moreno, a pulmonologist at the Institute of Internal Medicine at TecSalud‘s Zambrano Hellion Hospital, in an interview with TecScience.

In addition, these devices are advertised as a healthier alternative to smoking than cigarettes or even as a tool to quit smoking.

However, the scientific evidence that exists so far points to the fact that vapes can also be dangerous to human health and that they are not the best therapy to treat nicotine addiction.

“We cannot say that vaping is better than smoking cigarettes because we know that it has harmful effects,” says Moreno.

Vapes Also Contain Toxic Substances

Modern electronic cigarettes were created in Beijing, China, by Chinese pharmacologist Hon Lik and introduced to the market in 2003. By 2006, they had already reached Europe, in 2007 in the United States, and around 2010, they irregularly arrived in Mexico.

“Because they have been on the market for a relatively short time, we still don’t know precisely their long-term effects,” warns Moreno. “It took researchers two or three decades to be able to prove that smoking tobacco is associated with cancer.”

Although evidence on these effects is still scarce, there is evidence that vaping is not harmless to health. A 2018 study from the University of North Carolina found that propylene glycol and glycerin are toxic to cells and that the more ingredients a vape has, the greater the toxicity.

Another recent study found evidence of 22 toxic substances, other than nicotine, present in these devices. Some of these are acetaldehyde, acrolein, and formaldehyde, which can cause lung and cardiovascular diseases.

Sometimes, they also contain acrolein, a herbicide that can lead to acute lung injuries, as well as COPD, asthma, and lung cancer.

“We know that vapes are possibly less toxic than traditional cigarettes, but that doesn’t mean they are safe or harmless,” says Moreno.

For children and adolescents, who may consume them because they are promoted as safe, vapes represent an additional threat, as there is evidence that they affect brain development.

Another important factor to consider is that in Mexico, vapes are currently not regulated, so it is difficult to know their nicotine dose. This puts smokers at risk, as the tolerance to this substance can easily be augmented.

“It is very easy to increase the dose of nicotine in electronic cigarettes or chewing gum because you don’t realize you are increasing it as much as you do when you smoke tobacco,” emphasizes the pulmonologist.

We Still don’t Know if They Really Help you Quit Smoking

On the other hand, whether they are an effective tool to quit smoking is still up for debate, as there is conflicting evidence on the matter.

In Sweden and other countries in the European Union, for example, governments have established tobacco addiction treatment protocols, using vapes as a bridge to help users finally kick their smoking habit.

In the United Kingdom, vapes have been the most popular tool for quitting smoking among those who have succeeded in doing so in the last five years. Around 2.7 million people have managed to quit this habit using vapes.

However, other studies have shown that vapes are not truly effective in treating this addiction. A study published in 2020 found that only 9.6% of 2,770 smokers who decided to quit had succeeded in the last year.

“In some countries, vaping is used as a bridge to quit smoking, but it is done with strict supervision and after having exhausted the usual strategies,” says Moreno. “It should be used as a temporary way to get the users to abandon nicotine consumption completely and not just change one smoking method for another.”

Currently, what often happens is that those who smoke vapes continue smoking cigarettes, increasing their nicotine consumption instead of reducing it, according to the expert.

Countries where vapes have served as a therapy for tobacco addiction usually have strict regulations to reduce the presence of toxic substances in them.

Thus, the evidence points to the fact that for them to help, they need to be used in a formal context of accompanied therapy, in addition to there being regulations to control what they contain.

But, the most important thing is to create awareness campaigns to inform citizens about the risks associated with smoking, whether they do so with a vape or a cigarette.

“As doctors, our role is to offer evidence-based information on the damage associated with this habit,” says Moreno.

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