Are e-cigarettes harmful or not?
The current study situation is still too sparse to be able to assess exactly how harmful e-cigarettes are to health. In particular, it is not yet possible to say with certainty what long-term damage the consumption of e-cigarettes can have on health. The products have not been on the market long enough for that.
But they are not harmless – scientists and experts already agree on this.
Toxic vapor
Most liquids contain nicotine, which damages the heart, brain and lungs. It also promotes the development of cancer. Although the alkaloid is limited to 20 milligrams per milliliter as a liquid additive in Germany, this does not change the harmful effects on health.
Scientists attribute further damage to health caused by e-cigarettes to chemicals such as glycerine and propylene glycol. As food additives E 1520 and E 422, these are harmless. Under heat, however, they form aldehydes such as formaldehyde and acrolein, which are toxic in higher concentrations.
This means that even e-cigarettes without nicotine are not harmless.
In terms of oxidative stress, inflammation and endothelial function, they could even be more harmful than e-cigarettes with nicotine.
E-cigarettes – physical consequences
E-cigarettes have multiple harmful effects on the body:
Effects on the respiratory tract
Nicotine from e-cigarettes also has long-term effects on the lungs. It impairs the self-cleaning of the airways. As a result, a cough typical of smokers can also occur when using e-cigarettes: This is how the lungs try to get rid of the pollutants that accumulate.
Vaping also damages the lungs, according to a 3-year US longitudinal study. Compared to non-smokers, e-cigarette users have a 1.3 times higher risk of respiratory diseases such as chronic bronchitis, asthma, emphysema and COPD. This also applied to users who had not previously smoked.
For cigarette users, however, the risk was 2.6 times higher than for non-smokers and was therefore twice as high.
Effects on the heart and blood vessels
Even a single vaping episode (one-time use of an e-cigarette) is enough to increase the heart rate, make the arteries stiffer and impair the function of the endothelium. The latter is the cell layer on the inside of the blood vessels that is responsible for their dilation and constriction and also controls inflammation and blood clotting processes.
According to recent studies, the consumption of e-cigarettes increases the risk of
- heart attack (by around a third),
- coronary heart disease (by around a quarter) as well as for
- stroke and
- vascular occlusions.
E-cigarettes and cancer
E-cigarettes promote skin problems and allergies
As vapor has the property of attracting water molecules in its environment, e-cigarettes can cause skin problems such as dry flaking or redness and dry out the mouth. The ingredients in the liquids can also trigger allergies.
Deaths in the USA
In the USA, numerous unexplained lung diseases and even deaths have occurred following the consumption of e-cigarettes.
Vitamin E acetate – an oily liquid obtained from vitamin E that can be dangerous when vaporized due to its molecular structure – is believed to be the cause. Products containing the intoxicating cannabis active ingredient THC are also said to have played a role.
Are e-cigarettes healthier than tobacco cigarettes?
Many smokers hope to reduce their health risks by switching to e-cigarettes. In fact, only conventional cigarettes burn tobacco. The smoke contains numerous carcinogenic, toxic substances that pose a risk of illness and death.
These do not exist with e-cigarettes. The liquid vaporizes at lower temperatures, so no combustion pollutants develop. This is why experts consider e-cigarettes to be “probably less harmful” than normal tobacco cigarettes – but this only applies to the risk of cancer.
However, their vapor contains enough other dangerous substances that can harm the body.
E-cigarettes are also addictive!
Do e-cigarettes help you quit smoking?
Possibly yes – at least initially. In a British study published at the beginning of 2019, 18% of test subjects who had become smoke-free with e-cigarettes were still “abstinent” after one year, compared to only 9% of users of nicotine replacement products (patches, chewing gum, etc.).
However, the Federal Center for Health Education “does not recommend e-cigarettes as a means of quitting smoking”. Especially when someone tries to quit smoking with the help of nicotine-containing liquids, the basic nicotine addiction remains.
The habits associated with smoking are not changed either. There is therefore a high likelihood of returning to normal cigarettes.
Are e-cigarettes the gateway to smoking for young people?
Liquid vaporizers are popular with young people. Doctors warn that e-cigarettes could become a new “gateway drug”, as they are easy to consume and hook young people early on. In addition, a US study suggests that the fruity and sweet flavors of the liquids are particularly appealing to young people.
For this reason, a new Youth Protection Act came into force in Germany in 2016, which prohibits the sale of e-cigarettes to young people under the age of 18. However, it remains to be seen whether e-cigarettes actually encourage young people to smoke more. After all, according to some scientists, why would someone who is used to sweet flavors switch to bitter tobacco cigarettes?
E-cigarettes and pregnancy
It is considered certain that young mothers can pass nicotine on to their children via breast milk. Whether they also pass on the harmful substances in nicotine-free liquids from e-cigarettes to the child via breastfeeding has not yet been clarified. However, if you want to be on the safe side, you should avoid e-cigarettes during pregnancy and breastfeeding.
Is passive vaping also harmful?
E-cigarettes are unhealthy – even if you don’t vape yourself. There are hardly any (meaningful) studies on the subject of “passive vaping”. However, a study by the Bavarian State Office for Health and Food Safety showed that carcinogenic and allergenic particles could be detected in the air in a room in which e-cigarettes were vaped for two hours.
For asthmatics, “passive vaping” can exacerbate symptoms and possibly trigger attacks if they inhale the vapor from e-cigarettes.
Long-term inhalation of e-cigarette vapor increases the risks, especially for children and pregnant women.
How do e-cigarettes work?
There are different types of e-cigarettes that sometimes look more or less like “real” cigarettes. However, apart from their appearance, they all work in a similar way: inside the body there is a tank into which the user fills the liquid, as well as a battery-powered vaporizer. This is a heating element that heats the liquid and vaporizes it.
Ingredients of e-cigarettes
Depending on its composition, the liquid for e-cigarettes contains various ingredients. The carrier substance is usually propylene glycol or glycerine. These two substances are considered safe as food additives (E1520 and E422). When heated, however, formaldehyde and acrolein can form, which are toxic in higher concentrations.
Nicotine is often added to the liquid, sometimes not. Flavors are added to some liquids, for example apple, cinnamon or vanilla. Although all ingredients must be labeled in the EU, many substances can simply be treated as “flavours” without a more detailed description of what is hidden behind them.
Toxic ingredients in liquids
- Nickel
- silver
- aluminum
- Diacetyl and pentanedione (both can cause bronchial inflammation, e.g. the so-called popcorn lung)
Difference between e-cigarettes and tobacco heaters
In addition to e-cigarettes, there are also so-called tobacco heaters. Both look similar, but their operating principle is different: a liquid is heated and vaporized in an e-cigarette. It sometimes contains nicotine, but no tobacco. The user inserts a tobacco stick into a tobacco heater and heats it up.
Both products have one thing in common: to date, there have only been a few independent studies on the risk potential. It can only be assumed that neither tobacco heaters nor e-cigarettes are healthy in the short and, above all, long term.
