By now, you’ve probably seen people puffing on all sorts of odd-looking devices, walked through clouds of vapor on the street, and maybe even tried an e-cigarette yourself. It’s pretty safe to say—e-cigs are officially a thing.
So what are e-cigarettes anyway, and what do we know—and not know—about the risks?
First, let’s clear up a quick misconception: College students may not be using e-cigs as often as you think. In a 2016 nationwide survey, students thought that only 16 percent of their peers had never tried an e-cig. The reality? Eighty-five percent of students say they’ve never puffed on one (American College Health Association, National College Health Assessment, Fall 2016).
But even if our perception of how many students are smoking e-cigs is off, that doesn’t mean they’re not a problem. According to the 2013–2014 National Adult Tobacco Survey, 14 percent of young adults (ages 18–24) are using e-cigarettes compared to only 6 percent of those 25 and older.
E-cigarettes, vaporizers, and ENDS
There’s a lot of lingo associated with e-cigarettes and vaping, and trying to follow it can get a little confusing.
- Any device that lets you inhale an aerosol of chemicals (usually including nicotine) is considered an e-cigarette, according to the FDA.
- Some e-cigarettes look like regular cigarettes. Others, called vaporizers, don’t. Yup, file this under the confusing part. There are also e-hookahs, e-cigars, and e-pens. All of these are known as electronic nicotine delivery systems (ENDS).
- Vaporizers and e-cigarettes have a tank that holds liquid chemicals. There’s a heating element—usually a battery—that turns the liquid into an aerosol that is then inhaled.
- The liquid is called e-liquid or e-juice. The e-liquid in e-cigarettes and vaporizers often (though not always) contains nicotine (in varying amounts), flavors, and other chemicals.
What do experts say about vaping?
Vaping is widely thought to be safer than smoking, but that doesn’t mean it’s risk-free, says Dr. Hayden McRobbie, a professor and researcher in the Tobacco Dependence Research Unit at the Wolfson Institute of Preventive Medicine at Queen Mary University of London. Many e-cig products contain nicotine, which is highly addictive and has been shown to harm the developing brain of young adults, according to the surgeon general. The US Food and Drug Administration (FDA) has also found a number of cancer-causing chemicals in vaping products.
E-cigarettes have been available in the United States for about a decade, but not enough studies have been done to know for sure what the long-term risks might be. There are other variables at play, too.
“There are many models of e-cigarettes and vaporizers, including homemade products,” says Dr. Jean-Francois Etter, a professor of public health at the Faculty of Medicine of the University of Geneva in Switzerland and an expert in tobacco dependence. Little-known fact #1: There are more than 460 different e-cigs on the market today. Little-known fact #2: They’re so varied—from the number of puffs to the types of liquids to the depth of inhalation—that it’s difficult to assess their risk, Dr. Etter says.
We don’t know yet how e-cigs can affect our health in the long run, but we do know some interesting facts about them.
5 lesser-known facts about vaping and e-cigs
1. Everything is made of chemicals. E-cigarettes have some funky ones.
The FDA started regulating e-cigarettes in 2016, but the agency has not yet evaluated all the chemicals in these products to determine how safe they are. This means that, for now, users have no way of knowing what chemicals they’re smoking Many vaping products contain nicotine, which we know is addictive and harmful, and also affects attention and memory in developing brains, according to the American Lung Association. Other ingredients often found in vaping products include propylene glycol, a chemical that helps make smoke, and glycerin, a byproduct created when soap is made. Interestingly enough, glycerin can be found in materials ranging from toothpaste to brake fluid—you probably don’t want to be inhaling either of those.
2. Vaporizer batteries can explode.
Around here, we don’t love exploding electronics, and we bet you don’t either. (Anyone remember the Samsung Note 7 debacle?) While vape battery explosions appear to be rare (only about 25 were reported in the media in a five-year span, according to the US Fire Administration), they can obviously be dangerous and probably pretty terrifying. If you use battery-powered vaping products, here’s how to reduce your battery explosion risk:
- No charger swapping. Only use the charger your vape came with.
- Daytime charging only. Don’t charge your vape at night while you’re sleeping.
- Drop your vape into your reusable water bottle? Replace the batteries anytime they get wet.
- Don’t let the batteries come into contact with anything metal.
- Look for e-cigarettes with safety features, like an automatic shutoff feature when the battery is fully charged.
3. Vaping may increase the likelihood of using traditional tobacco products later on.
Early research suggests that using e-cigs may increase the chances of young people moving on to cigarettes and other traditional tobacco products later on, according to the National Institute on Drug Abuse. An analysis of more than 17,000 14- to 30-year-olds found that those who had ever tried vaping were 3.6 times more likely to start smoking traditional cigarettes than those who had never tried it, while those who had vaped in the past 30 days were more than 4 times more likely than non-vapers to turn to cigarettes (JAMA Pediatrics, 2017). As we know from decades of research, using traditional tobacco products can lead to a host of not-so-fun health issues, such as cancer, heart disease, erectile dysfunction, and emphysema.
4. Dripping can boost your exposure to toxic chemicals.
Dripping is a process of directly inhaling heated e-cig liquid at a higher temperature in order to produce a more concentrated vapor. Preliminary research suggests that doing this may increase the user’s exposure to toxic chemicals such as formaldehyde (a known carcinogen used in glues and adhesives), acetaldehyde (a chemical found in cigarettes and in some foods), and acetone (the active ingredient in nail polish remover) (Pediatrics, 2017). A tip for vapers and probably the rest of us: Avoid dripping.
5. Big tobacco is now playing the vaping game.
The popularity of vaping hasn’t gone unnoticed by big tobacco companies. Tobacco conglomerates started buying up popular e-cigarette companies back in 2012, and they’ve also started making their own e-cig products, according to a 2016 Newsweek special edition. Philip Morris recently filed an application to market a kind of cigarette that heats, rather than burns, tobacco and hopes to advertise it as “less harmful than traditional cigarettes,” according to Reuters.
Look out for anything tobacco companies tout as safe: In the 1920s–1950s, tobacco companies used ads featuring doctors, babies, and even Santa Claus himself to encourage smoking. The tobacco industry is also known for manipulating data and funding research that supports their best interests (read: making money), according to a 2017 editorial published in Public Health Ethics.
The risk of e-cigarettes: TBD
The dangers of traditional tobacco products are many and known; the dangers of e-cigarettes are still being determined. That leaves plenty of unknowns for students mulling whether to vape or not.
“I believe they definitely cause more harm to one’s health than people believe. Most people tell me that their vapes are practically harmless, but I believe otherwise.”
—Christopher G., fourth-year undergraduate, Kutztown University of Pennsylvania
“[They] may be beneficial to those who currently smoke, but [vaping] often gives the impression of being a ‘healthier’ option, potentially prompting non-smokers to try it.”
—David H., fourth-year undergraduate, Villanova University, Pennsylvania
Research published in BMC Medicine in 2015 found that e-cigarettes appear to be less harmful than traditional cigarettes. The researchers also noted that smokers who switched to vaping saw improvements in their respiratory health. “Better than,” though, isn’t the same as “safe,” and it will likely be decades before the risks of e-cigarettes are fully understood.
What about for people trying to quit traditional tobacco?
For people looking to cut down their cigarette habit, vaping may be a useful tool—though the results of recent studies are mixed. Let’s take a closer look: A study including more than 2,000 smokers found that those who also used e-cigarettes were more likely to cut their cigarette use in half than were those who only smoked traditional cigarettes (Addiction, 2017). However, the Centers for Disease Control and Prevention recommend a combination of counseling and nicotine replacement medication (such as the nicotine patch) as the most effective method for quitting smoking.
Want to ditch smoking for good? Here are some resources:
- Call 1-800-784-8669 for free help
- Sign up for texts for extra encouragement: Text QUIT to 47848
- Connect with others who are trying to quit
Third-year undergraduate, Mount Royal University, Alberta
“I love this app, plain and simple! Not only is it free (meaning you don’t have to pay to quit smoking), it sends you inspirational messages, tips, and information to encourage you to quit; identifies triggers that might cause your desire to smoke; and offers lots of cool distraction games to take your mind off any situation you’re in. The best part: You can monitor your progress and earn milestones toward your ultimate goal.”
This app was good at keeping me focused in case I was about to slip. One time, it reminded me that being smoke-free keeps you from inhaling over 7,000 chemicals, which definitely made me not want to pick up a cigarette.
quitSTART distracts you with mindless games—Monkey See Monkey Do, Diamond in the Rough, Hamster Arena, and more. It keeps you busy and thus not thinking about smoking.
I believe humans need reinforcement when we’re making positive changes in our lives. The encouraging messages the app offers in a situation where you want to smoke (e.g., “Stay cool, take deep breaths, and walk away”) allowed me to stay on track and avoid cravings much more easily.
Jean-Francois Etter, PhD, professor of public health, Faculty of Medicine, University of Geneva, Switzerland.
Hayden McRobbie, MB, ChB, PhD, Tobacco Dependence Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, United Kingdom.
Agency for Toxic Substances and Disease Registry. (2015, January 21). Public health statement for propylene glycol. Retrieved from https://www.atsdr.cdc.gov/phs/phs.asp?id=1120&tid=240
American College Health Association. (2016). National College Health Assessment, Fall 2016 reference group executive summary. Retrieved from http://www.acha-ncha.org/docs/NCHA-II_FALL_2016_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf
American Lung Association. (2016, December 8). E-cigarettes and lung health. Retrieved from http://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html
Brownson, E. G., Thompson, C. M., Goldsberry, S., Chong, J. H., et al. (2016). Explosion injuries from e-cigarettes. New England Journal of Medicine, 375(14), 1400–1402. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMc1608478
Dawson, A., & Verweij, M. (2017). No smoke without fire: Harm reduction, e-cigarettes and the smoking endgame. Public Health Ethics, 10(1), 1–4. Retrieved from https://academic.oup.com/phe/article/10/1/1/3100270/No-Smoke-Without-Fire-Harm-Reduction-E-Cigarettes
Elliot, S. (2008, October 6). When doctors, and even Santa, endorsed tobacco. New York Times. Retrieved from http://www.nytimes.com/2008/10/07/business/media/07adco.html
Ellis, J. (2016, April 24). Vaping: Big Tobacco’s big gamble on the future. Newsweek. Retrieved from http://www.newsweek.com/vaping-big-tobacco-big-gamble-future-451074
Environmental Working Group. (n.d.). Glycerin. Retrieved from https://www.ewg.org/skindeep/ingredient/702620/GLYCERIN/#
Heydari, G., Ahmady, A. E., Chamyani, F., Masjedi, M., et al. (2017). Electronic cigarette, effective or harmful for quitting smoking and respiratory health: A quantitative review papers. Lung India, 34(1), 25–28. http://doi.org/10.4103/0970-2113.197119
Krishnan-Sarin S., Morean, M., Kong, G., Bold, K. W., et al. (2017). E-cigarettes and “dripping” among high-school youth. Pediatrics, 139(3). Retrieved from http://pediatrics.aappublications.org/content/pediatrics/early/2017/02/02/peds.2016-3224.full.pdf
MedlinePlus. (2015, August 29). Risks of tobacco. Retrieved from https://medlineplus.gov/ency/article/002032.htm
Pasquereau, A., Guignard, R., Andler, R., & Nguyen-Thanh, V. (2017). Electronic cigarettes, quit attempts and smoking cessation: A six-month follow-up. Addiction, 112(9), 1620–1628.
Polosa, R. (2015). Electronic cigarette use and harm reversal: Emerging evidence in the lung. BMC Medicine, 13(54). Retrieved from https://bmcmedicine.biomedcentral.com/track/pdf/10.1186/s12916-015-0298-3?site=bmcmedicine.biomedcentral.com
Reuters. (2016, December 6). Philip Morris seeks US approval to market alternative cigarette. Retrieved from http://www.reuters.com/article/us-pmi-fda-idUSKBN13V2EP
Soneji, S., Barrington-Trimis, J. L., & Wills, T. A. (2017, June 26). Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults. JAMA Pediatrics, 171(8), 788–797. Retrieved from http://jamanetwork.com/journals/jamapediatrics/fullarticle/2634377
US Centers for Disease Control and Prevention (CDC). (2016, December 1). Current cigarette smoking among adults in the United States. Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm
US Centers for Disease Control and Prevention (CDC). (2017, June 15). Tobacco use among middle and high school students—United States (2011–2016). Retrieved from https://www.cdc.gov/mmwr/volumes/66/wr/mm6623a1.htm?s_cid=mm6623a1_w
US Department of Health and Human Services. (2016). E-cigarette use among youth and young adults: A report of the Surgeon General. Retrieved from https://e-cigarettes.surgeongeneral.gov/documents/2016_sgr_full_report_non-508.pdf
US Department of Health and Human Services. (n.d.). Electronic cigarettes. Retrieved from https://betobaccofree.hhs.gov/about-tobacco/Electronic-Cigarettes/index.html
US Fire Administration. (2014, October). Electronic cigarette fires and explosions. Retrieved from https://www.usfa.fema.gov/downloads/pdf/publications/electronic_cigarettes.pdf
US Food and Drug Administration. (2017, May 30). Tips to help avoid “vape” battery explosions. Retrieved from https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm539362.htm
US Food and Drug Administration. (2017, April 18). Vaporizers, e-cigarettes, and other electronic nicotine delivery systems (ENDS). Retrieved from https://www.fda.gov/tobaccoproducts/labeling/productsingredientscomponents/ucm456610.htm
US National Institute on Drug Abuse. (2017, June). Electronic cigarettes (e-cigarettes). Retrieved from https://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes