The Trump administration recently announced that it will soon ban flavoured e-cigarette products to deter an ever growing number of young users. It comes amid an outbreak of vaping-linked severe pulmonary disease that has killed six people and sickened hundreds.
Here are four things to know about vaping.
1. Is it safer than smoking?
The truth is, we don’t know.
Unlike tobacco cigarettes, e-cigarettes don’t “burn”. The devices have been available in the United States since 2006. They work by heating a liquid that turns into vapour that the user inhales. Therefore e-cigarette smokers do not face exposure to the estimated 7,000 chemical compounds in regular cigarettes. Also, tthere is no known link between vaping and cancer.
The liquids however contain highly addictive nicotine.
There are also a variety other compounds classed as “potentially harmful”. This is according to a 2018 study compiled by the US National Academy of Sciences. And there is “substantial evidence” that the vapour contains traces of metals. They could either come from the coil used to heat the liquid or from other parts of the device. Some flavourings also contain diacetyl, a chemical linked to a serious but relatively rare lung disease.
Most of existing scientific literature holds that vaping is less toxic than smoking. However, “the implications for long-term effects on morbidity and mortality are not yet clear”. They would also require decades of more data and studies to know for certain, said the NAS report.
But scientists carried out the bulk of this research before the current outbreak of severe lung disease in the US. More than 450 cases are currently under investigation.
2. The US investigation
The patients’ initial symptoms included breathing difficulty and chest pain before they hospitalised and placed some on ventilators. The doctors also placed several teens in medically-induced comas, including one who may need a lung transplant if he recovers.
New York’s health department focuses its probe on counterfeit cannabis cartridges containing vitamin E oil, which is harmful when inhaled. Federal authorities however have yet to identify a single substance common to all cases.
Some medics report seeing patients developed acute lipoid pneumonia. It is a non-infectious form of respiratory ailment that occurs when oils or fat-containing substances enter the lungs, a potential clue for what is driving the illness.
That said, it’s unclear why these cases have only been reported in the United States, and whether they are even new, or only being recognised after earlier misdiagnoses.
3. Local authorities acting
In June, San Francisco became the first US city to ban the sale and manufacture of electronic cigarettes, after which came Richmond, Virginia. Market leading maker JUUL’s response to the San Francisco ban was that it would “drive former adult smokers who successfully switched to vapor products back to deadly cigarettes.”
That claim is true, according to a study in the New England Journal of Medicine on 886 patients in Britain’s National Health Service published in February. The one-year abstinence rate among e-cigarette users was 18%. This compares to 9.9% among a group who used other nicotine replacement products like gum or patches.
But the conversions are not all in one direction. Recent studies found that, among adolescents, e-cigarettes provide a gateway toward full-fledged smoking.
4. Regulation or prohibition?
The vaping industry is adamant that it doesn’t want underage people using its products. It also says that more must be done to prevent their sale. E-cigarettes are already illegal to sell in the US to people under 18 or 21, depending on the state.
But bans also deprive adults addicted to smoking of a valuable tool to quit, the industry says.
“To deprive those smokers from access to e-cigarettes, which we know are substantially less harmful, I think is a terrible decision,” Neil McKeganey, of the UK-based Center for Substance Use Research — which is partly funded by the industry — told AFP.