Is Vaping Safer Than Smoking? Threats From Smokeless Nicotine Are Many

After e-cigarettes first emerged in 2004, they quickly became a popular, "healthier" alternative for those who wanted the feeling of smoking tobacco. This could be one of the reasons for the steady, continued decline of cigarette smoking in the United States. While nearly 42 percent of the population were smokers during the Mad Men era of the mid-60s, the figure dropped to around 17 percent in recent years.

While studies acknowledge vaping has far less of an impact on health compared to smoking, experts also cautioned long-term studies still can't make solid conclusions as the alternative has been in use for only a little more than a decade. Growing evidence from research, however, suggested we are just beginning to see the potential consequences.

In 2015, a letter from the New England Journal of Medicine expressed concern over formaldehyde, a toxic compound found in the vapors produced by e-cigarettes. While researchers are still studying its link to cancer, formaldehyde is known to cause irritation to the skin, eyes, nose, and throat.

Irfan Rahman, professor of Environmental Medicine at the University of Rochester, led the first study to examine the impact of e-cigarettes on oral health. 

"We showed that when the vapors from an e-cigarette are burned, it causes cells to release inflammatory proteins, which in turn aggravate stress within cells, resulting in damage that could lead to various oral diseases," he said. 

This year, he was one of the authors of a study that examined artificial flavors for inducing tissue damage and having a toxic effect on white blood cells, with the worst impact coming from cinnamon, vanilla, and buttery flavored e-juices. There are around 250 harmful chemicals found in traditional cigarettes while the number is significantly reduced in vaping. But the presence of nicotine still poses a threat (particularly risk of heart disease) in its concentrated, e-liquid form.

Another study using mice showed secondhand e-cigarette smoke could compromise the immune system. Thomas Sussan, lead author and an assistant scientist at the Bloomberg School, explained how the exposure to e-cigarette vapor "was followed by a bacterial or viral infection, the harmful effects of e-cigarette exposure became even more pronounced. The e-cigarette exposure inhibited the ability of mice to clear the bacteria from their lungs, and the viral infection led to increased weight loss and death indicative of an impaired immune response."

But experts and organizations have also defended the use of electronic cigarettes, as evidence suggested people who are already smokers are the ones likely to pick up the device rather than non-smokers. The conflict here is many believe people may go from not smoking to vaping to tobacco smoking rather than the other way around. 

"While e-cigarettes may act as a gateway to smoking, much of the evidence indicates that e-cigarette use encourages cessation from cigarettes by those people who would have otherwise smoked with or without e-cigarettes," said lead author David T. Levy. 

The Food and Drug Administration has not approved e-cigarettes as a smoking cessation aid as it may take another decade or so until researchers can gather sufficient evidence to be sure about which way the trend swings.