E-cigarette Health and Safety FAQ
Are e-cigarettes less harmful than smoking?
Overwhelming scientists agree that vaping is far less harmful today than smoking. There is no smoke in vaping. 7,000 toxic chemicals in smoke released from combustion - burning tobacco which are the main cause of almost all deaths and disease reported from smoking.
E-cigarettes heat e-liquids into an aerosol, without burning toxin rich tobacco or smoke. Some potentially harmful toxins are present in aerosol but at much lower levels than in cigarette smoke.
“Although it is not possible to precisely quantify the long-term health risks associated with e-cigarettes, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure.”
Public Health England concluded:
“While vaping may not be 100% safe, most of the chemicals causing smoking-related disease are absent and the chemicals which are present pose limited danger.”
US National Academies of Sciences, Engineering and Medicine concluded:
“There is substantial evidence that completely switching from regular use of combustible tobacco cigarettes to e-cigarettes results in reduced short-term adverse health outcomes in several organ systems.”
Studies have also shown significant lowering in biomarkers - toxins in the urine, saliva and blood - of smokers who have switched to vaping.
Is it fair to say that vaping is likely to be at least 95% lower risk than smoking?
Yes! The 95% is based on independent reviews of the scientific evidence by both Public Health England and the UK Royal College of Physicians. It now accurately puts a number on how much lower the risk from vaping is compared to smoking.
The Royal College of Physicians states:
“Although it is not possible to precisely quantify the long-term health risks associated with e-cigarettes, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure”
The 95% less harmful number is brow raising. Vapers know vaping is safer than smoking cigarettes. Now they have scientifically backed evidence of just how much safer it is. Saying “vaping is safer” has always been too vague.
The ”95% safer” statement is based on the following scientific evidence
- Most of the deadly toxins that can be found in smoke are completely absent from vapour. Those that are present are at much lower concentrations, mostly at levels below 1% of what they are in smoke. Logic dictates that the lower the toxins - the lower the danger and risk.
- The risk of cancer from vaping has been independently estimated to be <0.5% of the risk from smoking.
- There are significant health improvements in smokers who switch to vaping. Risk of a heart attack reduces, the blood pressure falls, asthma and COPD improve.
- The levels of toxins and carcinogens measured in the urine, saliva and blood are substantially lower. For many - biomarkers are the same as for a non-smoker.
Does vaping cause cancer?
Contrary to popular belief, nicotine in itself does not cause cancer. The cancer risk from vaping is only a fraction of the risk from smoking.
The cancer risk from vaping is estimated to be <0.5% of the risk from smoking tobacco. In fact, the risk of lung cancer has been estimated to be 50,000 times less than from traditional cigarette smoking. Switching from smoking to vaping is healthier and dramatically reduces the risk of developing cancer.
Tobacco smoke contains at least 700 known cancer-causing chemicals. These are either absent from vapour or are present at such low levels in vaping that the effects are negligible.
There is also a dramatic reduction in cancer-causing chemicals in the saliva and urine of vapers (biomarkers) compared to smokers.
Is vaping harmful to bystanders?
Passive vaping, or second hand “smoke” from vaping, is not harmful to bystanders. This misconception derives from peoples’ inaccurate perception that all secondhand smoke is harmful - be it from smoking or vaping.
Public Health England’s review in 2018 states,
“To date there have been no identified health risks of passive vaping to bystanders”.
The Royal College of Physicians in 2016 stated
“There is, so far, no direct evidence that such passive exposure is likely to cause significant harm.”
Vapour absorbs most of the inhaled aerosol. Less than 10% of the chemicals are exhaled when vaping. There is also no ‘side-stream’ vapour. Side-stream smoke accounts for at least 80% of second-hand smoke from cigarettes and accounts for much of the danger for bystanders.
The cancer risk for passive smokers was estimated to be 50,000 times greater than for passive vapers.
Should public vaping be banned?
There is no scientific evidence for banning public vaping on health reasons alone. Vaping is an issue of public nuisance, like loud music, talking in theatres, or wearing proper attire.
Using common sense, educating vapers, and teaching vaping etiquette can minimize vapour exposure for bystanders. For example - vapers should not blow large clouds in public areas. Sensibly exercising common courtesy will minimize vaper stigma as well as eliminate the need for overzealous authorities to step in and over complicate public vaping.
A hard line should be taken when considering vaping around certain areas such as schools and hospitals. Public Health England discourages blanket bans when considering public vaping calling for more education instead.
“A blanket ban on all public vaping sends the misleading message that vaping is just as harmful as smoking.”
One must not lose focus on the overall strategy - that of replacing smoking with vaping. A blanket ban would deter many smokers from switching to vaping. Vaping has always been seen as more discreet, convenient and more socially acceptable. Blanket bans would have an overall effect on public health as less people would quit smoking.
Isn’t nicotine harmful?
Nicotine is addictive yet it presents very little risk in itself and even has some potentially beneficial effects.
Many people incorrectly believe nicotine is the harmful ingredient in tobacco smoke. Many independent experts disagree:
“Nicotine use per se represents minimal risk of serious harm to physical health and that its addictiveness depends on how it is administered”
The Royal Society for Public Health has concluded that
“...nicotine is a mild recreational stimulant” and is “no more harmful to health than caffeine”.
“Use of nicotine alone, in the doses used by smokers, represents little if any hazard to the user” p. 125.
Nicotine does not cause cancer. Harm and health risks from smoking come from tar, carbon monoxide, toxic gases and solid particles released by tobacco combustion, and not from the nicotine itself.
Mild effects of nicotine exist such as impairing wound healing, temporarily raising blood glucose levels, increasing the pulse and blood pressure and narrowing the blood vessels.
The addictiveness of nicotine is also over exaggerated. Cigarettes are nicotine delivery products whose ingredients purposefully amplify nicotine addictiveness. Nicotine gum and patches have very low risk of addictiveness but are used long-term by some ex-smokers to prevent relapse.
What about the unknown long-term risks?
It is beyond reasonable doubt that the risks from vaping nicotine are much less than those of smoking which kills up to 2 in 3 long-term users.
Like all new products, the precise long-term health effects of vaping nicotine have yet to be established. However, we already have a lot of information about the ingredients of vapour, biomarkers (toxins in urine and saliva) and over 15 years of real-world experience and scientific studies to guide us. There are now an estimated 68 million people vaping in dozens of countries.
The Royal College of Physicians estimates the long-term risk is likely to be no more than 5% of the risk of smoking.
Some opponents argue that we should wait another 30 years to be sure about long-term risk. However, this is a double standard only applied to vaping and not used for any other medicine or treatment.
As with any new product, it is possible that some harms may emerge over time and ongoing monitoring of vaping should continue for any new side-effects. However, it may never be possible to completely separate the effects of smoking from those due to vaping as almost all regular vapers are former smokers.