The truth about vaping

Vaping products are often portrayed in a negative way, and this has led to confusion and a common misperception that vaping is as harmful as smoking tobacco.

We answer your questions about vaping, its safety compared to smoking, and how it works as a stop smoking aid.
 

I’ve read that vaping is just as dangerous as smoking. Is this true?

Vaping is significantly less harmful than smoking. Switching completely from smoking to vaping is likely to have substantial health benefits over continued smoking.

Yorkshire Cancer Research supports the use of vaping products as a tool to quit smoking and this position is supported by Public Health England (PHE) who, in February 2015, published an independent review which estimated that vaping is at least 95% less harmful than smoking.

Since then, PHE has published a further six independent e-cigarette reports, the last one being last month. All of them have consistently reinforced the finding from previous reports that vaping is significantly less harmful compared to smoking. 

The NHS also reflects this position in its guidance for smokers, stating that ‘In recent years, e-cigarettes have become a very popular stop smoking aid in the UK. Also known as vapes or e-cigs, they're far less harmful than cigarettes and can help you quit smoking for good.’

Almost all the harm from smoking comes from the thousands of chemicals (such as tar and carbon monoxide) contained in tobacco smoke. As vaping products do not contain or burn tobacco, these chemicals are either not present or are present at significantly lower levels.

Although smoking rates are declining, the proportion of smokers in Yorkshire (15.4%) is higher than the average for England (13.9%). There are more than 622 000 adult smokers in Yorkshire - half will die of a smoking-related disease if they do not quit. If all these smokers switched to vaping products, thousands of lives could be saved.

By spreading the message that vaping and smoking are not the same, and outlining vaping’s value as a tool to quit, we can reduce the number of people in the region who are needlessly dying through smoking-related cancers.
 

But don’t vaping products contain nicotine? Isn’t that bad for you?

Vaping products do contain nicotine, which is inhaled through a vapour. While it is nicotine that causes tobacco cigarettes to be so addictive, on its own it is relatively harmless.

At low doses, nicotine is a stimulant, which in the short term increases heart rate and may improve attention, memory and fine motor skills. If you have, or have had, any serious heart problems, it’s a good idea to talk to your doctor before using vaping products or nicotine replacement therapy.

Nicotine is not the cause of death from smoking. Nicotine is not a carcinogen; there is no evidence that sustained use of nicotine alone increases the risk of cancer. Of the three main causes of death from smoking (lung cancer, Chronic Obstructive Pulmonary Disease and cardiovascular disease), none are caused by nicotine. The harm from smoking comes from the thousands of other chemicals in tobacco smoke.
 

There are lots of other methods that can help people stop smoking, like patches or stop smoking medicines. Why do we need vaping as well?

Vaping products are the most popular stop smoking aid. It has been estimated that there are up to 57,000 additional quitters a year in England and 5,000 a year in Yorkshire because of them. They have gained popularity because they feel similar to smoking a cigarette.

Research also suggests that vaping products are more effective at supporting people to stop smoking than other stop smoking aids such as Nicotine Replacement Therapy (NRT). One trial of English stop smoking services found that smokers using vaping products were nearly twice as likely to stop smoking as those using NRT.
 

Vaping products are not available on prescription through the NHS. Does that mean they’re not regulated? How do we know what they contain?

The UK has some of the tightest regulations on vaping products in the world under the Tobacco and Related Products Regulations 2016.

These regulations ensure that vaping products are subject to maximum standards of quality and safety, as well as packaging and labelling requirements to provide consumers with the information they need to make informed choices. They cover nicotine strength, health warnings, advertising, childproof packaging, and a ban on certain ingredients.

Vaping product manufacturers must provide the UK Medicines and Healthcare Products Regulatory Agency (MHRA), with detailed information about their product, including a list of all ingredients.
 

I’ve heard that vaping products can cause harm to your lungs. Is this true?

There have been stories in the media about an outbreak of lung injury called EVALI in the USA. These cases of EVALI were caused by people using vaping products with homemade or illicit e-liquids that contained cannabis products and a chemical called vitamin E acetate.

The use of cannabis is illegal in the UK under the Misuse of Drugs Act 2010 and vitamin E acetate is a prohibited ingredient under the Tobacco and Related Products Regulations 2016. Therefore, the risk of getting EVALI by using a UK-regulated vaping product is low and so far, there has been one case in this country compared to 2600 cases in the US.

There have also been stories that vaping products cause a disease called ‘popcorn lung’. This was caused by a chemical flavouring called diacetyl, which had been used in e-liquids. Again, diacetyl is banned in e-liquids in the UK under the Tobacco and Related Products Regulations 2016. Therefore, using a UK-regulated vaping product and e-liquids will not cause ‘popcorn lung’.
 

It took a long time for the dangers of smoking to be fully realised. How do we really know if vaping products are safe? Shouldn’t there be more research before people are encouraged to use them?

Vaping products have been available in the UK since 2007. They are currently one of the most widely researched scientific topics. There is substantial evidence on the short-term impact of their use, which has shown that they are far less harmful than smoking and an effective and popular stop smoking aid.

What we know for certain is that smoking is Yorkshire’s leading cause of preventable cancer and is responsible for over 4500 new cancer cases each year. 1 in 2 long-term smokers will die prematurely if they do not quit – so action needs to be taken now. 

It’s true that there are some things about vaping that need more research, like for example, what might happen to someone’s health if they vaped for many years. However, through extensive evidence reviews, Public Health England has repeatedly found that vaping is significantly less harmful than smoking. We can’t afford to wait for 10 or 20 years for the long-term impact to be reviewed, while in the meantime the health of hundreds of thousands of people across Yorkshire continues to be harmed by tobacco smoke.
 

Can vapour cause harm to other people?

There is no evidence that vapour causes harm to bystanders. People with asthma and other respiratory conditions might be sensitive to very large clouds of vapour, in the same way that they can be sensitive to a range of environmental irritants.

This is in stark contrast to the known health risks of secondhand smoke that underpin UK smokefree laws. We know that non-smokers who live with a smoker have a 20-30% higher chance of getting lung cancer as a consequence. Secondhand smoke also increases the risk of breast and cervical cancer as well as heart disease and stroke.
 

Do vaping products encourage young people to start smoking?

There is no evidence that the rise in popularity of vaping has led to increased rates of smoking in adults or young people in the UK – in fact, smoking rates are continuing to fall in both groups.

The latest studies show that most vaping product experimentation does not turn into regular use, and levels of regular use in young people who have never smoked remain very low. It is also illegal to sell vaping products to people under 18 in the UK.
 

I have heard that vaping products can explode and cause fires. Is this true?

Fires caused by vaping products are rare and about as likely as fires caused by mobile phones. Where they do occur, it is likely the battery has malfunctioned, so those who vape should always use the charger supplied with the vaping product and avoid charging it for extended periods of time, such as overnight.

The risk of fire from vaping products is considerably lower than the risk of fire caused by cigarettes, which are the leading cause of death in domestic households, causing around 2000 house fires a year.
 

Should employees be able to vape at work?

UK smokefree laws prohibit smoking in enclosed public places and workplaces. However, these laws do not include vaping and so it is left to organisations to determine their own policy on vaping in the workplace.

Vaping and smoking are not the same activity - vaping products have significant potential to help reduce the harm from tobacco caused to smokers, those around them and the wider society. Recognition of this should be at the centre of any smokefree policy.

Imposing a blanket ban on workplace vaping may not be the best way forward. Treating vaping and smoking as the same thing may force vapers and smokers to share the same designated space - which may jeopardise a smoker’s attempt to quit.

Public Health England has developed guidance on how to create a new vaping policy or incorporate a vaping policy into an existing smokefree policy, which can be found here. These recommendations are supported by Yorkshire Cancer Research.

 

Find out more about vaping here, including the key facts and findings from experts and leading researchers.

For information and advice about quitting smoking, read our Q&A or contact your local stop smoking service. You can find a list of them here.

 

References

Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (2020). Statement on the potential toxicological risks from electronic nicotine (and non-nicotine) delivery systems (E(N)NDS – e-cigarettes). Available from: https://cot.food.gov.uk/sites/default/files/2020-09/COT%20E%28N%29NDS%20statement%202020-04.pdf [Last accessed September 2020].


Public Health England (2020). Vaping in England: an evidence update including mental health and pregnancy, March 2020: A report commissioned by Public Health England. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/869401/Vaping_in_England_evidence_update_March_2020.pdf [Last accessed May 2020].


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Royal College of Physicians (2016). Nicotine without smoke, Tobacco harm reduction: A report by the Tobacco Advisory Group of the Royal College of Physicians. Available from: https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction [Last accessed August 2020].

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