Reading Time: 4 minutes Only 17 % of colleges and universities in the US are officially âtobacco-free.â Whether yours is or isnât, promoting responsible tobacco use on campus can benefit everyoneâs health.
Reading Time: 12 minutes Everything you wanted to know about the effects of smoking, including juuling, e-cigarettes, vaping, and more.
Reading Time: 5 minutes E-cigarettes are often billed as the âhealthierâ alternative to traditional tobacco cigarettes. But are vapes really as safe as the companies who sell them would have you believe? Hereâs what we do know.
Rate this article and enter to win
When e-cigarettes hit the market 10 years ago, they were advertised as a clean, safe alternative to traditional smoking. To some extent, thatâs likely true; they do seem cleaner and safer, and they may prove helpful to smokers who are trying to quit. That said, they may also carry some health risks of their own. If this evaluation sounds noncommittal, it isâscientists and federal regulators are still duking it out, and the research on e-cigarettes (vaping) is in its early stages. Hereâs what we know so far:
E-cigarettes were designed as a way for people to hold and inhale something that looks and feels like a cigarette without being exposed to tobacco smoke and its indisputable health risks. E-cigarettes are battery-powered devices that contain a liquid cartridge. When heated, the cartridge releases a vapor that the user inhales.
The Food and Drug Administration (FDA) has only just started the process of regulating e-cigarettes, so manufacturers have been operating without much oversight. This means that some e-cigs may contain higher nicotine doses than it says on their packaging. The FDA has not approved e-cigarettes as a smoking cessation aid.
E-cigarettes are in use, but maybe not as commonly as you might think. That’s according to a 2015 survey of 6,300 college students.
Source: American College Health AssociationâNational College Health Assessment, Fall 2015; anonymous, randomized survey.
At this point, researchers are sounding reasonably confident that e-cigarettes are less harmful than traditional smoking—but the research is far from complete. And e-cigarettes are unlikely to be completely safe.
The Framework Convention Alliance, an international organization focusing on eliminating tobacco-related harm, acknowledges the many areas of dispute regarding e-cigarettes. Nevertheless, it concludes, “e-cigarettes are almost certainly considerably less hazardous for individuals than cigarettes.”
If young people vape instead of smoking traditional cigarettes, they will avoid the harsh health effects caused by smoking tobacco, according to a 2016 study in Nicotine & Tobacco Research. These include cancers and heart disease caused by inhaling tar, a substance released as tobacco burns.
That said, no one can realistically tell you that vaping isn’t harmful at all. “The use of e-cigarettes cannot be labeled ‘safe,’ because that implies no risk. Any time you inhale anything into lungs, even air, you incur some level of risk,” says Steve Lux, a former senior health educator at Northern Illinois University (who supports the use of e-cigarettes for smoking cessation).
In people who would not otherwise smoke, using e-cigarettes could potentially contribute to health problems, researchers acknowledged in the Nicotine & Tobacco Research study.
The nicotine in some e-cigs has the potential to harm brain development in people in their early twenties, according to the World Health Organization. It’s conceivable that vaping could aggravate respiratory diseases, such as asthma and bronchitis.
Again, e-cigarettes vary in their ingredients, so their health effects likely vary, too. And relative to traditional smoking, e-cigarettes are the safer choice.
This is a point of contention among health professionals.
Researchers are trying to figure out whether or not these devices can help people quit smoking altogether. The current evidence is mixed. E-cigs containing nicotine may be more effective for quitting smoking than a nicotine patch, according to a 2014 study published in Addiction. A 2016 analysis of multiple studies, however, found that e-cigarette use was associated with reduced rates of smoking cessation (The Lancet Respiratory Medicine).
In this context, it may be reasonable to try e-cigarettes as a smoking cessation aid—with caution. “I think that all smokers who are exploring options for quitting should look into the use of nicotine e-cigarettes as one of the many options that exist today,” says Steve Lux, a former senior health educator at Northern Illinois University.
The 2016 study in Nicotine & Tobacco Research explored whether vaping could create new smokers. The researchers (looking at a cohort of people born in 1997) found that although e-cigarette use has risen, traditional cigarette smoking has continued to fall. This suggests that vaping is not creating a new wave of smokers.
E-cigarettes don’t contain smoke, but they do create secondhand emissions. It’s still unknown what effect these emissions may have.
“Vaping involves exhalations, containing mainly water vapor, but also containing small amounts of other substances that may or may not have a negative effect,” says health educator Steve Lux. But traditional tobacco studies indicate that passive smoking in social situations is a lot less risky than living with a smoker, he says. This is not a license to vape anywhere: Many campuses and other institutions ban the use of nicotine-containing substances, including e-cigarettes.
Vaping hasn’t been around long enough for us to see its long-term effects. If e-cigarettes can potentially contribute to serious illnesses—such as cancer, lung disease, or heart disease—we won’t see that for years. Researchers can study how e-cigarette vapors affect the cells of lab animals, which may offer some insight but can’t show us exactly how vaping affects people in the long term.
In addition, we don’t have much data on people who vape and do not also smoke (or never smoked) traditional tobacco products. Potentially, those people could serve as a control group, helping scientists untangle the relative influence of vaping versus traditional smoking on health. Among people who do both, that’s hard to figure out.
Lastly, some researchers are studying how e-cigarettes may help people quit smoking altogether. For these claims to hold water, the products’ (relative) safety and effectiveness have to be proven through a series of clinical trials.
Starting in August this year, the Food and Drug Administration (FDA) began evaluating all e-cigarette products that are on the market. Each product will go through a new application process to determine whether or not it can continue to be sold.
While the FDA is working through a mighty high stack of applications, manufacturers can keep selling e-cigarettes. All this can take two to three years.
If manufacturers can’t show that their product has therapeutic benefits (e.g., helping smokers quit), that e-cigarette will be regulated as a tobacco product.
Nicotine is a highly addictive substance, whether you find it in traditional cigarettes or in e-cigarettes. The amount of nicotine in e-cigarettes can vary by product and manufacturer. There are no data yet on whether vaping leads to nicotine addiction.
November 17 is the Great American Smokeout, and there’s extra support available for quitting smoking.
Trying to quit without a plan can leave you without a way to cope when you get cravings. You’re more likely to succeed with a structured approach, says Smokefree.gov, a governmental resource for all things tobacco-free. Ask your health care provider for tools and strategies that have been evaluated in studies and shown to be successful. To get started, click on these links:
In studies, these tobacco cessation approaches have been shown to be helpful. For professional support, talk to a doctor or counselor about what has been shown to work best.
Evidence-based guide to quitting: American Cancer Society
Find free support in your state: North American Quitline Consortium
Find DBT resources: Behavioral Tech
Tips from former smokers: Centers for Disease Control & Prevention (CDC)
Want an app for that? Try quitSTART: Smokefree.gov
Tobacco QuitLine: American Lung Association
1-800-LUNGUSA (586-4872)
Daily text “quitspiration” (and more): Smokefree.gov
Use your smartphone to quit: US News & World Report
Steve Lux, former senior health educator, Northern Illinois University.
American Cancer Society. (2016). Guide to quitting smoking. Cancer.org. Retrieved from
https://www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/guide-to-quitting-smoking-other-methods-of-quitting
American College Health Association. National College Health Assessment. Fall 2015 Reference Group Data Report. Retrieved from
https://www.acha-ncha.org/docs/NCHA-II%20FALL%202015%20REFERENCE%20GROUP%20DATA%20REPORT.pdf
American Lung Association. (2016, June). E-cigarettes and lung health. Lung.org. Retrieved from https://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html
American Lung Association. (2016). What’s in a cigarette? Lung.org. Retrieved from https://www.lung.org/stop-smoking/smoking-facts/whats-in-a-cigarette.html
American Lung Association. (2011, June). General smoking facts. Lung.org. Retrieved from www.lung.org/stop-smoking/about-smoking/facts-figures/general-smoking-facts.html
American Lung Association. (2015). The facts. Lung.org. Retrieved from https://www.lung.org/associations/states/colorado/tobacco/the-facts.html
American Lung Association. (2015). What’s in a cigarette? Lung.org. Retrieved from https://www.lung.org/stop-smoking/about-smoking/facts-figures/whats-in-a-cigarette.html
Amsted, D. (2015, December 21). E-cigs’ inconvenient truth: It’s much safer to vape. Rollingstone.com. Retrieved from
https://www.rollingstone.com/politics/news/e-cigs-inconvenient-truth-its-much-safer-to-vape-20151221
Brown, B., & Kotz, M. (2014, May.) Real-world effectiveness of e-cigarettes when used to aid smoking cessation: A cross-sectional population study. Addiction. Retrieved from
https://www.wiley.com/WileyCDA/PressRelease/pressReleaseId-110827.html
Cahill, K., Stevens, S., Perera, R., & Lancaster, T. (2013). Pharmacological interventions for smoking cessation: An overview and network meta-analysis. Cochrane Database of Systematic
Reviews, 5. Retrieved from https://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009329.pub2/full
Campaign for Tobacco-Free Kids. (n.d.). Philip Morris and targeting kids. TobaccoFreeKids.org. Retrieved from https://www.tobaccofreekids.org/research/factsheets/pdf/philipmorris.pdf
Cancer Research: UK. (2016). Headlines about e-cigarettes don’t mean they’re ‘not safer than tobacco’. CancerResearchUK.org. Retrieved from
https://scienceblog.cancerresearchuk.org/2016/01/20/headlines-about-e-cigarettes-dont-mean-theyre-not-safer-than-tobacco/
Carter, B. D., Abnet, C. C., Feskanich, D., Freedman, N. D., et. al. (2015). Smoking and mortality—beyond established causes. New England Journal of Medicine, 372(7), 631–640. Retrieved from
https://www.nejm.org/doi/full/10.1056/NEJMsa1407211
Centers for Disease Control and Prevention. (2014, November). Tobacco-related mortality. CDC.gov. Retrieved from
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/
Centers for Disease Control and Prevention. (2014, November). Trends in current cigarette smoking among high school students and adults, United States, 1965–2011. CDC.gov.
Retrieved from https://www.cdc.gov/tobacco/data_statistics/tables/trends/cig_smoking/
Cochrane. (2015, March 2). Does motivational interviewing help people who smoke to quit? Cochrane.org. Retrieved from
https://www.cochrane.org/CD006936/TOBACCO_does-motivational-interviewing-help-people-who-smoke-to-quit
Dale, L. (2014, November 25). What are electronic cigarettes? Are they safer than conventional cigarettes? MayoClinic.org. Retrieved from
https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/expert-answers/electronic-cigarettes/faq-20057776
Framework Convention Alliance. (2014, 13–18 October). FCA policy briefing: Electronic nicotine delivery systems. [Policy briefing]. Retrieved from https://www.fctc.org/images/stories/policy_brief.pdf
Hartung, T. (2016, August 1). They’re far from harmless, but e-cigarettes can get people off tobacco. Scientificamerican.com. Retrieved from
https://www.scientificamerican.com/article/they-re-far-from-harmless-but-e-cigarettes-can-get-people-off-tobacco/
Kalkhoran, S., & Glantz, S. A. (2016). E-cigarettes and smoking cessation in real world and clinical settings: A systematic review and meta-analysis. The Lancet Respiratory Medicine. doi 10.1016/S2213-2600(15)00521-4. Retrieved from https://keepitsacred.itcmi.org/wp-content/uploads/sites/821/sites/5/2016/01/15tlrm0537_Glantz.pdf
Khan, A. (2014, July 9). Quitting smoking the geeky way. US News & World Report. Retrieved from
https://health.usnews.com/health-news/health-wellness/articles/2014/07/09/how-to-use-your-smartphone-to-quit-smoking
Landro, L. (2013, April 29). To motivate patients to change, doctors stop scolding. Wall Street Journal. Retrieved from https://www.wsj.com/articles/SB10001424127887323528404578452862092810552
Lineham Institute and Behavior Tech. (2015). Is DBT right for me? Retrieved from https://behavioraltech.org/resources/clients-family.cfm
Levy, D., Borland, R., Villanti, A., Niaura, R., et al. (2016, July 14). The application of a decision-theoretic model to estimate the public health impact of vaporized nicotine product initiation in the United States. Nicotine and Tobacco Research. Retrieved from https://ntr.oxfordjournals.org/content/early/2016/07/12/ntr.ntw158.abstract?sid=687cbbf1-1d86-41a7-af36-22f80a156b87
Madhani, A. (2016, August 7). It’s about to get much harder for minors to vape. USA Today. Retrieved from
https://www.usatoday.com/story/news/2016/08/07/e-cigarette-regulations-set-go-into-effect/88362926/#
McKelvy, C. (2016, August 1). What do e-cigarettes do to your lungs? TheWeek.com. Retrieved from https://theweek.com/articles/639363/what-ecigarettes-lungs
McNeill, A., Brose, L. S., Calder, R., Hitchman, S. C., et al. (2015). E-cigarettes: An evidence update. Public Health England. Retrieved from
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/457102/Ecigarettes_an_evidence_update_A_report_commissioned_by_Public_Health_England_FINAL.pdf
McRobbie, H., Bullen, C., Hartmann-Boyce, J., & Hajek, P. (2014). Electronic cigarettes for smoking cessation and reduction. Cochrane Database of Systematic Reviews. Retrieved from
https://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010216.pub2/full
Public Health England. (2015, August 19). E-cigarettes around 95% less harmful than tobacco estimates landmark review. Retrieved from
https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review
SmokeFree.gov. (n.d.). Sign up|smokefree TXT. Smokefree.gov. Retrieved from https://smokefree.gov/smokefreetxt
Student Health 101 survey, July 2016.
World Health Organization. (2014, July). Electronic nicotine delivery systems. WHO.int. Retrieved from https://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf
