Lung damage, pneumonia, cardiac arrest — death. The evidence emerging about the potential dangers of e-cigarettes is sobering.
A recent case highlighted by Royal Papworth Hospital in Cambridge involved a man who nearly died after taking up vaping and who had to be put on life support.
Yet e-cigarettes — battery-powered devices that vaporise nicotine to provide a smoker’s hit without the tar and carcinogens in tobacco — are promoted as an effective tool to help smokers quit.
Public Health England (PHE), amid what it described as ‘unfounded safety fears’, issued a fresh call for smokers to switch to vaping.
‘The evidence shows that vaping is one of the most effective quitting aids, helping around 50,000 smokers quit a year,’ said Professor John Newton, director of health improvement at PHE.
‘The evidence has been clear for some time that, while not risk-free, vaping is far less harmful than smoking.’
Yet experts fear that non-smoking teens are taking up vaping and potentially storing up long-term health problems.
Lung damage, pneumonia, cardiac arrest — death. The evidence emerging about the potential dangers of e-cigarettes is sobering
One paediatric lung specialist told Good Health that there had already been reports of severe lung damage in younger people following vaping.
The UK cases come in the wake of reports, mainly from the U.S., about deaths among e-cigarette users.
As of February 2020, 2,807 users had been hospitalised in the U.S., with 68 deaths where vaping was cited as the cause, the U.S. Centers for Disease Control and Prevention said.
M any of these reactions had been caused by vaping devices containing tetrahydrocannabinol — a cannabis-based liquid — and the additive vitamin E acetate.
Both chemicals are banned in vaping devices in the UK, and the implication is e-cigarettes in the UK are safe.
Proponents argue that with more than 70,000 people in the UK dying from smoking every year, vaping is a lesser evil. Yet, as Professor Newton acknowledged, vaping is not ‘risk-free’.
Lung damage from vaping has been recognised since 2019, when the first case was identified in the U.S., and has a name, Evali.
Symptoms of Evali include chest pain, shortness of breath, dizziness, nausea and headache.
Between January 2010 and January 2021, the UK Medicines and Healthcare products Regulatory Agency (MHRA), received 255 reports of 694 adverse reactions believed to be associated with nicotine-containing e-cigarettes.
In the UK, five adults are thought to have died as a result of vaping.
A disturbing example of the damage vaping can do was published last May by doctors at Royal Papworth Hospital, where a man, aged 40, arrived with severe, stabbing chest pains, struggling to breathe.
Six weeks earlier, he had given up smoking and taken up e-cigarettes.
He was put on a ventilator and needed a form of life support where patients don’t ‘breathe’ but their blood is continuously removed, re-oxygenated then returned. Fortunately, the patient survived.
Writing up his case in the journal ERJ Open Research, his doctors concluded: ‘Vaping generates aerosols containing a heterogeneous mix of potentially harmful substances and pulmonary disease related to vaping has been identified in recent case[s].’
They added: ‘While the risks may be ameliorated by UK and European legislation to reduce inhaled toxicant exposure, there is an ongoing hazard of life-threatening lung injury associated with the use of these devices.’
The World Health Organisation’s view is unequivocal. ‘The evidence is clear that the aerosols of the majority of ENDS [electronic nicotine delivery systems] contain toxic chemicals, including nicotine and other substances that can cause cancer.
‘ENDS on their own are associated with increased risk of cardiovascular diseases and lung disorders … both tobacco products and e-cigarettes pose risks to health and the safest approach is not to consume either.’
There are concerns that young people see vaping (it is illegal under the age of 18) as a safer alternative to smoking.
Dr Aaron Scott, a lecturer in respiratory science at Birmingham University, says he sees at least as many young people vaping as smoking. ‘Teenagers who have never smoked are now becoming chronic e-cigarette users.’
And Dr Hemant Kulkarni, a consultant in paediatric respiratory medicine at Sheffield Children’s NHS Foundation Trust, adds: ‘We are aware of younger people who have had acute and chronic lung damage after vaping.’
During a lab study in 2018, Dr Scott and his team found the vapour e-cigarettes produce may cause inflammation in the lungs and impair the activity of immune cells.
‘We also found that exposure to e-cigarette vapour induced many of the same cellular changes seen in cigarette smokers,’ says Dr Scott, who says those who give up smoking, then take up vaping may be swapping one addiction for another.
He cites a 2019 study, by Queen Mary University of London, in which 886 smokers switched to vaping or nicotine replacement.
After a year, 18 per cent on the e-cigarettes had not returned to smoking, compared to 9.9 per cent on nicotine replacement.
But 79.8 per cent of the e-cigarette group were still using them after a year, compared to 9.1 per cent on the nicotine replacements.
‘Even if it’s lower harm, it is a continuing source of harm,’ says Dr Scott. ‘And even if it’s only ten per cent as harmful as smoking, perhaps it just takes longer to get those negative impacts.
‘We don’t know the full ramifications of that because [e-cigarettes] simply haven’t been around long enough.’