Is Vaping Really 7 Times More Harmful Than Cigarettes?

Is it true that e-cigarettes are 7 times more harmful than cigarettes? Regardless of whether this article is a call for e-cigarettes, I think it is important to make the facts clear, rather than directly copy+paste the brainless information that e-cigarettes are 7 times more toxic than cigarettes, so that e-cigarettes can move forward better. Regardless of whether the national standard is restricted or not, as well as the attitudes and measures of relevant ministries and commissions, we electronic smokers must have a clear understanding and independent judgment of what we use so that we are not easily biased by all parties.

Is it true that e-cigarettes are 7 times more harmful than cigarettes?

In 2015, the UK's Public Health England (PHE) publicly announced that e-cigarettes are at least 95% less harmful than traditional cigarettes. It has to be said to be a boost in the arm for e-cigarette smokers. However, although the argument that e-cigarettes are seven times more toxic than cigarettes is popular in the domestic media, and reducing harm by 95% has become a magic weapon for e-cigarettes, most e-smokers do not understand why it is safer and why it is 95%., not 94%, 96%, Uncle Fan will take you to trace the origin.
 
The story began in 2014, when e-cigarettes were just emerging in the UK, so PHE commissioned a study to study the health impact of e-cigarettes. A year later, the 2015 annual report written by John Britton and Ilze Bogdanovica of the Center for Tobacco and Alcohol Research at the University of Nottingham in the UK was submitted to PHE. After carefully reviewing the report, PHE officially announced that the current hazards of using e-cigarette products on the market may be very low, of course much lower than that of smoking, and the health risks of passive exposure to e-cigarette vapors are likely to be extremely low.
   
The report first pointed out that electronic cigarettes contain toxic substances, including small amounts of formaldehyde and acetaldehyde, but the content of these substances is much lower than that of traditional cigarettes.

Then we continue to explain the reduced harm gained from smoking compared to smoking and describe some of the advantages of using e-cigarettes over nicotine replacement therapy (NRT). ldquo; E-cigarettes provide nicotine delivery in a form that mimics smoking and have a socially acceptable non-medical image, allowing users to retain their identity as smokers without the risk of smoking.

"So, unlike NRT, especially if the delivery of nicotine can be improved to more closely mimic cigarettes, these products have potential appeal and could challenge tobacco's status as the product of choice for nicotine users, the report authors added. ldquo; Choosing to switch to e-cigarettes as an alternative and a safer source of nicotine, as a personal lifestyle choice rather than a medical service, holds huge potential for smokers who currently have difficulty accessing existing methods. rdquo;

Subsequently, PHE released its own report: These conclusions were consistent with the assessment of an international team of experts, which assessed the risk of smoking below 5%. Another international team conducted a comprehensive review of the relevant literature and concluded that e-Cigarette liquids can contain some toxic substances present in tobacco smoke, but at much lower levels. The long-term health effects of e-cigarette use are unclear, but compared to cigarettes, e-cigarettes may be much less, if any, harmful to users or bystanders. rdquo;

To better understand the origin of the statement of at least a 95% reduction, we need to look at another study conducted by an international expert panel convened by the Independent Scientific Committee on Drugs (ISCD). Researchers at the latter developed a multi-criteria decision-making analysis model that describes the relative importance of different types of harm associated with the use of nicotine-containing products.

They analyzed 12 products and identified 14 hazard standards, 7 of which constituted harm standards to users, and the other 7 had the possibility of harm to surrounding people. The researchers used a 100 definition of the most harmful product under a specific criterion to average the harm rating of all products for each criterion, and defined a score of zero as harmless.

The results are as follows:
 
As mentioned above, an ENDS (e-cigarette) score is below 5, which means that such products represent only 5% of the risk of smoking. In other words, e-cigarettes are at least 95% safer than cigarettes.# p#pagination title #e#

After reviewing relevant scientific literature, the PHE concluded that the risks associated with smoking may be very low compared to the risks associated with smoking.

To ensure accurate findings, PHE also studied compounds in the vapor, particularly formaldehyde and acrolein.

The first study on these harmful substances was first mentioned by the Japan Times in 2014. According to the study, during testing of various electronic cigarettes, one of them was responsible for 10 times higher formaldehyde emissions than tobacco cigarettes.

However, PHE has explained that emissions of these toxic substances only occur when e-liquids are overheated. Moreover, the above-mentioned Japanese research has never been published in any academic journal.

According to experiments conducted by the California Department of Public Health (CDPH) in 2017, harmful substances such as formaldehyde and acetaldehyde will be gradually produced in large quantities when heated to above 250 degrees.
 
A few months later, in January 2015, a similar study was published, according to which when e-cigarettes were used at maximum power for 3 to 4 seconds, the rate of formaldehyde found in aerosols was 5 to 15 times higher than in tobacco.

However, in response to this, the PHE has officially explained that these results were obtained through testing on smoking machines, and no one would smoke for such a long time under such power. In addition, when e-cigarette users feel thirsty, they instinctively breathe out the vapor because of the unbearable smell that smoking machines cannot detect. Therefore, although the existence of these toxic substances is undeniable if the e-liquid is overheated, no substance will be inhaled repeatedly.

A study conducted by Dr. Konstantinos Farsalinos, a prominent anti-smoking expert at the Onassis Heart Surgery Center in Athens and the University of Patras in Greece, and his researchers confirmed these statements.

Dr. Farsalinos 'report noted that none of the testers involved in the study were able to perform vaping under the same conditions as smoking machines. Due to the smoke, everyone was forced to breathe out steam. In addition, he said, under normal use, levels of toxic compounds present in aerosols are absent or negligible.

Similarly, with regard to acrolein, other scientists have shown that levels of acrolein and crotonaldehyde in the urine of electronic smokers are much lower than those of tobacco smokers.

Note: Only when used under harsh and unrealistic conditions, the evaporator produces a higher formaldehyde content than the amount of smoke smoked. In normal use, the vapor produced by e-cigarettes contains toxic compounds that are absent or negligible.

Another study in 2015 linked e-cigarettes to lung health problems. By locking test mice in a box and exposing them to e-cigarette aerosols, the team concluded that vaping can cause inflammation and lung infections, and even cancer.

PHE once again pointed out that there were some problems with the study.

1. E-cigarettes should only be seen as a tool to reduce the risk of smoking. Therefore, any study that aims to highlight the problems caused by vaping must compare them to problems caused by smoking, which this study did not do.

2. The group of mice exposed to e-cigarette vapor was more stressed than the control group, and stress is known to affect bacterial and viral responses. As a result, the results of this study were once again considered unreliable.

3. In addition, given the limited metabolic characteristics of mice, they are also more likely to cause repeated nicotine poisoning. The UK Department of Health explained that the accelerated weight loss of recipients, reduced immunity and shortened lifespan are more likely caused by long-term stress and high-concentration nicotine poisoning than exposure to free radicals, especially based on the study's determination of free radical content, the aerosol content of electronic cigarettes is 1000 times lower than that of tobacco cigarettes.

Note: Free radicals are unstable and highly reactive molecules. Simply put, the oxygen in the body is divided into individual atoms, accompanied by mismatched electrons. The problem is that electrons work in pairs, so those that are isolated (called free radicals) will look for other electrons that form a pair with them, a process that destroys the composition of cells, DNA and proteins. Free radicals are found in large quantities in cigarette smoke and are known to cause various cancers, cardiovascular diseases and skin aging.# p#pagination title #e#

That same year, another study revealed similar results. However, as PHE points out, once again, there is no comparison with smoking.

Is it true that e-cigarettes are 7 times more harmful than cigarettes? Most of the symptoms currently reported when using e-cigarettes are local oral irritation and dry mouth. Regarding the respiratory tract, studies have shown that smokers with asthma have improved their conditions after using e-cigarettes. Another study found that there was no significant effect on the human body after using e-cigarettes for one year.

References:

[1] Britton, J. and Bogdanovica, I., Electronic cigarettes: A report commissioned by Public Health England. London: Public Health England, 2014

[2] McNeill, A., Brose, L.S., Calder, R., Hitchman, S.C., Hajek, P., and McRobbie, H., E-cigarettes: an evidence update – A report commissioned by Public Health England, 2015

[3] Nutt, D. J., et al., Estimating the harms of nicotine-containing products using the MCDA approach.European addiction research, 2014

[4] Hajek, P., et al., Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction, 2014

[5] Jensen, R. P., et al., Hidden Formaldehyde in E-Cigarette Aerosols. New England Journal of Medicine, 2015

[6] Farsalinos, C., E-cigarette aerosols generates high levels of formaldehyde only in ‘dry puff’ conditions. Addiction, （in press）

[7] Hecht, S.S., et al., Evaluation of toxicant and carcinogen metabolites in the urine of e-cigarette users versus cigarette smokers. Nicotine & Tobacco Research, 2014

[8] Sussan, T. E., et al., Exposure to Electronic Cigarettes Impairs Pulmonary Anti-Bacterial and Anti-Viral Defenses in a Mouse Model. PLoS One, 2015

[9] Lerner, C.A., et al., Vapors produced by electronic cigarettes and e-juices with flavorings induce toxicity, oxidative stress, and inflammatory response in lung epithelial cells and in mouse lung.PLoS One, 2015

[10] Hajek, P., et al., Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction, 2014

[11] Polosa, R., et al., Effect of smoking abstinence and reduction in asthmatic smokers switching to electronic cigarettes: evidence for harm reversal. Int J Environ Res Public Health, 2014

[12] McRobbie, H., et al., Electronic cigarettes for smoking cessation and reduction.Cochrane Database Syst Rev, 2014

[13] Alistair Servet，How is vaping 95% safer than smoking, 2019

This article was reproduced in Zhihu netizen Mojito.