To Vape or Not to Vape? 6 Common Myths About Vaping

Since its invention by Han Li in 2003, electronic cigarettes have developed over just a decade, rapidly spreading in the European and American markets in recent years. Traditional cigarettes entered the European and American markets around 1850, and it took nearly a century for medical literature to link smoking with lung cancer, while most people only began to recognize the health hazards of smoking around the 1970s. In comparison, the history of electronic cigarettes is much shorter, and for the majority of people in China, they remain a relatively unfamiliar new product. The debate surrounding electronic cigarettes has only just begun.

There are many controversies regarding electronic cigarettes; today, this article will list some common points of contention for a brief analysis.

Are electronic cigarettes more harmful than traditional cigarettes?

The claim that electronic cigarettes can reduce harm has been clearly stated by the UK Public Health Department, which indicates that electronic cigarettes are 95% less harmful than regular cigarettes and encourages smokers to switch to e-cigarettes. This report was primarily authored by various research institutions in the UK, including King's College London, the UK Cancer Research Center, the UK Tobacco and Alcohol Research Center, and Stirling University, and spans 243 pages.
 
The father of modern smoking cessation, British psychiatrist Michael Russell, famously stated in a 1976 BMJ article: "people smoke for nicotine but they die from the tar." We have previously analyzed the dangers of traditional cigarettes: tar is extremely harmful to the human body, and the thousands of harmful gases produced by combustion, along with nicotine as an addictive substance, can lead to addiction, while secondhand and thirdhand smoke can indirectly affect the health of those around smokers.

Most people are well aware that smoking is harmful to health, but quitting smoking is also a difficult task. Since quitting is hard, why not use other products as a substitute? This is where electronic cigarettes come in.
 
Electronic cigarettes avoid combustion, thus avoiding the harmful substances (tar, harmful gases produced by combustion) found in traditional cigarettes, as well as the issues of secondhand and thirdhand smoke. From this perspective, electronic cigarettes indeed reduce the harmful substances produced by the combustion of traditional cigarettes. For long-term addicted smokers, using electronic cigarettes as a substitute for traditional cigarettes to reduce harmful substance intake is a good option.

"A drop of nicotine can kill a horse"?

The saying "a drop of nicotine can kill a horse" does not equate the amount of nicotine inhaled to the harm it causes to the human body. Only a small portion of the nicotine inhaled is absorbed by the body, and it quickly degrades and is expelled through metabolism. As long as one does not consume large amounts of nicotine daily, the harm to the body is minimal.
 
Although nicotine is not classified as a carcinogen, excessive long-term intake may lead to neurodegenerative diseases and cardiovascular issues, and theoretically, it could cause brain development problems in children and fetuses. While there is no need to fear nicotine, it is still important to acknowledge the potential health risks. For those without a nicotine addiction, it is best to avoid nicotine-inhaling devices, including electronic cigarettes.

Can electronic cigarettes cause popcorn lung?

This concern arises because some brands of e-liquid may contain buttery flavoring agents, which could include diacetyl (2,3-butanedione). In the United States, there have been cases of eight workers at a popcorn factory suffering from "obstructive bronchiolitis," also known as "popcorn lung," hence the name.
 
However, the FDA has classified diacetyl as a "generally recognized as safe" flavoring agent, with no negative health impacts observed from consumption or ingestion. The cases at the popcorn factory occurred under very high exposure levels, meaning long-term exposure to large amounts of diacetyl, while the concentration of diacetyl in e-liquids is very low, hundreds of times lower than in cigarette smoke, and many e-liquids do not even contain diacetyl. Therefore, there is no need to worry about electronic cigarettes causing "popcorn lung"; if you are concerned, check the quality inspection reports when purchasing and choose trustworthy brands.
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Are electronic cigarettes completely harmless?

The main components of electronic cigarettes are propylene glycol, vegetable glycerin, food flavorings, and nicotine (there are also nicotine-free vapor products), which generate aerosol by heating the e-liquid through electronic components. The aerosol produced by electronic cigarettes is not completely harmless; it contains some tiny particles that may cause cancer and could include some heavy metals and volatile compounds.

The toxic and harmful components produced by burning traditional cigarettes, such as formaldehyde, acetaldehyde, propionaldehyde, toluene, N-nitrosamines, and nitrosamines, are significantly lower in electronic cigarettes than in regular cigarettes. This data was provided by the National Academies of Sciences, Engineering, and Medicine (NASEM) in their 2018 report "Public Health Consequences of E-Cigarettes."
 
Thus, electronic cigarettes are not as completely harmless as some businesses claim, but they still have significant harm reduction potential. For smokers, this is a lesser evil choice. This is also why the UK Public Health Agency, despite facing various criticisms, continues to advocate for electronic cigarettes to help more smokers transition away from traditional cigarettes.

Compared to the well-known harms of traditional cigarettes, electronic cigarettes have about 500 different brands and 8000 different flavors, and the risks depend not only on the brand and batch of the device and e-liquid but also on its flavor, atomizer structure, composition, power, temperature, contact plastics, packaging, etc. For example, one study found that two electronic cigarettes from the same batch had a 25-fold difference in formaldehyde concentration. Therefore, when choosing electronic cigarettes, it is essential to select reliable brands with authoritative testing reports to minimize unnecessary harmful substance intake.

Can electronic cigarettes help with quitting smoking?

A study published in the "Chinese Journal of Clinical Physicians" in 2015 indicated that electronic cigarettes can help smokers quit or reduce their smoking volume, with 47.1% of smokers reporting a decrease in smoking.

Although the World Health Organization believes it cannot be definitively determined that electronic cigarettes can help completely quit smoking, at the very least, they can help reduce traditional cigarette consumption, making them worth recommending to smokers.
 
Do electronic cigarettes affect youth smoking rates?

In January 2019, a charity called the UK Cancer Research Center stated that there is no evidence that electronic cigarettes lead to youth smoking in the UK. The smoking rate among young people has been declining, and the probability of non-smoking youth using electronic cigarettes is very low, around 0-1%.
 
However, the situation in the United States is different. In 2010, 1.8% of minors had used electronic cigarettes, which rapidly rose to 13.0% in 2013 and further increased to 16% in 2015. The CDC (Centers for Disease Control and Prevention) published survey results showing that the number of youth electronic cigarette users in the U.S. continues to rise sharply, increasing from 1.5 million in 2017 to 3.6 million in 2018, including over one-fifth of high school students.
 
The growing data is not the only concern for the U.S. government; the electronic cigarette industry is also worrying due to its targeted product designs and marketing towards minors. The CDC's survey also indicated that nearly 70% of youth electronic cigarette users use various flavored e-cigarette products (with 7000 different e-liquid flavors), and 50% of youth electronic cigarette users use mint and menthol-flavored e-cigarettes.

The emergence and popularity of electronic cigarettes in the market have occurred over just a decade, and research on electronic cigarettes is still in a phase of 'conflict.' The debate surrounding electronic cigarettes has only just begun.

China's regulation of electronic cigarettes is also expected to see more comprehensive regulatory laws introduced by the end of this year, clearly outlining requirements for devices, e-liquids, and aerosol emissions, hoping to effectively standardize industry standards and development in China's electronic cigarette sector. It is also hoped that the future development of electronic cigarettes will pose less harm and benefit smokers and the public environment more.