Major U.S. Analysis Finally Released: Vaping Has Potential Health Risks, but Is Far Less Harmful Tha

According to domestic export data statistics, the global e-cigarette market size in 2018 was estimated at $22 billion, and it is expected to grow by 19.9% annually over the next four years. The awakening of health consciousness and the increasing prevalence of related stores and specialty shops in certain cities are contributing factors to the current expansion of the e-cigarette market.

But when it comes to health consciousness, is e-cigarette really healthier? Many studies have attempted to explain this issue, but differing sponsors behind the research often lead to different conclusions and statements. The scientific community also has many debates about the authenticity of such claims.

Recently, the U.S. Food and Drug Administration (FDA) specifically commissioned a task force from the National Academies of Sciences, Engineering, and Medicine to analyze all studies related to e-cigarettes and human health issues, clarifying which studies are definitive, which are tenuous, and which do not exist at all.
 
The National Academies of Sciences is the collective of the highest academic bodies in the U.S., having a broad influence on scientific research, technological innovation, and science and technology policy in the U.S. The National Academies is a private, non-profit organization that provides expert advice on the most pressing national challenges and shapes sound policies, informs public opinion, and promotes the advancement of science, engineering, and medicine.

This study, titled "Public Health Consequences of E-Cigarettes," began in 2018, and the related report has recently been submitted to the FDA, acknowledging that while e-cigarettes have potential risks, their harm is far lower than that of traditional cigarettes.

1. Nicotine and Addiction

There is substantial evidence that e-cigarettes can still lead to addiction. The level of nicotine exposure varies significantly depending on the brand of e-cigarette, e-liquid, and the habits of the smoker.

However, the National Academies report states that substantial evidence shows e-cigarettes can still deliver nicotine, and the amount is comparable to that of traditional cigarettes. Moderate evidence indicates that the risks and severity of dependence on e-cigarettes are significantly lower than those of traditional cigarettes.

2. Toxic Substances

Traditional cigarettes pose a serious threat to human health, with the most harmful sources being the smoke, tar, and carbon monoxide produced during combustion. Definitive evidence indicates that most e-cigarettes also release various potential toxins, leading to increased particulate matter concentration in indoor air.

Nevertheless, evidence shows that unlike cigarettes, these particulates dissipate within minutes, and the types and concentrations of toxic substances in e-cigarettes are lower than those in traditional cigarettes.

Based on the robustness of the research evidence, while e-cigarettes do increase the concentration of suspended particles and nicotine in indoor air, in most cases, the toxic substances that e-cigarette users are exposed to are significantly lower than those from traditional cigarettes.

Additionally, there is evidence that the cadmium levels in e-cigarettes are lower than those in traditional cigarettes. Cadmium can enter the human body through the respiratory and gastrointestinal systems, with 6% absorbed when ingested and up to 50% absorbed when inhaled. Since cigarettes contain cadmium, many dialysis patients have died due to the inability to metabolize the cadmium absorbed during smoking due to kidney failure.

3. Health Effects on the Human Body

The National Academies task force reviewed multiple studies on the health effects of e-cigarettes on the human body, including cardiovascular, cancer, respiratory, and oral diseases. The results found that different studies made up to 20 different claims regarding e-cigarettes and human health.

The National Academies clarified that inhaling nicotine through e-cigarettes can lead to increased heart rate and blood pressure. However, there is currently insufficient evidence to show that this will affect long-term heart rate, blood pressure, and cardiac function. So far, there are almost no cases confirming whether e-cigarettes ultimately lead to cancer or respiratory diseases.

Of course, some scholars believe that e-cigarettes may be related to seizures, but it is worth noting that nicotine has a suppressive effect on the nervous system, so whether it will trigger seizures may require a lot of research to assess.

4. Reducing Harm Risks

Definitive evidence indicates that completely replacing traditional cigarettes with e-cigarettes can reduce users' exposure to many chemicals and carcinogens.
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On the other hand, a recent study also showed that daily use of e-cigarettes helps with quitting smoking.

This study found that among adult smokers, those who used e-cigarettes daily had a 77% higher chance of quitting smoking successfully after two years compared to those who did not use e-cigarettes. However, even though it helps with quitting, the researchers emphasized that "doctors and professionals still need to monitor to prevent long-term relapse."
This paper, published in the journal "Nicotine & Tobacco Research," used data from about 8,200 adults who participated in the "Tobacco and Health Population Assessment Study." Each participant provided health, lifestyle, and tobacco use data and updated their tobacco use status to the researchers after 1 to 2 years.

At the beginning of the study, only 3.6% of smokers reported using e-cigarettes daily, while 18% reported occasional use. However, researchers found that by the end of the study, this small group of daily e-cigarette users had a much higher chance of completely quitting traditional cigarettes compared to those who occasionally used or did not use e-cigarettes at all.

Among daily e-cigarette users, 11% reported quitting smoking in two follow-up surveys, which is not a high overall percentage but significantly higher than the 6% of non-e-cigarette users.

Researchers found that occasional use of e-cigarettes was not associated with a higher chance of quitting smoking; this may be because occasional users do not intend to quit or may not use them consistently enough to satisfy their nicotine cravings. The researchers speculate that past studies may not have found a link between e-cigarette use and quitting smoking because they did not consider the differences between daily and occasional use.

Additionally, some public health experts are concerned that maintaining nicotine intake through e-cigarettes may increase the chances of former smokers returning to smoking, and recent studies support this claim.

However, in the aforementioned new study, daily e-cigarette users had only a slightly higher chance of resuming smoking habits compared to non-e-cigarette users; the proportion of those who quit smoking in the first year but resumed in the second year was about 4% for e-cigarette users and about 3% for non-users.
 
Overall, e-cigarettes are far less harmful than traditional cigarettes, but they are not without risks.

As the research indicates, many smokers still have the habit of using traditional cigarettes, which may increase the risks further. However, this study provides strong evidence that e-cigarettes can play a very important role in reducing smoking rates.

Moreover, regarding the "gateway theory" of e-cigarettes, the National Academies emphasize that there is currently no research confirming that e-cigarettes will become a gateway product to tobacco, but it is concerning that there is no evidence showing that using e-cigarettes will not lead to the use of tobacco products. Therefore, industry players and regulatory bodies should focus on how to effectively prevent youth access to e-cigarettes.

In other words, if you are a smoker, based on the current research findings, e-cigarettes can effectively help you stay away from traditional tobacco products while avoiding the potential risks associated with traditional cigarettes. But if you are not a smoker or if you are a teenager, please stay away from e-cigarettes!