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Updated 04 September 2018

To vape or not to vape?

Some claim they’re safer than smoking but studies suggest e-cigarettes may increase the risk of DNA damage and other health.

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You’ll see them in cars, gathered outside office buildings and hanging around bars and nightclubs: people shrouded in clouds of aromatic “smoke”, pulling on hitech-looking devices a little thicker than a pencil.

They’re the growing band of smokers the world over who are taking to vaping, a much-hailed “safer” alternative to cigarettes and a pastime touted as an effective way to give up conventional smoking.

Yet recent research might make vapers want to reconsider inhaling the stuff their e-cigarettes produce – because these devices could apparently lead to several scary diseases.

What the boffins found

Earlier this year, scientists at New York University (NYU) led by environmental professor Moon-Shong Tang exposed laboratory mice to electronic cigarette vapour for 12 weeks. The dose and duration of the nicotine exposure was the equivalent of 10 years of light e-cigarette smoking in humans.

Researchers found DNA damage in the hearts, lungs and bladders of mice exposed to the vapours. This damage wasn’t found in a control group of animals that breathed ordinary filtered air.

Natural DNA repair mechanisms were also found to be suppressed in the mice exposed to the smoke.

Nicotine inhaled from e-cigarettes could be converted into chemicals that damage DNA and slow down the body’s genetic repair mechanisms, Tang concluded.

He also found that exposing human lung and bladder cells to nicotine and its breakdown products made the cells turn into tumour tissue more easily.

Tang and his team concluded that although vaping delivers fewer carcinogens (substances that cause cancer) than tobacco smoke, e-cigarette smokers might have a higher risk of developing lung and bladder cancer as well as heart disease.

But then others say . . .

The NYU mice may have become the poster children for the dangers of vaping but other researchers have dismissed these findings as irrelevant to human smokers.

The animals were exposed to extremely large doses of nicotine and this can’t be compared to the consumption of vapour in humans, says Peter Hajek, director of the Wolfson Institute of Preventive Medicine’s tobacco dependence research unit at Queen Mary University of London.

Jasmine Just of Cancer Research UK agrees. The study looked at the effect of e-cigarettes on mice, she says, and it’s not possible to draw conclusions about how vaping affects humans.

“Research in people has shown that those who make a switch from smoking tobacco to e-cigarettes can significantly reduce their exposure to the key harmful chemicals in tobacco smoke.”

And then there’s this

Soon after the Tang study was released, a study published in the European Respiratory Journal suggested users of e-cigarettes might be at higher risk of lung infection.

Scientists at Queen Mary University conducted three experiments: one exposed human nose-lining cells to e-cigarette vapour in a lab; another involved mice inhaling vapour and then being exposed to pneumococcal bacteria, the main cause of pneumonia; and a third studied the nose  lining of 11 e-cigarette users compared with that of six non-vapers.

The team noticed a sharp increase in the amount of bacteria sticking to airway cells after e-cigarette exposure.

This has previously been shown to increase people’s susceptibility to disease.

“Some people might be vaping because they think it’s totally safe or in an attempt to quit smoking, but this study adds to growing evidence that inhaling vapour has the potential to cause adverse health effects,” said Professor Jonathan Grigg, co-author of the study.

By contrast, other aids to quitting such as nicotine patches or gum don’t result in airway cells being exposed to high concentrations of potentially toxic compounds.” 

But this study also has its detractors. Peter Openshaw, an experimental medicine professor at Imperial College London, says any evidence that vaping raised the risk of lung infection was only indirect.

“Although it’s possible that vaping might increase susceptibility to pneumonia, the effect is likely to be lower than from smoking itself,” he said.

“This study shouldn’t be used as a reason to continue to smoke rather than vape – the evidence so far is that e-cigarettes are far less harmful than smoking.”

What do South African experts say?

There’s no scientific evidence that vaping is safer than smoking, says Professor Michael Herbst of the Cancer Association of South Africa (Cansa).

“E-cigarettes have been around only since 2004 and insufficient scientific research has been conducted to really declare e-cigarettes ‘safer’ than cigarettes,” he says. “The long-term effects of e-cigarettes on the human body remain unknown.” Savera Kalideen, executive director of the National Council against Smoking, says it considers vaping less harmful than smoking cigarettes but not harmless.

She believes there’s enough evidence to show that e-cigarettes have been linked to damage and inflammation of the airways and lung disease, as well as stiffening of the arteries that can lead to heart attacks and strokes.

“We’d recommend that those who want to give up smoking do so without the aid of e-cigarettes.”

Vaping goes viral

The popularity of e-cigarettes is increasing rapidly in South Africa, with “a proliferation of vape stores in shopping malls and places where young people congregate”, Kalideen says.

The industry is clearly targeting young people by introducing flavours such as cream soda float and chocolate “to mask the unpleasant flavour of  e-cigarettes to encourage young people to use them”, she adds.

The liquid in an e-cigarette usually contains nicotine, the addictive ingredient in cigarettes – but nicotine on its own is no more harmful than caffeine, says Greg Oliver, CEO of e-cigarette company Evolution Vape.

The dangers associated with smoking cigarettes come from the tar and toxic gases released from burning tobacco.

“The e-liquid is added to a device that contains a disposable coil, which is made up of organic cotton and a metal coil element.

“When the device is activated with an ignition button, the coil heats up and converts the e-liquid on the cotton into a vapour that’s inhaled,” Oliver explains.

Kalideen agrees that e-cigarettes have substantially less nicotine than cigarettes, but “they release toxins in the vapours they produce. It’s these toxins that can harm health.”

Calling it quits

“Feedback from our customers has been that vaping has been the most appropriate enabler to quit smoking cigarettes,” Oliver says.

Vaping also eliminates the effects of second-hand smoke and negates the unpleasant odour cigarettes create. But Kalideen says there’s no evidence that vaping has reduced the number of cigarette smokers in SA.

There are still about six million smokers in the country and around 500 000 vapers, she adds. “Most people who call our Quitline are looking for assistance to stop smoking completely.

We don’t propose e-cigarettes as an alternative.” Not only are they “less satisfying” as they contain less nicotine, they’re also vastly more expensive than cigarettes.

 
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