What is more harmful - vaping or cigarettes: doctors' opinion, scientific research

Long-term nicotine addiction can provoke a functional disorder of the body and reduce a person’s quality of life . Electronic cigarettes (replacements for traditional smoking sticks with nicotine), which appeared recently, are positioned by manufacturers as a revolutionary and safe alternative that can reduce damage to health. However, discussions about the harmlessness of the new invention have not subsided since its appearance. The question remains: which method of consumption poses a greater threat to health—traditional tobacco smoking or inhaling vaping vapor?

What is more harmful: vaping or cigarettes?

We can say for sure: both are dangerous! Scientists from the University of California at San Francisco have calculated that vaping users almost double the risk of having a heart attack, and people who use both electronic and regular cigarettes increase this risk 5 times!

Let's figure out what is worse: cigarettes or vaping. By the way, we have already written about the dangers of smoking cigarettes, and in the same article there is information about the dangers of hookah.

What is the difference between a regular cigarette and a vape?

In order to understand whether a cigarette or a vape is more harmful, you need to understand how both work. Let's go over the main differences between vaping and cigarettes.

What is a regular cigarette? Tobacco wrapped in paper with a special filter. In the process of smoking, tobacco smoke, containing a huge amount of harmful substances, first enters the body, and then exhales into the environment.

The vape consists of two main parts, the battery and the vaporizer. The heating element of the evaporator is heated by the energy of the battery and evaporates the liquid.

Some new e-cigarette models allow users to increase the vapor output. These higher voltage devices can emit carcinogens, including formaldehyde, at levels comparable to cigarette smoke.

Mortality

Okay, we've learned that any source of nicotine other than the pure stuff is addictive and addictive. But what about the method of delivering it to the body? I won’t languish for a long time - cigarettes are much more harmful!

The CDC states that cigarette smoking is responsible for 1 in 5 deaths in this country (3). The CDC is a very serious division of the Ministry of Health (like the FDA), their budget alone is about 12 billion dollars (4), which is approximately the entire Russian budget for health care (5).

Where does death come from? Briefly: cigarettes contain thousands of different chemical elements, some of them are carcinogens + the combustion process itself, this is in no way comparable to vaping.

Don’t assume that vaping is being used less. 37% of high school students in the United States enjoy vaping, which is even more than regular smokers (6). Despite the fact that in 2021 there were 28%. And according to data from the CDC for 2021, almost 7 million Americans prefer electronic cigarettes, and 34 million use regular cigarettes (7). Taking into account the dynamics of change over 3 years and the fact that users of conventional cigarettes, roughly speaking, are “quickly dying out,” we are already close to parity between cigarettes and vaping. These statistics lead to the fact that vaping is not some incomprehensible dregs from among hipsters, but a completely ordinary phenomenon.

In short, what about mortality from vaping?

40 people in less than 2021 due to acute lung injury, 2000 hospitalizations (8). This is for all 328 million people in the United States. A little math: in the USA there are 2.8 million deaths per year, let’s reduce it to 2 million, since 40 with vaping is not a full year. And let's plug in the CDC data that 1 in 5 from cigarettes = 400,000 deaths. The difference with vaping is 10,000 times.

Immediately a nuance! Vaping is a new topic; cigarettes have been studied for decades. Therefore, the effects of vaping in terms of cancer and other popular risks will be observed over the next 20-30 years.

Even taking this into account, modern scientific data, including from Harvard, call “vaping” safer than cigarettes (9, 10).

But even if we assume that the death rate from vaping will skyrocket 100 times in 20 years, the difference will still be 100.

The dangers of tobacco smoke

I can write endlessly about the harm cigarettes cause to the body, so I will try to present everything briefly. The main reason why cigarettes are dangerous is the combustion of tobacco smoke, which releases about 250 harmful substances. This number includes 69 carcinogens.

Microscopic particles of tobacco smoke, entering the body, provoke the development of a number of diseases - from osteoporosis, anemia, infertility and impotence to toxic hepatitis and oncology. Each puff has a destructive effect on DNA (damages the P16 gene) and leads to the appearance of cancer mutations. The respiratory organs and cardiovascular system receive the most severe blow.

A little about passive smoking

However, even if you yourself have never touched a cigarette, stay away from hostages of smoky vice. Passive smoking is no less dangerous for the body than active smoking: it not only reduces the mental activity of the brain, affects the bronchi and lungs, but also increases the risk of heart disease and cancer.

By the way, in 2013, Russia adopted a federal law banning smoking in public places (stadiums, hospitals, shops, train stations, hotels, cafes, restaurants and even on the landings of apartment buildings). Remember this when your neighbor starts smoking on the shared balcony.

Nicotine

Nicotine is one of the most harmful and dangerous compounds for human health. It not only causes physical and mental dependence, but is also capable of changing the human genome. It is for this reason that women during pregnancy are strongly advised to quit smoking. Otherwise, the unborn child risks getting a whole bunch of diseases - from hypertension, obesity, respiratory diseases to diabetes and mental disorders.

It is impossible to make regular cigarettes nicotine-free, since this alkaloid is contained in small doses in tobacco. With liquids for electronic cigarettes, the situation is simpler - many manufacturers simply do not add nicotine to the mixes. Such liquids are called nicotine-free or “nulevka”.

You can switch from regular cigarettes to electronic ones, first filling them with nicotine liquids. This will help significantly reduce harm to health. And if you want to get rid of nicotine addiction, buy liquids with a lower strength each time. So, in a few months you will be able to switch to “zero”.

If we compare which is better - a cigarette or an electronic cigarette - then the advantage will be on the side of electronic devices. You can refill them with nicotine-free e-liquids, minimizing the risks of addiction and health harm that arise from nicotine use.

Is vaping harmful or not?

Many people are turning to vaping to quit smoking. After all, every second advertisement dedicated to electronic cigarettes talks about the incredible benefits for smokers. There are no nasty tars emitted from a vape like there are when smoking. We gradually reduce the dosage and quit smoking completely. But not many people succeed. Is vaping harmful and how does it affect the body?

Every year, sales of vapes are only increasing and more and more young people are becoming addicted to nicotine. It turns out that vaping may help a motivated adult quit smoking, but for others it will help them start or worsen the situation.

Many are also concerned that e-cigarettes, considered safer, are attracting teenagers. Their use by middle and high school students has increased from 6% to 20% in three years (2021 data). Is vaping without nicotine harmful? Yes, and here's why.

Main components

The main components of the aerosol are propylene glycol and glycerin. These seem to be two harmless substances, but when heated, the first can turn into propylene oxide, which, according to the International Agency for Research on Cancer, is carcinogenic to humans.

A carcinogen is a substance that promotes the development of malignant tumors.

Nicotine

Liquids contain nicotine, which increases the risk of many diseases, including cardiovascular diseases. Nicotine also contributes to the emergence and development of cancer.

It was experimentally established that the nicotine concentration in the analyzes of people who exchanged regular cigarettes for electronic ones does not change. Either the math is bad and it’s difficult to calculate the dose, or the body can’t be fooled and as the dosage decreases, the person begins to smoke more.

The main disadvantage of vaping is the difficulty of controlling the dosage. A replacement vape cartridge has the same harmful effects as a pack of cigarettes, so when using it, you need to look at your watch to control the dosage. I already wrote above that some devices allow you to increase the amount of steam, which aggravates the situation.

Many people do not realize how much nicotine they are putting into their bodies and how quickly they are doing it. A toxic concentration of nicotine of 50 g is achieved very quickly, so I repeat, you need to monitor the time you use the vape in order to avoid unpleasant consequences.

In addition, nicotine in a vape is absorbed faster and better. When you smoke a cigarette, nicotine reaches the brain within 7 seconds. When vaping, nicotine reaches the brain in 2 seconds.

Due to improper use, cases of nicotine poisoning have become more frequent. After all, many people think that it smells nice, the clouds of steam are beautiful, but the rest is nonsense.

Symptoms of liquid nicotine poisoning:

• vomit;
• diarrhea;
• cardiopalmus;
• labored breathing;
• headache.

There are also liquids without nicotine, but with a set of other toxic substances. Besides, whether they contain nicotine or not, no one actually checks. Neither cartridges nor the devices themselves are subject to mandatory certification. So, only the manufacturers know what exactly the device is stuffed with.

Since vapes appeared not so long ago, their effects on the body have not been fully studied to date. So the health consequences can be unpredictable.

Flavors

In 2021, scientists from the University of Rochester Medical Center in New York decided to test the hypothesis that electronic cigarettes that do not contain nicotine would be less harmful and analyzed in detail the flavors included in their composition.

It turned out that flavorings are also toxic. For example, they contain diacetyl and acetylpropionyl, both toxic chemicals. Diacetyl adds flavor. Inhaling it leads to scarring of the lungs or popcorn lung disease.

The disease got its name after hundreds of people who worked in popcorn production suffered permanent lung damage.

This is an example of how the lack of control over the composition of electronic cigarettes can lead to serious consequences. The most dangerous scents are those that are sweet and oily, such as vanilla and cinnamon.

Acrolein

Some electronic cigarettes contain acrolein in the vape liquid. This unsaturated aldehyde is toxic and is used primarily as a weed control agent. It can be formed when glycerin is heated, and can provoke chronic lung diseases.

And also do not forget that the electronic device is explosive. There are many similar cases, here is an example of one of them.

Remember, vaping is not that safe! And even if it does not contain nicotine, it still contains elements hazardous to health.

Effect of electronic cigarettes

The liquid filler contains the following components:

1. Propylene glycol is a colorless, viscous substance that is a good solvent for many substances.
2. Glycerin is a viscous, odorless liquid that, when combined with water, generates heat and creates steam.
3. Flavoring additives.
4. Filtered water is an absolutely harmless component that serves to create a certain consistency.
5. Nicotine is an alkaloid (an oily liquid with a bitter taste that easily mixes with water). Not present in all fillers.

The main danger lies in the composition of the flavoring additive and the presence of nicotine in the mixture . Many scientific works are devoted to the toxic effects of nicotine. It causes harm to the body in any form of use (smoking or vaping - it doesn’t matter).

The influence of an electronic device often does not go beyond the negative effects of nicotine, but it happens that irresponsible manufacturers mix substances (in particular, essential oils) into the filler that are harmful to health.

The presence of essential oils is a danger that provokes various complications over time. There is a possibility of poisoning from oil solvents (for example, glycerin triacetate, an ester of acetic acid and glycerin, used in some mixtures).

The possible harmful effects of vaping are as follows:

• Damage to the cilia of the cells lining the airways. The cilia are responsible for cleaning the incoming air from dust and mucus. Their damage leads to pollution and lung dysfunction.
• Damage to the pulmonary alveoli by oils that disrupt the structure of tissues and the process of gas formation in the lungs. It is extremely difficult to remove oils from the body (they are difficult to dilute with special preparations).
• Violation of local or general blood circulation under the influence of flavoring reagents.
• Disorientation in space (fogged consciousness).
• Allergic reactions.
• Damage to the nasal mucosa when trying to inhale vapors through the olfactory organ.
• Addiction to the bad habit of teenagers who imitate adults and consider e-cigarettes to be harmless fun.

Adding nicotine to a smoking mixture is fraught with negative consequences. The use of a dangerous substance leads to disruption of the brain, heart, blood vessels, joints, digestive tract and endocrine system.

How vaping is regulated in America

Recently, in the United States, the Center for Disease Prevention and Control (CDC) reported an outbreak of a mysterious disease of mild to severe respiratory illness among vapers. Hundreds of cases are being investigated across the country. Unfortunately, there have already been several deaths.

As a result, the US government seriously intends to ban vapes throughout the country (they are especially popular among American teenagers), and some states have already introduced an age limit for their sale.

San Francisco authorities have already introduced a ban on the sale of electronic devices. Distribution of products is prohibited both in stores and on online platforms. Manufacturers of vapes and e-cigarettes can distribute their products as long as their product has been inspected by the Food and Drug Administration and received a safety certificate. But as you may have guessed, no company has been given such permission yet.

Who shouldn't vape?

Vaping is dangerous to anyone's health. However, there are groups of people who may be more affected by e-cigarettes than others. These primarily include children of any age and pregnant women. People with chronic lung and heart diseases may have their disease worsened by vaping. Inhalation of toxic substances accelerates the development of cardiovascular disorders, which is especially dangerous for people with a predisposition to such problems.

Health organizations are urging non-cigarette smokers not to put themselves at risk by vaping.

Is hookah harmful to the human body?

Now about hookahs. Their fans are sure that this activity does not cause harm to health. After all, tobacco in hookahs passes through a water filter. This means that all the toxic impurities contained in it remain in the water. In addition, there are completely harmless tobacco-free hookah mixtures infused with fruits and vegetables.

Unfortunately, WHO experts do not share these optimistic beliefs. According to experts, filtering smoke through water does not improve the situation: most components of tobacco smoke do not dissolve in water. Therefore, carbon monoxide, formaldehyde, tars and other toxic substances enter the lungs.

As for “harmless fruit mixtures,” combustion products in any case are harmful to health. These are carcinogenic substances that lead to cancer and other diseases. Plus, when smoking a hookah, the risk of contracting an infectious disease increases. For example, the herpes virus or tuberculosis. Alas, sterility and safety are not guaranteed even by disposable mouthpieces. So draw your own conclusions!

What to replace vape with?

Vaping is addictive, making it difficult to quit. To make this process easier, you can replace smoking with one of the safe habits.

The following will help you take your mind off vaping:

• sparkling water, which will cause a sensation in the throat similar to the effect of steam;
• chewing gum with nicotine or berry flavors, reminiscent of the aroma of a vape;
• playing with a toothpick in your mouth to distract your hands and mouth;
• sunflower seeds to imitate the movements of the hand while smoking;
• take deep breaths, just like when vaping.

The best way to quit vaping is to realize how dangerous it is to your health and life. There is no harmless alternative to smoking, only under-researched options.

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Author: Sergienko Natalia Leonidovna

Pulmonologist. Second category. Work experience more than 11 years.

On the bronchi and lungs - direct fire!

Inflammatory mechanisms also determine the damaging effects of e-cigarette aerosols on lung tissue and the development of bronchial and lung diseases in their consumers. And if the cardiovascular effects of exposure to ES are realized mainly due to the nicotine contained in aerosols, and in some cases CO, then the respiratory organs are affected by both nicotine and other components of aerosols - propylene glycol, glycerol, acrolein and flavorings.

Thus, acute exposure to EC aerosols has been shown to induce inflammation and endothelial oxidative stress in healthy young nonsmokers. Research suggests that fragrances and other additives in EC aerosols increase inflammation and lead to decreased lung function. Short-term exposure to EC damages lung tissue to the same or greater extent than conventional cigarettes [27].

Nicotine leads to the death of epithelial cells (a dose-dependent effect), and soluble components of EC aerosols, such as acrolein, propylene glycol and glycerol, along with nicotine lead to a dose-dependent loss of the protective function of the pulmonary endothelium and, consequently, to oxidative stress and inflammation [28, 29].

The inflammatory reaction to exposure to ES aerosols is associated, on the one hand, with an increase in the activation of neutrophils and increased mucus production, and on the other, with a violation of mucociliary clearance [30]. It has been shown that the cytotoxicity of ES aerosols correlates with the amount of flavoring additives in the liquid for refilling them. In addition, it has been shown that nicotine-containing ES aerosols are as dangerous for microcirculation in the lungs as tobacco smoke [16].

In addition, consumption of EC disrupts the composition of immune proteins in bronchial secretions, leading to specific changes characteristic of tobacco smoke. This observation, along with many others, proves that e-cigarettes cannot be considered as a less harmful alternative to conventional cigarettes [31]. Such processes can lead to the development of chronic respiratory diseases in ES users [32].

It has also been established that ENDS aerosols damage DNA in the tissues of the lungs, heart and bladder in mice and reduce the DNA repair function and protein levels in lung tissue due to exposure to nicotine and its nitrosation products. These same substances stimulate mutations and tumor transformation of cells in cultured human tissues of the lungs, heart and bladder. The results demonstrate that ENDS aerosols, through DNA damage and repair functions, may contribute to the development of lung and bladder cancer, as well as heart disease in humans [33].

At the same time, not only ES and evaporators in the narrow sense are dangerous. It has recently been demonstrated that the effects of so-called heated tobacco systems, in particular their representative IQOS, are as detrimental to human lung tissue as the effects of EC aerosol and tobacco smoke. Exposure to IQOS, as well as ES and conventional cigarettes, leads to mitochondrial dysfunction, cell proliferation, increases oxidative stress, thereby leading to inflammation, persistent airway deformation, irreversible obstruction, infections, and through activation of the epithelial-mesenchymal transition - to cancer lungs [34]. This is natural, and no matter how manufacturers position IQOS, it remains a tobacco product with a high content of nicotine, combustion products, glycerin and propylene glycol [1].

These results are confirmed by clinical practice. Thus, the results of 2 cohort studies (COPDGene, n

=3536;
SPIROMICS, n
=1060) involving smokers aged 45-80 years, observed in 2010-2016, showed that consumption of ES in adult smokers at risk of COPD or with the disease itself led to an increase in symptoms of chronic bronchitis, more frequent exacerbations and more rapid decreased lung function, but did not lead to cessation of smoking conventional cigarettes. The authors did not find evidence that ECs can be used as a “harm reduction” intervention among smokers at risk of or existing COPD [35].

A study of the associations of ES consumption with diagnosed respiratory pathology, according to the Behavioral Risk Factor Surveillance Survey (BRFSS), revealed a significant association between ES consumption and chronic respiratory diseases in the overall sample, independent of smoking and other factors (RR = 2.58). , 95% CI 1.36—4.89; p

<0.01) and a sample of people with bronchial asthma among non-smokers (OR=1.33, 95% CI 1.00-1.77;
p
<0.05). These associations were stronger among nonsmokers than among smokers [36].

A population-based study of 30,272 respondents from the OLIN (Obstructive Pulmonary Disease in Northern Sweden) and WSAS (Western Sweden Study of Asthma) samples showed conclusive evidence that EC use, which was more common among tobacco smokers, resulted in “dual” smoking, Moreover, it was “double” smokers who had the highest prevalence of respiratory symptoms. The results showed that EC consumption cannot be considered as a way to quit smoking [37].

History of origin

You might be surprised (we certainly were) to learn that the e-cigarette is not as new as it seems. The idea appeared in 1927 and was first patented in 1963, but the inventor failed to interest manufacturers in his device. Electronic cigarettes appeared in their current form in 2003. Where did vaping come from? The word, quite obviously, is a derivative of the English word vapour - vapor, which served as the basis for the designation of vaporizer devices, vaporizers, or, for short, vapes. The vape itself (electronic cigarette) consists of a battery pack, an evaporator and a container for the evaporated liquid. Some devices also have a power management board.

There is a common misconception that when using a vape, you simply get water vapor containing certain flavoring and psychoactive components. This is not entirely true. In fact, the clouds that envelop vapers are an aerosol, which differs from vapor in that it contains tiny particles of various substances. There is very little water vapor in the vape; what we see is propylene glycol, glycerin and a little distilled water. The vape also contains flavors: berry, fruit, floral, chocolate, vanilla, coffee and many others, but seeing them with the naked eye is, of course, problematic. But the matter is not limited to berries and flowers. It is clear that vapes are used not only for the sake of pleasant smells, but also to obtain pleasures of a different kind - delivering nicotine to the body, and in some cases, prohibited substances.

WHO conclusions about the electronic steam generator.

Back in 2008, the World Health Organization considered the question of the harm from vaping with nicotine to the human body. The result of studying this problem was an unequivocal statement that there is no scientific basis regarding their safety and effectiveness as a substitute for tobacco products.

According to experts, vaping with nicotine causes no less damage than a regular cigarette. The presence of flavorings increases its attractiveness for the younger generation several times, and the imaginary safety makes this habit younger and younger.

Therefore, in 2014, at a conference on combating the consumption of tobacco products, a WHO report refuted the idea that electronic cigarettes are harmless. The attention of the forum participants was particularly focused on their health hazards and the emergence of persistent addiction.

The resolution emphasized the need to:

• a ban on the free distribution of liquids with nicotine, aromatic and flavoring additives;
• popularization of the conclusions that there is no evidence regarding the nicotine-replacement effect of smoking vapor generators;
• applying the same restrictions to electronic cigarettes as to conventional tobacco products in the areas of trade, advertising, and use.

At the same conference, experts expressed their concern about the spread of vaping among students and students and developed recommendations to combat its further popularization.

Thus, the most influential world health organization has settled the question of whether vaping with nicotine is harmful.

Today, the promotion and free sale of electronic cigarettes is prohibited in many countries. Among them are Canada, Brazil, Turkey, Denmark, Italy, Norway, Uruguay, Australia, Jordan, Thailand. Despite the debunking of myths about the carelessness of the product, the conclusions of specialists and health workers, the global vaporizer market is constantly growing.

Smokers often try to choose between a regular cigarette and its electronic equivalent. It's hard to settle on something if you have to give preference to the lesser evil. Moreover, there is no clear answer as to which of them is greater.

This is precisely why you should think carefully before becoming dependent on a vape or a regular cigarette.