Vaping has been popular in the UK for over 10 years now, and back when I started working on e-cigarette design 10 years ago, most rational scientific opinion was that it had to be better for your health than smoking. However, many people in the medical and healthcare professions quite rightly held concerns about the potential long-term side effects of vaping. What are the side effects of vaping?
A few still seem to be asking the same questions, but others have been able to answer some of them pretty well. 10 years ago there were around 0.5 million vapers in Great Britain, and a big proportion of them probably still smoked. There are now 3.6 million vapers, and 65% of them no longer smoke. It is time for an open and honest look into what we know, and also to be realistic about what we don’t know about the side effects of vaping.
Is vaping bad for you?
It still amazes me how this question splits opinions. I’ll give my own, but remember I work in the vape industry, so don’t trust my opinion; follow some of the links that I refer to later. These are trusted and balanced scientific opinions from people that don’t have any built-in bias towards the vaping industry. I could never encourage someone that has never smoked to vape, not because I don’t think it is relatively safe, I am sure that it is; but why put something in your body that you don’t need to?
However for anyone that smokes, or would smoke if they weren’t vaping, vaping is good for you. There is never a time when it is better to smoke than it is to vape, and there is absolutely no doubt that vaping helps people to quit or reduce their smoking. But what are the side effects, and how important are they?
Short-term Vaping Side Effects
Most people have a few short-term side effects from vaping, and we can save the best until last. They are pretty minor in general.
- Dry mouth: Vaping can make your mouth feel a little dry. Just drinking an extra glass of water a couple of times a day provides complete relief from this.
- Coughing: When you first vape, you may cough as you get used to the vapour. Longer, slower puffs on the e-cigarette help a lot with this. If you do swap completely from smoking to vaping, you might later have several weeks with a “productive” cough. This is not a side effect of vaping, but of giving up smoking, and is very well explained in this Mayo Clinic post.
- Headaches, dizziness, nausea: These are much rarer symptoms, and are typically caused by getting too much nicotine into your body. The effects are short-lived; just stop vaping for 20-40 minutes and you should find everything returns to normal.
- Sore throat: This is one we read about online, but we hear about only incredibly rarely from our own customers. If you are affected by a sore throat, make sure you are using a good quality e-liquid from a reputable source.
- Stopping smoking: For some it needs some effort and willpower, but for others, vaping actually causes them to quit pretty much accidentally. A great side-effect. In our last customer survey around 90% of our customers told us they weren’t smoking at all anymore.
Long-term side effects of vaping
It is all too easy to say “no-one knows what the long term effects might be”, and to just dream up a lot of potential harms. The truth is that vaping has been around for over 10 years, and a lot of people have continued to vape for 10 years or more now. There is a mixture of conjecture and scientifically validated factual research available.
The conjecture generally tends towards predicting potential long term harm, but the factual research has moved ever closer to long term vaping being a lot safer than smoking, and possibly not objectively any more risky than crossing the road.
The Effects of Vaping on the Lungs
It would be all too easy to take lazy science seriously, and to believe that because e-liquid has been shown to damage mouse lung cells, in a petri dish, in a lab, that vaping is bad for your lungs. In actual fact the longer term effects of vaping on the lungs are being researched not in petri dishes, but in living human beings, and ongoing publications are showing that among vapers that have never smoked, lung function remains similar to that of healthy non-smokers, and over a period of years.
Even more surprising was a study into lung function among people that suffer from Chronic Obstructive Pulmonary disease (COPD). Those switching to vaping exhibited harm reversal that was at least as good as those giving up smoking by other means. It is difficult to believe that so much good science is backing vaping as the very best route out of smoking, and yet mainstream media, social media and high-profile public health bodies like the WHO err on the side of extreme caution. It gets worse…
The Effects of Vaping on the Heart
Yet again there are plenty of examples of lazy science available online. It is certainly true that vaping nicotine temporarily increases arterial stiffness, raises heart-rate, and can be associated with increased blood pressure. But then so does caffeine, and other drugs that we commonly use as stimulants, and those short-term effects are not generally associated with unreasonable long-term health risks.
However the risks to the heart from vaping were very much brought to a head when the authors of a (now retracted) study linking heart disease with vaping were found not to have considered when people had heart attacks. In many cases the heart attack had happened before the people under review had started vaping, so either their vaping caused some kind of time travel, or having a heart attack might cause smokers to consider giving up. Given vaping is one of the most popular ways of quitting, it seems far more likely that myocardial infarction (AKA heart attack) causes vaping among smokers than the reverse.
There are also other examples of bad science making links between e-cigarette use and heart disease. In the main they come from a fixed group of authors that seem to singularly fail to take in that a huge majority of vapers are smokers or recent ex-smokers. Unfortunately that means that smoking is a confounding factor, and the long-term effects of smoking linger for quite some time after quitting.
It is some relief to find that there is also some good science available. It seems dual-users and recent ex-smokers that vape do have a high risk of cardiovascular disease, but nicotine vapers that have never smoked have no increased risk. Could it conceivably be that dual-users that smoke, and recent ex-smokers that vape, have been drawn towards improving their likely health outcomes by their illness? Given just how harmful smoking is, this has to be likely. Most researchers agree that more research is required in this area.
The Effects of Vaping on Teeth
Surprisingly little research seems to have been published about the effects of vaping on teeth and gums long term, and what is available is a mixture of conjecture and informal review. Most vapers do not appear to have any problems with teeth or gums; in fact if anything, our oral health seems to improve through reducing or quitting smoking.
If you do notice your gums bleeding more when you switch from smoking to vaping, try not to panic, they are just coming back to life. There was a long held theory that nicotine vasoconstriction (narrowing of blood vessels) was the main reason smokers’ gums bleed less than non-smokers when they have similar levels of gingivitis (mild gum disease). This has since been shown not to be the case, but there is definitely a mechanism caused by some (or all) of the other 6000+ chemicals in cigarette smoke that reduces blood flow in the gums and prevents bleeding.
Consequently, once your gums are not getting coated with tar from cigarettes, you are likely to notice them bleeding more if you have any gum disease, however mild. This is no different from quitting through any other method, including “cold turkey”. If you have managed to quit through vaping, and you are unhappy about your gums bleeding more easily, it is a great time to get on top of oral health with a dentist and hygienist. Not only will you get back to “non-smoker’s” pink and healthy gums, but you will also slowly lose the tar stains, and find what colour your teeth really are.
Vaping versus Smoking
Smoking is bad for you. Really bad. It causes lung disease, heart and cardiovascular disease, and if you smoke for a lifetime your odds of dying of anything other than a smoking related disease are much less than 50:50. It also costs a small fortune, makes your clothes and hair stink, yellows your teeth, and prematurely ages your skin.
Vaping by comparison, while not perfect, carries a really tiny proportion of the cancer-causing substances that are found in cigarette smoke. Only 3 of the 6000 substances in cigarette smoke are typically found in e-cigarette vapour, and they are found at much, much lower levels. Compare that with 69 of the 6000+ chemicals with known risk of causing cancer in cigarette smoke, and at levels between 9 and 450 times higher than anything that appears in vapour, and vaping instead of smoking is an absolute “no-brainer”.
References
Quit Smoking. Expert Answers. Mayo Clinic. March 19th.
https://www.mayoclinic.org/healthy-lifestyle/quit-smoking/expert-answers/quit-smoking/faq-20057818
Polosa, R., Cibella, F., Caponnetto, P. et al. Health impact of E-cigarettes: a prospective 3.5-year study of regular daily users who have never smoked. Sci Rep 7, 13825 (2017).
https://doi.org/10.1038/s41598-017-14043-2
Polosa, R., Morjaria, J. B., Prosperini, U., Russo, C., Pennisi, A., Puleo, R., Caruso, M., & Caponnetto, P. (2018). Health effects in COPD smokers who switch to electronic cigarettes: a retrospective-prospective 3-year follow-up. International journal of chronic obstructive pulmonary disease, 13, 2533–2542.
https://doi.org/10.2147/COPD.S161138
Association Between E-Cigarette Use and Cardiovascular Disease Among Never and Current Combustible-Cigarette Smokers Albert D. Osei, MD, MPH, Mohammadhassan Mirbolouk, MD, Olusola A. Orimoloye, MD, MPH, Omar Dzaye, MD, PhD, S.M. Iftekhar Uddin, MBBS, MSPH, Emelia J. Benjamin, MD, ScM, Michael E. Hall, MD, MSc, Andrew P. DeFilippis, MD, MSc;, Andrew Stokes, PhD, Aruni Bhatnagar, PhD, Khurram Nasir, MD, MPH , Michael J. Blaha, MD, MPH Published: March 07, 2019:
https://doi.org/10.1016/j.amjmed.2019.02.016
E-cigarette safety. Cancer Research UK, Published 28th January 202:
https://www.cancerresearchuk.org/health-professional/awareness-and-prevention/e-cigarette-hub-information-for-health-professionals/safety#E-cigs_safety1
