What are the health effects of vaping?

Female with an Electronic Cigarette.

aping and its effects have gained immense popularity over the past weeks due to the emergence of a mysterious and severe lung disease. Electronic cigarettes or e-cigarettes, also called vapes, electronic nicotine delivery systems, vape pens, or mods, have become very popular across the globe, especially among teens.

Vaping is the act of inhaling and exhaling the aerosol, often referred to as vapor, which is produced by an e-cigarette. The term is used because e-cigarettes do not produce tobacco smoke, but rather an aerosol, often mistaken for water vapor, that actually consists of fine particles. The e-liquid in vaporizer products usually contains a propylene glycol or vegetable glycerin-based liquid with nicotine, flavoring and other chemicals and metals, but not tobacco. Some people use these devices to vape THC, the chemical responsible for most of marijuana's mind-altering effects, or even synthetic drugs like flakka, instead of nicotine.

On August, however, cases of a mysterious severe lung disease rocked the health society, with doctors looking for the cause of the illness. They found the link between vaping and lung disease. Now, there are 805 lung injury cases reported across 46 states in the United States. There had been 12 deaths reported, and all cases reported a history of e-cigarette use.

In the hopes to determine the cause of the illness and if it’s associated with vaping, health experts from four leading universities in the United States performed a comprehensive review of all vaping-related peer-reviewed scientific journals, to determine the respiratory effects of e-cigarette use.

Published in the British Medical Journal, the study explored the effects of e-cigarettes on health, particularly to the lungs. The researchers found that there are measurable biologic effects on lung health and cells in humans, and that e-cigarette products have certain similarities in terms of their effects as seen in cigarettes.

More than a billion people across the globe smoked tobacco in 2016 alone. In the United States, about 34.3 million adults were current smokers in 2017. In terms of e-cigarette use, 6.9 million vaped in the U.S. in 2017. The rates of e-cigarette use are higher in younger people, including teens in the 8th, 10th, and 12th grade.

E-cigarette use is not without effects

The doctors know that developing chronic and life-threatening linked to cigarette smoking may take decades to develop. It took even decades to prove that cigarette smoking can lead to cancer. But, e-cigarette use has only been popular for ten years, and research was done to see the effects of vaping for just five years. These studies, however, point that vaping has effects, and it’s not safe.

“The scientific community’s current knowledge is insufficient to determine whether the respiratory health effects of e-cigarettes are less than the now obvious health effects of combustible tobacco products,” Rob Tarran, PhD, professor of cell biology and physiology and member of the UNC Marsico Lung Institute, said in a statement.

The researchers found that many epidemiological studies showed increase respiratory symptoms in adolescent e-cigarette users, including asthma, shortness of breath, and bronchitis-like symptoms, among others. Also, some studies have shown the link between vaping and possible lung damage, such as damage to the blood supply to the lungs, and some cases showed some cases of lipoid pneumonia, that is similar to what is seen in the present vaping-related severe lung-disease spreading in the U.S.

“We also evaluated the effects of vaping on cells in the laboratory (in vitro studies),” Tarran said. “Most studies found that e-liquid exposure to pulmonary cells had effects, including general cytotoxicity and impaired specialized functions, such as secretion and phagocytosis, which are important for proper lung function.”

Other health effects of e-cigarette explored in the study include airway inflammation and injury, alveolar inflammation, and immune effects. Also, the researchers studied the effects of e-liquid constituents such as propylene glycol, flavorings, and nicotine. All the chemicals have shown adverse effects on laboratory animal studies.

The team looked at all published studies related to primary pulmonary cells and found that all showed effects on the cells, except those which were funded by tobacco companies. They recommend that future regulations should take into consideration the use of e-cigarettes, particularly for heavy smokers who want to quit smoking.

E-cigarettes have been used as a smoking alternative. But the researchers recommend that clinicians should prescribe them cautiously to heavy smokers or those who want to quit smoking. It should be recommended only when combined with counseling and other therapies, to help people quit smoking and nicotine-product use permanently.

“We recommend that vape products be regulated more stringently along the lines of pharmaceutical products that go through a well-defined series of pre-clinical and human studies before they are released on the market,” Tarran said.

Journal reference:

Gotts, J., Jordt, S.E., McCornell, R., and Tarran, R. (2019). What are the respiratory effects of e-cigarettes?. British Medical Journal. https://www.bmj.com/content/366/bmj.l5275