In 2014, the Centers for Disease Control and Prevention (CDC) reported that more than half a million Americans are now using electronic cigarettes. A new study in the Journal of the American Medical Association shows that people who vape daily are at much lower risk of developing lung cancer than those who smoke tobacco sticks.
“We found that vapers were about 20 to 30 percent less likely to develop lung cancer compared with smokers,” says lead author Dr. Sridhar Ratnakar from the National Cancer Institute (NCI). “There is also no evidence, as far as we know, of differences in lung cancer rates between light users and nonusers. So, while there may be some benefits to vaping compared with smoking, it doesn’t seem to outweigh the risks associated with smoking.”
Ratnakar’s team analyzed data on more than 1.6 million participants in the United States who had never smoked regularly before enrolling in one of five large health studies over a period of 12 years. They compared their chances of getting lung cancer against that of people who had been regular daily smokers.
The researchers controlled for factors such as age, sex, body mass index, education level, alcohol consumption, and income level. The analysis included nearly 300,000 participants who had never used any nicotine products before.
About 10.7 percent of these non–smokers eventually developed lung cancer. Of those who were regular smokers, 15.8 percent ended up having the disease. That’s a difference of 4.1 percentage points. It was also found that the greater the number of years of smoking, the higher the likelihood of being diagnosed with lung cancer.
Interestingly, the researchers found that current e-cigarette users had a similar rate of contracting the disease as ex-smokers who had quit smoking. This suggests that vaping has an equal effect on lowering the chance of developing lung cancer. The findings suggest that switching from conventional cigarettes to electronic ones could provide similar benefits.
“Vaping is not without potential health risks, but these appear to be substantially less than from cigarette smoking,” says Ratnakar. “And, the health risks are probably outweighed by the benefits of not inhaling toxins that cause cancer and heart disease—and by avoiding secondhand smoke.”
According to Ratnakar, the major limitation of this study is that it did not account for other possible risk factors that have been linked to both lung cancer and smoking such as diet, occupation, and exposure to environmental tobacco smoke. He believes that further research will need to examine whether or not the benefits of vaping outweigh the risks.
A 2015 review published in the British Journal of Cancer reported that electronic cigarettes significantly reduced the amount of tar and carbon monoxide in the air breathed by smokers. However, the authors said that the safety of e-cigarettes has yet to be established.
They added that long-term effects of the inhalation of vaporized liquids remain unclear, and there is a lack of information regarding how safe they are for children and teenagers. The World Health Organization recommends that e-cigarettes be banned indoors.
Dr. Andrew Melnick, director of the Center for Tobacco Products at the U.S. Food and Drug Administration, told reporters during a press conference that he does not expect to see FDA approval of electronic cigarettes until the agency completes its investigation into the risks and benefits of e-cigarettes.
He warned of the potential for youth addiction to nicotine, saying that the agency should consider all available information when making decisions about whether to regulate e-cigarettes.
“It’s important that we do everything we can to keep kids away from e-cigarettes, including advertising them and marketing them to them,” Melnick said. “That’s why I think it’s so critical for us to get the science right, because if we don’t understand what we’re doing, then we don’t have that foundation to make good decisions.”
E-cigarette makers say that the devices are safer than traditional tobacco cigarettes and can help smokers quit. Some manufacturers even claim that they can help prevent death due to chronic diseases like lung cancer and coronary artery disease.
For example, Blu Cigs boasts on its website that its battery-powered devices contain only water vapor, propylene glycol, flavoring, and nicotine. It claims that the vapor is odorless and harmless, and that it contains no carcinogens.
The company’s website also states that the device releases fewer harmful chemicals than combustible cigarettes. In addition, it says that the vapor can be inhaled through the mouthpiece, which reduces the possibility of breathing in toxic substances.
“The main reason why we believe our product is safer than traditional cigarettes is because of the unique design of our electronic cigarettes,” said Anthony Sullivan, vice president of public affairs at Blu Cigs. “Our e-cigs look like regular cigarettes, but they work like cigars, delivering the same satisfying hit of nicotine to the brain. And unlike most other electronic cigarettes, our product delivers no combustion, so there is no smoky smell.”
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However, some experts disagree with such statements. One of the biggest concerns about the safety of e-cigarettes is that the liquid used in them doesn’t burn completely. This means that some of the ingredients found in the vaporized liquids could still enter the lungs when someone uses the product.
Another concern is that the atomizers in e-cigarette devices aren’t designed to filter out dangerous particles, so the user is inhaling potentially harmful chemical compounds.
“When you heat a substance under pressure, it usually produces different compounds than when you just expose it to oxygen,” says Dr. David Abrams, professor of medicine at Columbia University College of Physicians and Surgeons. “If you heat it under pressure, you produce different compounds, and it’s hard to know what those compounds are. We don’t really know what’s in the vapor.”
Abrams is also concerned about the potential for a child to accidentally swallow an e-cigarette battery. He thinks that a small child could seriously injure themselves if swallowed.
“One thing that makes e-cigarettes a problem is that batteries and parts can be ingested, and it’s very easy to swallow them accidentally,” Abrams said. “So, my concern is that a child might put something down and swallow something that shouldn’t have gone down.”