What You Need to Know About Vaping

By Bart N. Green, DC, MSEd, PhD, Kevin Rose, DC, MPH and Claire Johnson, DC, MSEd, PhD

Editor's Note: This article has been modified from the original, which was directed toward a professional (doctor) audience.

Smoking can be harmful in so many ways. Not only are there a multitude of negative health consequences from smoking, but recent research even shows a connection between smoking and back pain.¹ Thus, any aid that can help people stop smoking is of interest. However, what happens if the aid causes new problems? The health impact, use and safety of electronic cigarettes (e-cigarettes) are still under investigation. We offer a brief overview on this important public health issue.

1. What Is Vaping?

When someone smokes traditional cigarettes, they inhale the smoke of burning tobacco. However, someone using an electronic device, such as an electronic cigarette, inhales vaporized chemical liquids – thus the term vaping.

The liquids in e-cigarettes often contain nicotine or other drugs, as well as scents or flavors to increase the pleasure of the experience. E-cigarettes are now the most commonly used smoking product by U.S. youth² and the number of users continues to rise.

2. What Are the Arguments in Favor of Vaping?

Vaping is considered an option to reduce the harmful effects of traditional tobacco cigarette smoking and as an aid to help people quit. The thought is that e-cigarettes might help someone step down to lower levels of addictive substances (e.g., nicotine) and reduce the amount of carcinogens inhaled. Some studies have shown the use of e-cigarettes may help some people to reduce or stop smoking.³

3. What Are the Potential Harms of Vaping?

Although e-cigarettes do not use burning tobacco, they still contain harmful substances. Issues with vaping include:

• Intake of vaporized substances in e-cigarettes may be harmful.^4-6
• E-cigarettes have vapors that can include formaldehyde, acetaldehyde and metal nanoparticles.⁷
• E-cigarette devices could potentially be used to intake illegal or other potentially harmful drugs,⁸  such as synthetic drugs or cannabis.^9-10
• Secondhand vapors are harmful to those who are exposed.^4-5
• There is potential harm with short-term use, although the effects of long-term use on health are unknown.
• Targeting minors with bright colors and candy flavors, and re-establishing the culture that smoking is "cool" or "safe," may entice youth to start or continue smoking.
• The potential exists for physical danger from e-cigarettes (e.g., explosions and burns).

4. What Can You Do to Learn More?

In addition to speaking with your doctor, helpful resources on e-cigarettes include the following:

• The U.S. Surgeon General has a "Know the Risks" fact sheet on youth and e-cigarettes.
• The American Heart Association has a fact sheet on e-cigarettes and public health.
• The Centers for Disease Control and Prevention (CD) has a website with information for patients.
• The American Lung Association has a statement on e-cigarettes.
• The American Public Health Association has a policy statement on the regulation of e-cigarettes.

5. So, Is Vaping Good or Bad?

Although vaping is touted as an aid for smoking cessation to help those who are addicted to tobacco, this does not mean vaping is harmless. Harms may be experienced by the person vaping, as well as those who are inhaling the vapors secondhand. The best thing for your health is to refrain from smoking at all – electronic or tobacco.

References

1. Green BN, Johnson CD, Snodgrass J, et al. Association between smoking and back pain in a cross-section of adult Americans. Cureus, 2016 Sep 26;8(9):e806.
2. Singh T, Kennedy S, Marynak K, et al. Characteristics of electronic cigarette use among middle and high school students - United States, 2015. MMWR Morb Mortal Wkly Rep, 2016 Dec 30;65(5051):1425-1429.
3. Hartmann-Boyce J, McRobbie H, Bullen C, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev, 2016 Sep 14;9:CD010216.
4. Pankow JF, Kim K, McWhirter KJ, et al. Benzene formation in electronic cigarettes. PLoS One, 2017 Mar 8;12(3).
5. Hess IM, Lachireddy K, Capon A. A systematic review of the health risks from passive exposure to electronic cigarette vapour. Public Health Res Pract, 2016 Apr 15;26(2).
6. Kaisar MA, Prasad S, Liles T, Cucullo L. A decade of e-cigarettes: limited research and unresolved safety concerns. Toxicology, 2016 Jul 15;365:67-75.
7. Drug Facts: Electronic Cigarettes (e-Cigarettes). Washington, DC: National Institutes of Health, National Institute on Drug Abuse, May 2016.
8. Blundell MS, Dargan PI, Wood DM. The dark cloud of recreational drugs and vaping. QJM, 2017 Mar 9.
9. Giroud C, de Cesare M, Berthet A, et al. E-cigarettes: a review of new trends in cannabis use. Int J Environ Res Public Health, 2015 Aug 21;12(8):9988-10008.
10. Budney AJ, Sargent JD, Lee DC. Vaping cannabis (marijuana): parallel concerns to e-cigs? Addiction, 2015 Nov;110(11):1699-704.

Bart Green, DC, MSEd, PhD, is a full-time corporate health chiropractor; a part-time faculty member at National University of Health Sciences; and a member of the APHA-CHC. He has extensive experience working in interdisciplinary pain management teams for patients with chronic non-cancer pain.

Kevin Rose, DC, MPH, is a public health professor at the Southern California University of Health Sciences and a diplomate of the American Board of Chiropractic Orthopedists.

Claire Johnson, DC, MSEd, PhD, is a professor at National University of Health Sciences and editor in chief of JMPT, the Journal of Chiropractic Medicine and the Journal of Chiropractic Humanities. She also serves as the communications chair for the APHA-CHC.