Whenever a new technology comes along, its marketers proclaim it is better than the previously existing technology. If the original product had associated health concerns, then the new product is also said to be safer.
So it was with Big Pharma’s new opioids, which it said were less or not-at-all addictive compared to morphine and codeine, and so it is with electronic or e-cigarettes, sometimes called electronic nicotine delivery systems (ENDS). The former has proven to be erroneous, if not a bald-faced lie, and the jury is still out on the latter. But e-cigarettes and other forms of “vaping” are big business. The Wall Street Journal reported that worldwide sales were $7bn in 2014. Last year, UK sales alone were £1bn and expected to double by 2020.
What Is Vaping?
The e-cigarette is a reusable delivery device, not a paper cylinder that is consumed by flame as you smoke. The modern e-cigarette dates to 2003 and Hon Lik, a research pharmacologist in China (though a similar patent, never commercially used, dates back to 1963 and Herbert A. Gilbert of the US). The e-cigarette has gone through several evolutions since then – from a simulacrum cigarette to a more stylised shape, and design – and vaping has greatly increased in popularity.
It is called vaping because an e-cigarette does not release smoke but vapour from heated water that contains the nicotine and/or other additives. The liquid is heated using a battery, with no flame required. The vapour itself contains fewer of the harmful chemicals associated with smoking traditional cigarettes, such as carbon monoxide and tar, making it safer than cigarette smoke.
Is Vaping Safe? Safer than Smoking?
How much safer is in question. A 2014 report from Japan’s National Institute of Public Health found that e-cigarette vapour contains as much as ten times as much of some carcinogens, such as formaldehyde, compared to traditional cigarettes, but a 2015 report from Public Health England faulted the study and concluded e-cigarettes are “95% less harmful” than tobacco. The reason for the discrepancy was that the liquid in NIPH study was overheated, and the method of simulating inhalation was different from how real vapers inhale. When corrected, negligible amounts of formaldehyde were detected.
A separate University of Connecticut study found that vaping caused as much DNA damage as smoking, which can lead to cellular mutations and cancer. (For some reason, the report also emphasised that it was conducted “using a new low-cost, 3D printed testing device.”) And the European Lung Foundation warned that e-cigarettes contain “potential respiratory irritants.”
But vaping has only been around for about a decade. What its long-term hazards may be is unknown. Whether secondhand “vape” is as harmful as secondhand smoke also is in question. Most nations seem to be taking a cautious approach, regulating the sale and use of e-cigarettes as if they were tobacco: no sales to minors, no use in enclosed public spaces. India is considering a complete ban.
Why People Vape
Why people vape is even disputed. Some see it as a safer substitute for smoking or a way to wean people from smoking altogether. Studies have found that most vapers are also smokers, and vice versa. If vaping helps people quit, or improve health by doing less damage than smoking, then it is positive for society as a whole. Smoking still costs lives and tax dollars. In the US alone, the annual cost of smoking-related illness is more than $300bn each year, and six million lives.
Others see e-cigarettes as a nefarious way to get young people to start smoking, maybe by vaping non-nicotine e-liquids at first. (The journal Preventive Medicine reported that students in middle or high school who had tried an e-cigarette were twice as likely to start smoking cigarettes.).
What increases these concerns is that traditional Big Tobacco has been buying up e-cigarette companies and aggressively marketing their products in a manner akin to how tobacco was marketed in the 50s and 60s. The flavoured e-liquids, both nicotine and nicotine-free, are seen as a means to enticing young people to smoke.
This dichotomy is reflected in vaping policy at substance abuse treatment, whether 12-step meetings or luxury rehab facilities. Like smoking in general, vaping is sometimes allowed. That cannabis can be vaped is another complicating factor (although cannabis use has been found to decrease prescription drug use, and one rehab in California, High Sobriety, is using marijuana as an “exit” drug for opioid and other addictions.)
Regulations, Taxes Increase
For whatever reason, the light regulatory hand that e-cigs have faced is getting heavier. The UK has increased regulation slightly in May. Canada is among the nations imposing much stronger restrictions on vaping. Australia bans the sale of e-cigarettes, but importing for personal use is allowed under certain circumstances. Some nations, such as Thailand, ban e-cigs completely, even nations where tobacco is still legal. Penalties can range from confiscation to fines to prison.
Vaping is starting to be heavily taxed in some US states, as sin taxes are always popular with politicians, while in others they are not even subject to normal tobacco taxes. In Pennsylvania, the state legislature imposed a 40 % tax on vaping products, which has brought in $13.7m in revenue for the state but caused one quarter of the state’s vaping businesses to close. Connecticut is contemplating a 75% tax. Meanwhile, the European Commission is trying to come up with one common e-cig tax policy for the EU.
Still, e-cigarettes and other, related products – Philip Morris is awaiting an FDA decision on its IQOS, though it is already available elsewhere, including the UK, Europe and Canada – are expected to continue to grow in popularity and profits. Whether that is ultimately good, bad or indifferent remains to be seen.