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Is vaping as harmful as traditional cigarettes? And other questions | Column

Moffitt researchers sort out questions about whether vaping is as harmful as smoking traditional cigarettes.
A man exhales while smoking an e-cigarette in Portland, Maine. (Associated Press 2018) [ROBERT F. BUKATY | AP]
Updated Dec. 27, 2019

Editor’s note: This column was submitted by Thomas Brandon, Vani Simmons, Damon Vidrine, Jennifer Vidrine and Christine Vinci. They are faculty members at the Tobacco Research & Intervention Program at Moffitt Cancer Center and Research Institute in Tampa, one of the largest tobacco research teams in the nation.

There is growing public confusion about the true harms and potential benefits of vaping. Collectively, we have over 100 years of experience with tobacco research, including the development and evaluation of tobacco cessation treatments. We have seen the devastating effects that tobacco has on health, and we have dedicated our careers to fighting this epidemic. Here we address some of the common questions about e-cigarettes based on our interpretation of the most current research.

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Isn’t vaping just as harmful as smoking traditional cigarettes?

While vaping is not harmless, it is far less dangerous than traditional, combustible cigarettes. Smoking causes 7 million deaths each year, including almost half a million deaths in the United State. Cigarettes are the leading cause of cancer. Nicotine causes dependence, but there are thousands of chemicals in tobacco smoke, including dozens of carcinogens and toxicants. It is these chemicals, not the nicotine, that cause tobacco-related diseases. Vaping products often contain nicotine, so vapers can become dependent. Because vaping does not involve combustion, far fewer harmful chemicals are inhaled. The scientific consensus is that vaping causes a fraction of the harm of smoking.

What about the cases of lung injury associated with vaping?

In recent months, over 2,200 cases of vaping-related lung injury, including nearly 50 deaths, have been reported. However, it is critical to recognize that these cases have not been linked to legal vaping products. Rather, the lung injury epidemic has been traced to the use of illegal, or black market, THC-containing vape cartridges (“e-joints”). Specifically, vitamin E acetate, an additive used in these illegal products, appears to be the primary culprit.

Do e-cigarettes help smokers quit smoking?

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Emerging evidence indicates that switching completely to vaping can be an effective way to quit smoking. A recent clinical trial published in the New England Journal of Medicine reported that e-cigarettes were twice as effective as traditional nicotine replacement products such as nicotine gum or the patch.

Should e-cigarette flavors be banned?

Some flavors may attract nonsmoking youth to vaping, which we certainly do not want. But flavors also help smokers make the switch to vaping. Eliminating flavors may also push youths and adults back to smoking or to more dangerous black market products.

What is the best approach for public health?

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We should aim for balanced policies that promote public health across the population by discouraging vaping by youth, while also encouraging smokers to switch to vaping if other cessation methods have failed. Examples include raising the minimum age to purchase any tobacco product to 21, banning marketing to kids, eliminating the most child-friendly flavors, and limiting the amount of nicotine delivered by the products. Most importantly, we must continue to prioritize the elimination of combustible tobacco use, which remains by far the biggest public health threat. Confusion about the relative risks of smoking and vaping benefits only the tobacco industry.

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