Are vapes really a safer alternative to cigarettes?

Vaping is better than smoking, rather, it helps one quit smoking. This is a common notion among many smokers as well as non-smokers. How true is it? No one really knows. "Many smokers have turned to e-cigarettes, also known as vapes, in hopes of reducing their tobacco consumption or quitting altogether. However, the effectiveness of switching to vapes to quit smoking is yet to be proven," says Dr Atul Narayankar, consultant medical oncologist, Wockhardt Hospitals, Mira Road.

Adding to this, Dr Pankaj Jain, consultant chest physician and pulmonologist, Jehangir Hospital says, "Although many people assume vaping helps quit smoking, it is important to understand that it is still a relatively new product, and there is not enough research to say for sure whether it is a safe or effective means to give up on the addiction of smoking."

Rising popularity among the young
Over the past few years, there has been an exponential rise in the use of e-cigarettes as an alternative to traditional tobacco smoking. Vaping has especially become more common among the youth. For the young, vaping is seen as an edgy, fashionable activity.

Responding to the cool quotient attached to these products, manufacturers are coming up with stylish and colourful designs making them more attractive for the young. Further, vapes come in various nicotine strengths and flavours, making them more tempting to the younger generation.

Another factor that can be a possible cause of the rise of their popularity is the ease of access to these devices. They can be purchased either online or in many local stores, so they're much more convenient than traditional cigarettes. Vape kits are relatively affordable and come with clear instructions, enabling young users to start vaping with minimal effort.

E-cigarettes vs cigarettes
Cigarettes and vapes are two popular ways to consume nicotine, but they differ greatly in their composition, usage and potential health risks.

Vapes are electronic devices that aim to mimic the act of smoking by delivering nicotine through a vaporised solution. Unlike conventional cigarettes that burn tobacco, e-cigarettes operate by heating a liquid comprising nicotine, flavourings and other chemical components.

Cigarettes are made from tobacco leaves that undergo combustion when lit, releasing harmful chemicals like tar, carbon monoxide and other carcinogens (cancer-causing substances) into the air and the smoker's lungs.

Additionally, cigarettes are cheaper than vapes. A pack of cigarettes typically costs around Rs 12, while the minimum price of an e-cigarette stands somewhere around Rs 1200. However, the long-term cost of smoking is much higher than the cost of vaping.

Health impacts of vaping
There is no doubt that smoking cigarettes increases the risk of lung cancer, heart disease, stroke and tuberculosis (TB), but vaping too has its own health risks that must not be ignored.

"Although vapes are marketed as a healthier alternative to smoking cigarettes, research suggests that vaping is just as harmful to your health," says Jain. Studies have shown that vaping can lead to respiratory problems like bronchitis and pneumonia.

"Those who vape may experience coughing, shortness of breath, wheezing and chest tightness. Vaping also raises the risk of lung cancer, asthma and bronchitis and is harmful to reproductive health," adds Narayankar.

E-cigarettes also contain nicotine, a highly addictive chemical and a known carcinogen. Additionally, many vapes also contain diacetyl, a chemical associated with lung disease. Propylene glycol, a chemical commonly found in e-cigarette liquids, also has a negative effect on the respiratory system over time. Inhaling these chemicals can cause many short-term negative side effects like changes in breathing rate, increased blood pressure, increased heart rate and increased temperature.

Electronic cigarettes can also weaken the body's immune system, making it more susceptible to colds and flu. Vaping can also have negative long-term health effects, including changes in blood vessel elasticity and increased risk of stroke and heart attack. It can also lead to cancer, as well as an increased risk of chronic obstructive pulmonary disease (COPD).

Effectiveness of vaping to help quit smoking
Vapers argue that vaping can be an effective tool for quitting smoking due to its ability to deliver nicotine in a less harmful manner compared to traditional cigarettes. By inhaling vapour instead of smoke, individuals may decrease their exposure to harmful chemicals found in tobacco smoke.

Vaping offers users a greater degree of control over their nicotine consumption in comparison to conventional smoking. E-cigarettes are available with varying levels of nicotine concentration in their e-liquids, ranging from high amounts resembling regular cigarettes to zero-nicotine alternatives.

This enables users to gradually reduce their nicotine intake over time. Nevertheless, health experts say that whether it is cigarettes or vapes, both pose equal health risks.

If you are a smoker looking to quit, switching to vapes may not be the best option for you. Instead, talk to a specialist about Nicotine Replacement Therapy (NRT) options best suited for you.

They might also suggest some exercises to reduce stress and give you more energy to help break the habit and involve you in social groups that are working towards the goal of quitting smoking.

While switching to vapes may offer some short-term relief to smokers, the potential dangers far outweigh the benefits. Therefore, it is always advisable to consult a specialist who can offer more healthy solutions.

Vaping is an addiction too
Both cigarettes and vapes contain nicotine, which is a highly addictive drug. However, nicotine is more addictive in cigarettes than in vapes. This is because the smoke from cigarettes contains other chemicals that promote easy absorption of nicotine into the bloodstream. This triggers the release of dopamine which is a neurotransmitter linked to pleasure and reward.

This is not to say that vaping is less addictive. Upon inhalation through vaping, nicotine swiftly enters the bloodstream and reaches the brain. This flood of dopamine generates a feeling of contentment that strengthens the urge to vape again, resulting in gradual dependence. It thus has the same effect on the brain as cigarettes. In fact, experts say that certain e-cigarette liquids offer an array of enticing flavours that attract young users, making them more vulnerable to addiction.

Flavoured vapes contain a flavoured e-liquid, rather than the standard unflavoured nicotine e-liquids that are commonly found in traditional e-cigarettes and similar vaporiser devices. The flavouring is usually derived from popular food or drinks, such as chocolate, caramel, coffee, cola and more. The reason flavoured vapes exist is that many people find the taste of traditional e-cigarettes to be unpleasant. The flavoured versions are meant to provide a more enjoyable vaping experience.

Legality of vaping in India
The sale, manufacture, import, export, transport, distribution and running of advertisements of e-cigarettes, or vapes are prohibited in India. India's Ministry of Health and Family Welfare brought this into effect in September 2019. The ban was imposed due to concerns about the health risks of vaping. Despite a complete ban on vapes, young people are still able to access e-cigarettes in India illegally.

We asked experts, ‘Why is it that cigarettes, being more harmful to health, continue to be sold but vapes are banned?'

In response to this question, Narayankar says, "According to the World Health Organisation (WHO), India's massive population makes it the largest tobacco market in the world. India is one of the only countries that has completely banned the sale of e-cigarettes. Yet 23 per cent of the Indian population reported using e-cigarettes, 70 per cent reported using tobacco, and 8 per cent were dual users of both e-cigarettes and tobacco."

Adding to this, Jain says, "Although many would be of the opinion that both vapes and cigarettes should be banned, given the dangerous health risks both pose, that is not the case. When it comes to cigarettes, they are heavily taxed by both state and federal governments, providing a substantial amount of revenue to fund public health initiatives and other government programs. If tobacco sales were to be banned, this revenue would be lost, which could create major fiscal issues for governments and public health efforts. Thus, it makes more sense to keep cigarettes legal, while enacting stricter regulations and policies to reduce consumption, such as a higher age limit for purchasing, increased taxes, etc. Vapes, on the other hand, have been identified as a potential gateway to traditional cigarettes for youth, and in order to protect public health, it is more beneficial to have a complete ban on their sale."