Vaping must be a harmless alternative to smoking, right? It comes in a slim, pen-like, portable device that smells nice. It also has fun flavours and won't stain your nails yellow. However, the truth about vaping isn't quite so simple. Let's investigate what a vape is, what it contains, and whether it's as safe as we've been led to believe.

What is a vape and how does it work?

A vape (or an e-cigarette) is a small electronic device that heats up a liquid solution held within a small pod. This creates an aerosol you can inhale. This liquid contains nicotine and various chemicals, as well as an array of flavoring options to make the vaping experience more enjoyable.

Vapes can contain thousands of chemicals, which you end up inhaling directly into your lungs. Here are just some of these chemicals:

• Nicotine: an addictive substance, also present in cigarettes
• Propylene glycol: often used as the base liquid, this is also used to make antifreeze and paint solvent
• Carcinogens: cancer causing chemicals, including acetaldehyde and formaldehyde
• Acrolein: an herbicide, which can cause permanent lung damage
• Benzene: a chemical also found in car exhaust
• Heavy metals: such as nickel, tin, and lead
• Cadmium: a toxic metal found in traditional cigarettes, that may cause breathing problems
• Vitamin E acetate: an additive in some THC-containing e-cigarettes

Inhalation of these substances can cause harm over time.

EVALI

E-cigarette or vaping use-associated lung injury (EVALI) was first identified in 2019. Since then, there have been a growing number of cases, with the Centers for Disease Control and Prevention (CDC) confirming 2,807 cases of EVALI and 68 deaths in February of 2020¹. Lung damage can be so severe it may lead to needing a ventilator to breathe or, in the worst-case scenario, death.

Asthma Flares

The chemicals mentioned above, as well as the vapour itself can irritate the airways. This may lead to worse and more frequent asthma flares. Additionally, toxic metals found in vapes can trigger allergic reactions, also leading to asthma flares.

Nicotine Addiction

The addictive nature of nicotine is undeniable; it's what makes cigarette smoking so difficult to quit. One e-cigarette device (with a 10mL well of 5% nicotine) may deliver the nicotine equivalent of over 10 packs of cigarettes. Even more concerning is that these devices are often marketed to a younger audience, with their sleek designs and fun flavours. They are easily concealed and can be used discreetly.

Many teens (and even adults) think that vaping is safe and take up the habit even if they would never consider smoking traditional cigarettes. However, nicotine is a toxic substance – it increases your blood pressure and increases your risk of a heart attack. Developing a nicotine addiction at a younger age makes it much harder to stop, and longer exposure to its harmful effects is likely to lead to heart and lung damage at an earlier stage in life.

Quitting Support

You might ask: Can you use e-cigarettes to quit smoking? So far, the Food and Drug Administration (FDA) has not found e-cigarettes to be a safe or effective method to help quit smoking. We suggest talking with your doctor to explore options to help quit smoking as well as nicotine addiction. You can also call 1-800-QUIT NOW or visit the official CDC website (https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/index.html) for further information, resources, and guidance.

Alena Malik, MD, is accepting patients at White River Health Internal Medicine. To schedule an appointment, call 870-262-1510.