E-Cigarettes: a Public Health Disaster Waiting to Happen?

Heavy smog in Piccadilly Circus, London, December 1952. (Photo by Central Press/Hulton Archive/Getty Images)

Do you know what a pea-souper is? You don’t really want to know, at least not at first-hand. It was the humorous name given to an decidedly unfunny atmospheric condition, not uncommon in the winter months in London in the nineteenth century and up to the 1950s, when a combination of smoke and fog (‘smog’), reduced visibility sometimes to the distance of your hand on your outstretched arm in front of your face. The smoke came from burning coal to heat buildings. Many deaths were attributed to smog.

If you lived in London in those days you had no choice in the air you breathed. Of course, no one would normally choose to breath polluted air, unless, that is, you’re a smoker – or a ‘vaper’ which, as everyone knows, means a person who uses e-cigarettes.

Inhaling the smoke from burning tobacco doesn’t sound like a good idea, but if you feel you have to do it, or something similar to get the equivalent effect, then vaping seems to be the answer – at least according to a certain nutty professor who, in concert with other researchers, has declared that e-cigarettes are, by a nice round figure of 95 per cent, safer than smoking conventional cancer sticks. Incidentally, Professor David Nutt also thinks hallucinogenic drugs are a good idea for treating depression.

And now comes news that scientists at the prestigious Karolinska Institute in Stockholm have discovered that vaping can raise blood pressure and start the process of hardening of the arteries leading to heart disease. They also found that the food additives used to flavour the fumes – fine when eaten – don’t do you any good when inhaled into your lungs. On top of all that, they concluded, hardly surprisingly, that using e-cigarettes is not a particularly effective way to stop smoking.

The Swedish researchers made a further interesting observation about e-cigarettes: the average user takes 230 puffs a day or 84,000 puffs in a year. This means, if we assume one sleeps for eight hours and spends two hours a day eating, there are fourteen hours or 840 minutes available for vaping. At 230 puffs per day, the vaper will suck the fumes from the e-cigarette device into his or her lungs on average every 3.7 minutes. And this is supposed to be 95 per cent safer than smoking? It could be a public health disaster waiting to happen.

There are other voices of caution about e-cigarettes, apart from mine, such as that of Professor Martin McKee of the London School of Hygiene and Tropical Medicine. He is concerned about the health risks of e-cigarettes in the long term and wants to regulate them ‘as much as possible’. Does he perhaps mean regulating them out of existence? He is also worried about nicotine itself:

For a start, nicotine is more dangerous than previously thought. It negatively affects the developing brain, helps cancer spread by encouraging the growth of blood vessels around tumours, and increases the risk of dangerous heart rhythms in those who have just had a heart attack.

These eminently sensible comments, however, do not do much to dampen the enthusiasm of some proponents of e-cigarettes such as Professor John Britton of the University of Nottingham, who has a foot in both camps:

We should not let studies rightly highlighting the potential dangers of e-cigarettes blind us to the fact that these devices are much, much safer than smoking tobacco.

For a smoker, moving to e-cigarettes brings a huge health benefit. The decision should be a no-brainer. When you smoke a cigarette you inhale not only nicotine but also more than 4,000 highly toxic chemicals, including carcinogens. And you inhale many of them in fairly high concentrations. So there’s nothing better you can do for your health than to quit smoking. Let’s be clear: e-cigarettes are not harmless and we shouldn’t be complacent. E-cigarette vapour contains toxic chemicals, and tiny particles that can harm lungs and blood vessels. But in terms of the harm they cause, they simply aren’t in the same league as smoked tobacco.

Further, we should not get carried away by the claimed success of e-cigarettes in helping 18,000 people in the UK to quit smoking in 2015, according to research by University College London and Cancer Research UK.

Since there are currently 9,600,000 adult smokers in the UK this reduction in the total number is trivial. Instead of it being presented as a point in favour of e-cigarettes it should be a wake-up call to re-think the whole smoking problem.

Professor Britton again:

Each cigarette, and especially the first of the day, restores normality and feels good – in much the same way as it feels good when someone stops twisting your arm. Most smokers smoke to feel normal. Half die as a consequence.

Too true. But non-smokers don’t have this problem: they are in a normal state and feel good (other things being equal) without nicotine.

You don’t need to smoke to feel normal. You just need to stop smoking!

Text © Gabriel Symonds