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Jury still out on the impact of vaping on your health

Vaping is less harmful than lighting up the real thing, but there’s still not enough good evidence showing that it’s harmless

There’s no question e-cigarettes, also known as vaporizers, are growing in popularity. Many people see vaporizing, or vaping, as an alternative to using traditional cigarettes — and potentially as a tool to help people quit smoking. Vaping is less harmful than lighting up the real thing, but there’s still not enough good evidence showing that it’s harmless.

The first e-cigarette was introduced just over a decade ago. The devices are made up of three components: a cartridge for e-liquids, which may contain nicotine and flavourings; a heating device to generate vapour, which the user inhales; and a battery. Manufacturers have already introduced multiple generations of e-cigarettes. The fact that the technology is relatively new and changes quickly hampers research into the safety of these devices and their utility as smoking cessation aids.

Originally, e-cigarettes looked just like the real thing, and had red LED lights at the end that lit up when users took a drag. Some people even called them “cig-alikes.” Now, they come in variety of different colours and styles and no longer resemble their paper-rolled, tobacco filled counterparts. A new term that’s gaining popularity is Electronic Nicotine Delivery System, or ENDS.

Health Canada hasn’t approved e-liquids containing any nicotine for sale in this country, but that doesn’t mean you can’t buy them. Even the e-liquids that don’t contain nicotine may not be safe.

Some of these “juices” are flavoured with diacetyl, which is known to be toxic when ingested or inhaled in large quantities. Determining the long-term effects of the various chemicals in e-liquids is just one active area of study when it comes to vaping.

My research focuses on tobacco dependence and treatment, including two recent studies involving vaping. One study looked at how effective e-cigarettes are in alleviating cravings for traditional cigarettes. We found they were effective, but only for a short time. The second study involved people enrolled in a free smoking cessation treatment program involving nicotine replacement therapy and counselling. That research found that people using e-cigarettes during treatment were less likely to have quit three and six months after enrolling in the program. Both cases require further research.

Within the tobacco research and control community, vaping remains a polarizing issue. Some of my colleagues believe vaping will spell the end of traditional cigarettes and think the health-care community should be encouraging people to switch to e-cigarettes. Other colleagues believe vaping will renormalize cigarette smoking and undo the progress made through tobacco control efforts over the last 20 years. I think that more high quality research is needed to resolve this issue.

To further complicate matters, many tobacco companies have bought the smaller e-cigarette companies, and are heavily promoting their battery-operated alternatives. For tobacco companies, this has the potential not just to recoup the lost revenue from falling cigarette sales, but it may also be a new way to get new people hooked on their products.

The number of people “lighting up” electronically nearly doubles each year. If the trend continues, vaping could overtake smoking one day. As the demand for these products grows, so does the need to find out all we can about their benefits and risks.

Dr. Laurie Zawertailo is an assistant professor in the Department of Pharmacology and Toxicology. She is also a scientist in the Addictions Program at the Centre for Addiction and Mental Health.

Doctors’ Notes is a weekly column by members of the University of Toronto’s Faculty of Medicine. If you have a question or comment for one of our experts, email .

Vaping Facts

  • The first vaporizing e-cigarette was invented in Beijing in 2003 by a pharmacist, Hon Lik, who hoped to quit his own smoking habit.
  • Imperial Tobacco, which sells its products in 160 countries, bought the patents for Hon’s invention in 2013
  • Disposable vaporizers were introduced in Canada in 2007
  • The World Health Organization called for a ban on the use of e-cigarettes in public places and work places last August
  • In May, Ontario passed a law banning the sale of e-cigarettes to anyone under the age of 19, banning vaping in smoke-free areas, and regulating the promotion and display of e-cigarettes
  • In Canada, it’s illegal for companies to market their vaporizers by claiming e-cigarettes are an effective way to quit smoking or to suggest it’s a safer alternative
  • More than 460 brands of vaporizers are sold worldwide
  • The global market for e-cigarettes is estimated to reach a value of $3 billion this year

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