Despite e-cigarettes’s potential to help smokers quit smoking, a recent study suggests that they are more harmful than beneficial to the American population.
The study, titled “Quantifying Population-Level Health Benefits and Harms of E-Cigarette Use in the United States,” was conducted by researchers from The Dartmouth Institute for Health Policy and Clinical Practice and the Geisel School of Medicine, as well as the Moores Cancer Center at the University of California, San Diego; the University of California, San Francisco School of Nursing; and the University of Pittsburgh School of Medicine. The researchers developed a model to estimate how many people would both begin and cease smoking as a result of using e-cigarettes.
The results of the study show that the number of youth introduced to smoking from e-cigarettes, and thus experiencing shortened lifespans, vastly outweighs the number of years saved from adult smokers quitting through the use of e-cigarettes.
According to Geisel School of Medicine professor and study co-author James Sargent, youth who start smoking e-cigarettes are three to four times more likely to start smoking real cigarettes than youth who do not smoke e-cigarettes.
E-cigarettes also put youth at risk because they are more harmful to health than how they are advertised, according to professor at The Dartmouth Institute Samir Soneji, who was the study’s principal investigator. The fruit flavors of e-juice, ranging from strawberry to blueberry-pomegranate, attempt to dupe children into thinking that e-cigarettes are harmless, he said. Much like advertisements for cigarettes in previous decades, those for e-cigarettes claim there are little health risks to the product, he said.
“There is a myth among kids that it is just water or fruit and candy flavoring, but it is not safe,” Soneji said.
The glycerine in e-cigarettes can stick to the user’s airways, according to professor John Pierce, professor of family medicine and public health at USCD and a co-author of the study.
Soneji said that e-juice is often labeled as nicotine-free, but very little juice is truly free of nicotine. Additionally, e-cigarettes mimic the nicotine delivery of cigarettes and can easily lead to nicotine addiction.
Breathing in oils from the e-juice may also lead to serious health consequences, such as lipoid pneumonia — the presence of oil in the lungs, according to Sargent.
E-cigarettes are increasingly becoming a more popular and viable replacement to smoking cigarettes, Soneji said. Smoking e-cigarettes allows smokers to inhale nicotine without the combustion — the tar — that is the carcinogen, he added.
In 2017, ten million adults attempted and failed to quit smoking, he said, adding that approximately half attempted to quit through the use of standard methods like nicotine gum or counseling, while the other half attempted to quit “cold turkey.”
Additionally, smokers may quit smoking entirely after using e-cigarettes.
“It is a different behavior,” Soneji said. “Adult smokers may not understand how to charge [the e-cigarettes’] USB or refill the e-juice. Vaping can be a challenge.”
Whereas e-cigarettes are often adult smokers’ last smoke, they are also commonly young teenagers’ first, which is “the most important puff,” according to Soneji.
Due to the increasing popularity of e-cigarettes, their lack of regulations of the product, young teenagers who would otherwise not be exposed to smoking are then introduced to e-cigarettes and the sensation of smoking, Soneji said. He added that until 2016, most states had no age restrictions on purchasing e-cigarettes and that since 2014, e-cigarette smoking has exceeded the use of cigarettes among youth.
Many brands specifically target college-age users, Soneji said, some brands go even further and target affluent, highly-educated college students in their advertising campaigns, he said, adding that he believes this focus on appealing to young adults is dangerous.
“Young adults’ brains are not completely developed and e-cigarettes negatively affect brain development,” Soneji said.
He added that there is a large concern that the focus on youth, instead of adults, will normalize the consumption of e-cigarettes and will be harmful in the long term.
Soneji and Sargent both suggested further regulation of e-juice flavoring and changing the target audience of e-cigarette advertisements to adults as ways to steer adolescents away from smoking e-cigarettes and potentially also cigarettes.
“The harm is happening now,” Soneji said. “It is prudent not to wait [to take action].”
