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Smoking or vaping: e-cigarettes as a lesser evil

May 31, 2019

Smoking's out, steaming's in. Both are indisputably unhealthy, but is one better than the other? Supporters of smoke alternatives say they aren't as bad as traditional tobacco cigarettes. But is there any truth in that?

Wettbewerb Cloud chasing in Mexico Stadt
Image: Reuters/V. R. Garcia

It's best not to inhale any tobacco whatsoever. That's what most people agree on. But some smokers of electronic cigarettes say there are advantages to vaping over traditional tobacco smoking.

What are they? Here's nine potential advantages (with caveats, of course). 

1. E-cigarettes can help people to stop smoking

While the World Health Organization outrightly rejects the use e-cigarettes, the switch from tobacco to e-cigarettes is actively promoted by the UK government as a means of smoking cessation.

British physicians of the Royal College of Physician and Public Health England outlined the positive effects of e-cigarettes, as opposed to tobacco consumption, in their 2016 article "Nicotine without smoke: tobacco harm reduction."

And although this assessment was initially viewed critically in many EU countries because there was a lack of valid data from long-term studies, some have since changed their stance. 

According to theGerman e-cigarette lobbyists, "91% of all e-cigarette users are former tobacco smokers" and "8% use both the e-cigarette and the tobacco cigarette and fall thereby into the category 'dual-user'."

"Only 1% of those questioned are newcomers who have not smoked before," they found. 

Meanwhile the German Federal Ministry of Health  reports that for dependent and/or strong smokers the change to e-cigarettes can be a healthier alternative, particularly if smokers don't want to live without nicotine altogether and want an alternative to tobacco consumption.

2. E-cigarettes are less harmful than tobacco cigarettes, but...

The burning process of tobacco cigarettes produces thousands of substances, several hundred of which are considered toxic or even carcinogenic. Since the e-cigarette does not burn tobacco, "characteristic carcinogenic combustion products" don't exist in e-cigarettes, writes the Federal Institute for Risk Assessment (BfR).

E-cigarette smokers don't inhale tar, often have fewer throat inflammation issues than tobacco smokers; they cough less, often feel fitter and their sense of taste improves again. When smokers renounce nicotine, their addiction weakens.

Malaysia : Smoking an electronic cigarette
Less harmful, but not healthy. Most concerningly, the long-term consequences of e-cigarettes aren't known.Image: Getty Images/AFP/M. Rasfan

However, fine, toxic particles are transported deep into the lungs by the e-cigarette steam. This can cause coughing, inflammation and reduced lung function. Some aromas can cause allergies or severe respiratory diseases.

The liquids contain pollutants that are held responsible for numerous (secondary) diseases. They consist mainly of propylene glycol, which can irritate the the eyes and respiratory tract. Heating the liquids produces acetaldehyde and formaldehyde, which also damage the respiratory tract, irritate the skin and mucous membranes and are considered carcinogenic.

3. E-cigarette smokers have more choice

Although the classic tobacco product range also includes numerous flavors and varieties, the range of controlled and unregulated e-cigarettes, depot and tank systems, as well as disposable and reusable products and the countless liquids and flavors available are even more extensive.

E-cigarettes are to be marketed as a harmless lifestyle product
E-cigarettes are marketed as a harmless lifestyle product in order to make smoking socially acceptable again. Image: Reuters/C.Platiau

This huge selection could pose a big problem, because often little is known about the ingredients and their effects in the long run. After all, the devastating damage to health caused by tobacco consumption only became apparent over time.

4. E-cigarette consumption has a less harmful effect on the environment

Unfortunately, the e-cigarette aromas don't smell much better than tobacco smoke. In fact, the experience of sitting in a cafe and being enveloped by a sticky-sweet strawberry cloud from an e-cigarette is arguably just as disgusting.

But at least passive e-smoking isn't as harmful as it is in the case of tobacco smoke. According to the German Cancer Research Center (DFKZ), passive tobacco smoking is linked to breast cancer, respiratory diseases and asthma attacks in young women. Children of smoking parents more frequently suffer from acute and chronic respiratory diseases and they get ear infections more frequently than children of non-smoking parents.

No smoking sign
Of course, it's healthiest not to vape or smoke at all.Image: picture-alliance/dpa

Every year in Germany about 2150 people die from coronary heart disease caused by passive smoking, and more than 770 non-smokers die from a stroke caused by passive smoking, according to the research center. 

Passive e-smoking doesn't have these same effects. Additionally, e-smokers no longer carry the typical stench of cigarette-smokers; their teeth and fingers are no longer stained yellow, and their clothing doesn't stink of tobacco smoke (although, perhaps still of sickly sweet strawberries).

5. E-cigarettes produce less waste

When it comes to ocean pollution we tend to think of plastic waste, but in terms of the numbers, cigarette butts (which do actually contain plastic too) are the biggest problem. According to a study byJustus Liebig University in Giessen, 4.5 trillion of the 5.6 trillion cigarettes smoked each year are disposed of improperly.

Trash at the coast of Barcelona
Cigarette butts are not biodegradable as they contain toxins and heavy metals.Image: picture alliance/dpa

They're not only ugly, but also harmful to the environment because they contain toxins and heavy metals. Cigarette butts aren't biodegradable and, especially in salt water, the decomposition process can take centuries.

But although e-cigarettes don't end up as stubs in the sand or the gutter, they can't just be thrown out with regular household waste. They are — particularly their battery — electronic waste that must be disposed of properly. The devices also contain valuable raw materials that can be recycled.

6. The fast e-cigarette for in between

When it comes to tobacco cigarettes, the first drag is the most impactful.

The "nicotine flash" billows into the lungs, the slight scratching sensation in the throat — the so-called "throat hit" — grabs you, at the same time as a certain sense of relaxation sets in. For tobacco smokers, this is what is pleasurable about smoking. But the first inhalation is the most salient; after a few more inhalations these sensations subside and it's more about finishing the cigarette.

These sensations are often missing with e-cigarettes, but e-smokers can smoke for a shorter period of time, for example in the car or in places that tobacco cigarette smoke would linger for hours. 

7. Fewer fires due to e-cigarettes

The European Commission announced in 2011 that unattended burning cigarettes are one of the main causes of fatal fires in Europe. According to the study, more than 30,000 cigarette-related fires occur in the EU every year, killing more than 1,000 people and injuring more than 4,000.

Forest fire
One discarded cigarette is enough to trigger an inferno.Image: Reuters/Yonhap

Not only have houses and flats been burnt down, but whole forests and towns have gone up in flames because cigarette butts were carelessly thrown out of moving cars, trains or otherwise.

To address this, theEuropean Commission introduced the so-called RIP ("Reduced Ignition Propensity") procedure. Cigarette papers must now contain two thick paper rings, which cause cigarettes to go out if they aren't being inhaled from. This measure was already in place in the US, Canada and Australia.

8. E-cigar smoking is cheaper

The decisive factor for cost calculations is of course usage. A heavy tobacco smoker smokes about one box a day, which costs between 150 and 220 euros per month.

Even a heavy e-smoker that occasionally buys other liquids, a new evaporator head or even a new appliance, wouldn't spend so much on a yearly basis. The purchase price for e-cigarettes is about 50 euros on average. A 10ml liquid bottle costs only a few euros. 

9. E-cigarettes aren't a gateway drug to tobacco consumption

According to the "gateway hypothesis," the consumption of e-cigarettes encourages young people to smoke conventional tobacco cigarettes. According to the hypothesis, e-cigarettes are a kind of entry-level drug.

The tobacco industry is trying to market the e-cigarette as a lifestyle product with supposedly harmless aromas and to make smoking socially acceptable again through alternatives to conventional cigarettes. Vera Luiza da Costa e Silvadie, chairwoman of the World Health Organization's Secretariat for the Tobacco Control Convention, believes that they must be banned or strictly regulated accordingly.

The German Federal Centre for Health Education (BZGA) also takes the view that "the consumption of e-cigarettes can encourage young people to experiment with tobacco cigarettes."

But Germany's Federal Ministry of Health disagrees, saying "The fear that young people are enticed to try (traditional) tobacco products by smoking e-cigarettes cannot be confirmed bythe data."

According to the Ministry, it's not clear that e-cigarettes encourage smoking in general. "For Germany," the ministry says, "the proportion of young smokers has fallen continuously over the last few years, despite increasing consumption of e-cigarettes."

But the e-cigarette industry is relying on a strong growth in numbers: The prognosis of the industry federation alliance for tobacco-free benefit (BfTG) is an at least 25% increase, equal to approximately 500 million euros.

However, the industry fears "a possible taxation and a politically discussed advertising prohibition — analogous to the tobacco cigarette. In this way, the e-cigarette will be politically slowed down instead of being actively promoted, as is the case in the UK, for example."