IDK about you, but it seems like there are more e-cigarettes on the street now than, you know, regular cigarettes. Hell, you might even be one of the 3.2 percent of people (and more than two million teenagers) in the U.S. who are riding the vape train, per the Centers for Disease Control and Prevention.
That’s a lot of people—and vaping is officially an epidemic right now, according to the Food and Drug Administration (FDA). The agency released a statement earlier this month, saying it “won’t tolerate a whole generation of young people becoming addicted to nicotine,”—it even issued more than 1,000 warning letters to stores for selling e-cigs to minors. Damn.
So yeah, it seems like vaping might be problematic—but exactly how bad is it?
Hold on, exactly what is vaping, anyway?
“Electronic cigarettes are battery-operated devices that heat a liquid usually containing nicotine, producing a vapor,” says Tanya Elliott, M.D., an allergist and internist.
Vaping is what you’re doing when you inhale that vapor. The habit is also sometimes referred to as Juuling; Juul is a specific brand of e-cigarette.
Even though some e-cigs may look like traditional cigarettes (other devices resemble slim flash drives or fancy pens), vaping is not the same as smoking. While e-cigarettes heat liquid, says Elliott, they don’t burn. That’s an important distinction since it means users are not exposed to the tars, oxidant gases, carbon monoxide, and other toxins found in conventional cigarettes.
So, does that mean vaping is healthier than smoking?
Not quite, says Elliott. “Most e-cigarettes do contain a number of potentially toxic chemical substances, such as propylene glycol or glycerol,” she says, adding that, at high-temperatures, those substances can morph into something called propylene oxide, which is suspected to cause cancer in humans.
A 2018 study published in the American Journal of Preventive Medicine combined data from two national surveys of nearly 70,000 people in 2014 and 2016, and found that daily use of e-cigarettes may double a person’s odds of a heart attack. The long-term effects of e-cigs on heart health and cancer risk are not yet known—but that’s because they haven’t been around long enough to be studied for any significant period of time.
Then there’s the nicotine factor to consider. “Most vapers still use it in their devices, and others, like Juul for example, don’t even offer non-nicotine options,” says Ana María Rule, Ph.D., author and assistant professor at Johns Hopkins Bloomberg School of Public Health.
Nicotine is addictive and is generally considered to be detrimental for overall health, says Rule. The Surgeon General even wrote an entire chapter on the effects of nicotine in a 2014 report called The Health Consequences of Smoking—50 Years of Progress, citing its negative effects on reproductive health, cardiovascular diseases, and even immune function.
Keep in mind, too, that vaping is still relatively new, and that negative health effects can “take many years to manifest,” says Rule.
Well, can’t vaping help smokers quit smoking?
One of the “benefits” claimed by e-cigarette users is that it can help you quit smoking old-school cigarettes. But it’s hard to say if that’s the smartest way to kick the habit.
According to Rule, the studies to support this are inconclusive. “It works for some people, but most people end up being ‘dual’ users,” she says—that means they use both cigarettes and e-cigarettes.
So, what are the guidelines on e-cigarette use right now?
Basically, no one under 18 can buy any kind of device that delivers nicotine—including e-cigarettes. Still, that doesn’t mean it never happens.
“Part of the problem is that e-cigarettes can be bought on the internet, and kids are very savvy and can easily get around controls,” says Rule.
In 2016, the FDA went even further and finalized a rule to extend its regulatory authority on cigarettes to all tobacco products, including e-cigarettes. That ruling also meant slapping a “nicotine addictiveness” warning sticker on all tobacco and e-cigarette packages and advertisements, starting in 2018.
The bottom line: E-cigarette use is still extremely new—and while it may be slightly less dangerous than actually smoking, it’s still decidedly unsafe. So yeah, it’s pretty bad for you.