Few people take up smoking in their thirties. It’s a habit young people pick up in their teens and early twenties to make a statement about their burgeoning adulthood and putting aside of childish things. It’s a part of an ancient recipe whose other ingredients include motorcycles, alcohol, fast cars, and faster girls (or boys). It’s not just opinion - a 2012 study from Universities found that the most popular high schoolers were more likely to be those who smoked. Taking risks is a part of growing up.
And while the motorcycles and fast cars are traded for something more responsible, cigarettes tend to stay a beloved part of most adults lives. In 1970 there were 10 million smokers in Malaysia. By 2019, that number had dropped to around 7 million or 22% of the population, and whichever way you spin it, those numbers don’t point to an overwhelming success by the anti-smoking lobby.
But here’s a curious thing: as we entered the second decade of the millennium, electronic cigarettes started to appear in people’s hands. They were new, they had weird blue LEDs, they smelled of candyfloss and apples, they come in forms like box mods, pod systems, and disposables. And in 2023, the MVCC reported that more than 1.4 million Malaysians were regularly taking their nicotine from electronic devices. And their popularity isn’t going away any time soon, as of 2023, the vaping market in the Malaysia was worth a staggering RM3.5 Billion, and the global vape market is expected to be worth USD$61 billion globally by 2025.
What’s the appeal?
For the older market, the appeal is obvious. Most smokers want to quit. After a certain age, the cool appeal of smoking fades and they’re stuck with an expensive habit, failing fitness, loss of sexual potency, stinky clothes, and are banned from engaging in their malodorous habit in enclosed public spaces in the US. There’s a social stigma, and an assumption among most non-smokers that addicts are poorly educated, and of a lower social order. That’s not to mention the insane costs that come hand in hand with a cancer diagnosis in America.
The chances are that they’ve already tried quitting and failed multiple times. Nicotine patches have some limited success, as do the various gums, lozenges and sweets. Zyban - one of the more effective drugs - comes with a range of unpleasant side effects and can actually kill users.
Electronic cigarettes were just one more potential remedy to try, but one which shockingly seems to work as a full or partial replacement for cigarettes with 52% of vape users in England being former smokers. There’s no tar, and no carbon monoxide produced, meaning that users usually feel an immediate benefit to myocardial function. And there’s also the convenience factor - electronic cigarettes can be purchased in gas stations, chemists, mall kiosks, and most other places you would be able to purchase real cigarettes.
For the youth, the attraction is the same as that which first pushed their parents generation to buy a packet of Marlboro Red from the 7-eleven. It’s cool, and more to the point, it’s a habit of which adults disapprove. By vaping, they are defying authority, flouting their parents wishes, and they’re sticking it to the man.
There’s the added bonus that vaping is harder to detect - there’s no lingering tobacco odor, and vape pens can be easily concealed in pockets, on key rings, or even disguised as USB sticks. As recently as 2014, 23% of teens were tobacco users, however by 2018, only 8% of high schoolers were using cigarettes, and in 2017, 11% of high school students vaped nicotine.
What’s the controversy?
It would be straightforward to think that any new product which helps adults to give up smoking, improves health, and prevents kids from taking up the habit would deserve to be greeted with open arms. But electronic cigarettes have not received the universally rapturous response you might expect. And there are a few good reasons for this.
Health concerns
The ingredients
A worry shared by many people is that by replacing conventional cigarettes with their electronic equivalents, users are simply swapping out one bunch of poisons for another. And looking at the ingredients list on a bottle of vape juice does very little to assuage their concerns: Propylene glycol, nicotine, a whole bunch of unpronounceable chemicals, such as Vegetable glycerine, benzoic acid (which can, under certain circumstances, convert to the carcinogenic molecule benzene), flavorings such as linalool, diacetyl, and cinnamaldehyde, which are associated with a host of serious conditions.
Nicotine
The truth is that only one of the ingredients in your vape juice is (as far as we know) actually a poison. Nicotine is a powerful neurotoxin, and can be lethal in large amounts. But as any experienced vape user would tell you, the nausea and sickness you feel from inhaling too much will cause you to throw up before any permanent harm is done.
Propylene Glycol
It’s in antifreeze. It’s a solvent. It’s used to make plastics. Alternate uses of Propylene Glycol, the main component of most e-juice blends, Do not necessarily inspire confidence in users.
No, but no-one’s suggesting that propylene glycol has any benefits for your health. It doesn’t have any negative impact either. Agency for Toxic Substances and Disease Registry states that propylene glycol “is generally considered to be a safe chemical,” “breaks down very quickly in the body,” and “is acceptable for use in flavorings, drugs, and cosmetics, and as a direct food additive.”
Propylene glycol is used in electronic cigarettes for the simple reason that it breaks down into water vapor when heated. Vape users are quite literally breathing in steam.
One cautionary note worth mentioning is that if the heated coils are ‘dry’, residual Propylene Glycol can generate free radicals which damage cell components and may play a role in the development of cancer. However, as the linked study noted, “These values are 100- to 1000-fold lower than those measured previously in mainstream smoke from conventional cigarettes.”
The other stuff
Anything else listed as an ingredient is likely to have an extremely long and complicated chemical name. These are usually food flavorings and colorings - The kind of thing you might put in a cake or a pastry.
Granted, unless you have an utterly insatiable appetite, you’re unlikely to be sucking these chemicals directly into your lungs. Currently, there isn't any real evidence about the health implications of inhaling heated flavor chemicals in high concentrations directly into your lungs.
Potential health issues
One major problem with assessing the health risks associated with vaping is that it hasn’t been around long enough to make a proper assessment. The negative health impacts of smoking have been well documented precisely because it has been so prevalent for so long. Vaping isn’t at that point yet.
Nonetheless, there have been a couple of significant scares, which have made users and potential users have second thoughts.
Popcorn lung
It’s a phrase almost custom built to fill you with dread. Lungs aren’t supposed to look, function, or in any other way resemble America’s favorite theatre snack.
Also known as bronchiolitis obliterans, ‘Popcorn Lung’ causes obstruction, inflammation and scarring of lung tissue, and reduces the usable lung volume by up to 90%. It’s not nice. The disease is, while not common, most prevalent among workers in the nylon industry, battery manufacturers and food industry workers who work with the diacetyl chemical - responsible for the butterscotch flavor of popcorn.
And it’s because of this butterscotch flavor that diacetyl has an association with vaping. Butterscotch is delicious and sweet. The flavouring is cheap and easy to make. And there is a definite link between diacetyl flavoring and popcorn lung. It’s easy to point an accusatory finger at electronic cigarettes.
Claims that the use of electronic cigarettes causes popcorn lung began to surface in 2016, but were outed by Snopes as being a viral hoax.
Another, less well-known fact, is that diacetyl is present in conventional cigarettes at far higher concentrations than in e-cigarette liquid.
COPD
Chronic Obstructive Pulmonary Disorder is another nasty sounding illness and it does exactly what it says on the tin. The short version is that it gets worse over time and it makes it progressively more difficult for an affected person to breathe.
Over 90% cases are caused by smoking, and while it is not yet known if the condition can be caused by vaping, it has been suggested by one study that the nicotine in e-liquids, “triggered the effects associated with the development of COPD.”
It’s too early to tell what the long term effects might be.
Cardiovascular disease
The effects of smoking conventional cigarettes are well known, and a google search will link to so very many studies showing the link between smoking and heart disease that it’s difficult to pick which one is worse.
With electronic cigarettes, the long term effects on the cardiovascular system are unknown.
But think of the children!
We’ve established that teens are rebellious, tend to indulge in dangerous behavior, and will absolutely go out of their way to annoy and worry any adults who care enough about them to express an opinion.
It’s part of growing up. It’s a rite of passage. Stone age teenagers were doing it, and no doubt 1,000 years from now, the descendants of the first Martian colonists will be surfing down Olympus Mons backwards while setting fire to alien vegetation for thrills.
Parents and other responsible adults need to accept this behavior, and look at the relative risks.
If my child is vaping, are they smoking?
No. They’re two superficially similar, but totally different things. Cigarettes contain somewhere in the region of 6,000 different chemicals. Most of these are toxic to some degree.
Electronic cigarettes usually contain six chemicals. Exactly one of these is known to be toxic, and even then, only under specific circumstances. It is almost impossible to suffer fatal nicotine poisoning from electronic cigarettes.
But electronic cigarettes are addictive!
Again, the technology hasn’t been around long enough to establish solid facts on this, and there’s a great deal of equivocation in academic circles, but the evidence points to the addictiveness in nicotine in cigarettes being dependent on other chemicals. Chemicals which are not present in electronic cigarettes. Of course, vaping may be habit forming, but there is, as yet, no hard evidence pointing towards this.
Can someone underage vape a nicotine-free vape juice?
Nicotine is harsh. It’s scratchy on the back of your throat, and unless it’s something you’ve been introduced to through regular smoking there’s no real reason why underage teens would want to subject themselves to the unpleasantness. After all, if they’ve bought the gear, they can look the part - exhaling huge clouds of strawberry scented steam and alarming passers-by.
But is it legal? The short answer is possibly - although it’s not something you or they would want to test in court. The FDA considers nicotine free e-juice to still be a tobacco product ‘under certain circumstances’, but without nicotine in their juice, underage vapers are simply inhaling steam mixed with food flavorings through a device which heats the juice up. That’s it.
Are there 100% safe nicotine free e-juices for e-cigarettes?
Nothing is 100% safe ever. Even if you were just inhaling steam on its own - that’s not 100% safe, as high humidity is great for viruses, fungi, and bacteria to survive and thrive. Once you add in food flavorings - designed to be ingested rather than inhaled, we’re in unknown territory.
But whichever territory it is, vaping is nowhere near as harmful as tobacco smoking.
Nur Andi Ravsanjani Gusma
/ PexelsOther Dangers
Vaping isn’t as simple as smoking. Instead of applying a lit match to dried organic material, vapers are pressing high technology to their lips and breathing in a hot mix of designer chemicals. Even if the chemicals don’t harm you, the technology might.
The ‘dry puff’ phenomenon
Almost everything mentioned so far assumes that an electronic cigarette is functioning normally. By this, we mean that the coils are covered in vape juice, there is sufficient airflow, and there is an appropriate current passing through.
When these conditions are not satisfied, vape users may experience a ‘dry puff’. This phenomenon occurs when coils are heated when they are not sufficiently coated in liquid, the residual coating heats up, and in instead of being vaporized, these chemicals are instead, burned or undergo thermal decomposition This can lead to the production of aldehydes, and the breakdown of propylene glycol and glycerin into other harmful chemicals.
Most vape users are anxious to avoid ‘dry puffs’ as aside from potential health implications, the taste is extremely unpleasant.
Batteries
It’s probably not a surprise to learn that electronic cigarettes use batteries to provide the power to run them. But these aren’t the AAA variety that you use in your TV remote control. The latest generation of advanced vaping devices use 20700 batteries, which are long life, power dense, and were pioneered by Tesla to power their cars. They are perfect if you use want a moderately high powered device which will last all day.
But even with their extraordinary charge capacity, it’s not uncommon for vapers to keep a spare in their pocket ‘just in case’.
Unfortunately, it’s also not uncommon for vapers to keep other items in their pockets. Metallic items such as keys, coins, and other paraphernalia.
These can cause the battery to short circuit, and lead to a phenomenon known as ‘thermal runaway’. This sounds exactly as bad as it is. The battery heats up. Its internal protections break down, it heat up even more, and in a very short time it explodes or catches fire - potentially taking most of your trouser area with it.
There’s a simple solution here - store batteries separately from anything and everything else. Most retailers provide batteries in a purpose built carry case. Use it.
Chargers
Like any electronic device which relies on chargers, it’s important to get the right one for your electronic cigarette - preferably one supplied by the manufacture.
Lithium Ion batteries have a maximum charge rate. If this is exceeded, the battery will heat up, and as in the previous example, there’s a potential for thermal runaway.
Over a seven year period ending in 2016, 195 separate incidents of explosion and fire involving an electronic cigarette were reported by the U.S. media, resulting in 38 severe injuries.
Conclusion
The prospect of having your pants set on fire is not, perhaps, the best note to end on, but consider this: Fires caused by smoking cause around 1,500 deaths, 16,000 hospitalizations, and 400,000 injuries in the US each year. Compared to this, the number of fires caused by electronic cigarettes is an insignificant drop in the ocean.
Yes. It is a non-zero risk, but compared with the alternative, it is infinitely better.
In fact, nothing to do with electronic cigarettes is completely risk free. But in every possible way, they seem to present less of a risk than smoking the old fashioned way.
Obviously, this might change in the future, but as we understand it now, there is no link between vaping and lung cancer, a minimal possible link between vaping and COPD, and minimal evidence suggesting that vaping acts as a teenage gateway to tobacco or any other kind of drug abuse.
It has also proved extraordinarily effective in getting Americans to stop smoking, when virtually every other treatment has proved either ineffective or dangerous.
Anecdotal evidence exists in abundance of individuals who have switched to vaping and successfully reduced their nicotine intake to the point where they have been able to ditch both the analogue and digital versions of cigarettes. And the UK National Health Service actually recommends that smokers take up vaping as a way of smokers reducing the harm they do to themselves.
In the end it’s your decision whether or not you want to give up smoking and how you want to go about it. Vaping is only one way among many you may look at. But it does seem to work.