Written by Prof. Renald Blundell, Emma Camilleri
Photo: AI-generated image created by Prof. Blundell
The allure of vaping as a perceived safer alternative to smoking has led to a surge in popularity, particularly among young people. Sleek designs, enticing flavours, and aggressive marketing have painted vaping as a modern, less harmful option compared to traditional smoking. However, the reality is far from harmless. Both vaping and smoking pose significant health risks, with long-term consequences that can be devastating. It is crucial to understand the differences between vaping and smoking, the health impacts of each, and the importance of avoiding both.
Vaping is often seen as less harmful than smoking because it doesn't involve burning tobacco, which produces many of the dangerous chemicals found in cigarette smoke. However, vaping is far from safe. E-cigarettes deliver nicotine, a highly addictive substance, along with a mixture of other chemicals, including flavourings, heavy metals like lead, and volatile organic compounds (VOCs). These substances can irritate the lungs, impair lung function, and contribute to the development of chronic respiratory diseases.
One particularly alarming issue associated with vaping is EVALI (e-cigarette, or vaping, product use-associated lung injury), a condition that has led to severe respiratory symptoms, hospitalisations and even deaths. EVALI is believed to be linked to substances like vitamin E acetate, found in some vaping products, particularly those containing THC (the psychoactive component of cannabis). While regulatory measures have been introduced to address this issue, the potential for other harmful substances in vaping products remains a concern.
The long-term health effects of vaping are still being studied, and although vaping eliminates some of the harmful chemicals present in traditional cigarettes, such as tar and carbon monoxide, the vapour still contains potentially dangerous substances. Studies suggest that vaping can damage the lungs and heart, with growing evidence indicating it may contribute to chronic obstructive pulmonary disease (COPD), cardiovascular disease and even cancer over time.
On the other hand, the detrimental effects of smoking are well-known and extensively documented. Smoking is the leading cause of preventable death worldwide, linked to numerous serious health conditions such as lung cancer, heart disease, chronic bronchitis and emphysema. Each cigarette inhaled delivers over 7,000 chemicals, many of which are toxic and carcinogenic. The tar produced by burning tobacco coats the lungs and airways, leading to chronic inflammation and damage to lung tissue.
Secondhand smoke further compounds the problem, posing serious risks to non-smokers. Exposure to secondhand smoke increases the risk of lung cancer, heart disease and respiratory infections in adults, while children face heightened risks of sudden infant death syndrome (SIDS), asthma and ear infections.
Nicotine addiction is a common thread linking both vaping and smoking. Nicotine is a substance that affects the brain's reward system, making both practices highly addictive. Nicotine addiction can develop quickly, leading to dependence that is difficult to overcome. The brain of a developing adolescent is particularly vulnerable to nicotine's effects, which can impact learning, memory and attention. This is especially concerning given the rising popularity of vaping among teenagers and young adults.
While vaping and smoking share the dangers of nicotine addiction and the potential for severe health consequences, there are some key differences. Traditional cigarettes contain tobacco, which is burned to produce smoke inhaled by the user, releasing thousands of harmful chemicals, including tar, carbon monoxide and nicotine. As stated earlier, these substances are responsible for the wide range of diseases associated with smoking. Vaping devices, by contrast, heat a liquid solution - often referred to as e-liquid or vape juice - typically containing nicotine, flavourings, and other chemicals, to produce vapour. While vaping eliminates some of the harmful substances produced by burning tobacco, the vapour still contains nicotine and other potentially harmful chemicals. The flavours used in e-liquids may contain chemicals that, when heated and inhaled, can cause irritation and damage to the lungs.
Socially and psychologically, vaping is often viewed as more acceptable, particularly among younger generations. The discreet nature of e-cigarettes and the absence of the strong odour associated with smoking make vaping easier to conceal, potentially contributing to higher rates of use among teenagers. This perception of safety and acceptability can lead to a false sense of security, masking the true dangers of vaping.
The debate over vaping as a smoking cessation tool is ongoing. Some studies suggest that e-cigarettes can help smokers reduce or quit smoking by providing a less harmful alternative to traditional cigarettes. However, the long-term effectiveness of vaping as a cessation tool remains unclear, and there is concern that individuals may continue to use both cigarettes and e-cigarettes, or even return to smoking after a period of vaping. The use of vaping products among non-smokers, particularly young people, also raises ethical concerns. If vaping serves as a gateway to nicotine addiction and smoking, its role as a harm reduction tool is questionable.
It is essential to dispel the myth that vaping is a safer alternative to smoking. Both practices pose significant health risks and can lead to nicotine addiction. While the long-term consequences of vaping are still being studied, the evidence so far suggests that it is not without harm. Smoking, with its well-documented health risks, remains one of the deadliest habits an individual can adopt.
For those looking to quit smoking, proven methods such as nicotine replacement therapy, counselling and prescription medications can help. Consulting with a healthcare provider for personalised advice is crucial. Ultimately, the healthiest choice is clear: avoiding both vaping and smoking not only protects your health but also the health of those around you. The wisest choice is to never start, but if you already have, it's important to seek help and support to quit.
Renald Blundell is a biochemist and biotechnologist with a special interest in Natural and Alternative Medicine. He is a professor at the Faculty of Medicine and Surgery, University of Malta.
Emma Camilleri is currently a medical student at the University of Malta.
