Is vaping safe? That seems to be the question asked by skeptics, but often also by smokers wondering if it’s a good way to help them quit smoking. But is that even the right question to ask? The problem is that demanding absolute safety from any product leads down a tricky path.
What does “safe” even mean? Are cars safe? How about fresh produce? In fact, no product offers the consumer absolute safety. Cars can fail in many ways — even aside from user error, the most common failure — that can cause death or terrible injury. And every year many people die and many more get sick from bacteria in fruits and vegetables.
But we keep driving and eating salads. Because with common sense precautions and a little knowledge, we understand that the risks are low. We also use harm reduction tactics to reduce the danger of many products.
Harm reduction: what is it?
When you hear the term harm reduction, you may immediately think of heroin addicts or safe sex. And it’s true that providing clean needles for IV drug users and condoms for those with HIV or other STD’s is harm reduction. Those are ways to reduce the risk and potential harm from those activities. Is injecting heroin safe with a clean needle? No. Is it safer? Absolutely.
Likewise, using seat belts in cars doesn’t make them safe, but safer. And washing produce and refrigerating it lessens the likelihood that e coli or salmonella might make us sick. Some people call it risk reduction, or harm minimization, but they’re all synonyms for harm reduction. It’s simply a way to lessen the danger of any activity.
Smoking prematurely kills a lot of people. The CDC says over 450,000 Americans die each year from smoking-related causes. And about six million die around the world. Many more have health effects that don’t kill them but make life unpleasant or even miserable. Reducing the proven dangers of cigarettes by offering smokers lower-risk alternatives is a way to reduce the health burdens of smoking without completely eliminating risk. Vaping is tobacco harm reduction.
Based on available evidence, e-cigarettes are almost certainly far less harmful than combustible cigarettes. The U.S. Surgeon General and other experts have linked the vast majority of smoking-related disease to the combustion products of smoke, not to the nicotine per se.
Tobacco harm reduction (sometimes abbreviated to THR) is touted by some as a way to reduce smoking health risks on a large scale. That’s because it is understood by honest public health advocates that replacing smoking with modern smokeless tobacco (like snus) or e-cigarettes would offer committed nicotine users a way to keep getting nicotine without the proven dangers of smoking.
We know that this would work because it has worked. In Sweden, a huge percentage of the population uses snus (moist oral tobacco) instead of smoking, and has for a long time. Sweden has the lowest rates of smoking-related disease in the western world. Population-level studies show beyond a doubt that long-term snus use carries almost no risk at all.
The simple fact is that nothing compares to the risk of setting dead plant material on fire and inhaling the smoke. If you’re someone who wants to use nicotine without the known dangers of smoking — lung cancer, heart disease, and COPD among them — switching to vaping or smokeless tobacco is almost certainly a smart choice.
The potential safety risks
We’ve explored the dangers of vaping at Vaping360 before, so we’ll take an abbreviated look at the potential risks this time.
The chemical flavorings that give e-liquids their unique profiles were never intended to be inhaled. They all began as food flavorings, commonly used by bakeries and candy makers. While they are usually viewed by the FDA as GRAS (generally recognized as safe), that’s a designation for ingestion. Honestly, there isn’t much information on how our lungs handle most flavorings.
Flavorings may irritate the lungs and upper airways, which causes brief and minor inflammation. But since vaping is such a new phenomenon, we just don’t know that chronic airway irritation won’t lead to more serious issues in the long term. Some flavorings are known to be especially powerful irritants. Benzaldehyde (used in cherry and almond flavorings) is among the flavors that has been researched and found to cause upper airway irritation.
One group of flavorings has been linked to serious lung damage, when inhaled in large quantities. Diketones are a family of chemicals that are usually used to impart a savory or buttery flavor in e-liquid. They include acetyl proprionyl, acetoin, and the famous diacetyl. (Check out our more detailed look at diketones and their dangers.)
Diacetyl made headlines around the country in the early 2000’s when workers at a Missouri microwave popcorn factory were diagnosed with incurable lung condition called bronchiolitis obliterans after working with diacetyl used to flavor the popcorn. The condition was even nicknamed popcorn lung.
However, vapers using e-liquids that contain diacetyl would probably be unable to ever inhale diketones in amounts comparable to what the popcorn workers experienced. Cigarettes contain diacetyl too, and considerably more than any e-liquid. So is it safe to inhale diacetyl? Probably not, but your odds are better vaping it than smoking. Not all e-liquid contains diketones.And, by the way, no smoker or vaper has been diagnosed with popcorn lung.
Formaldehyde and other toxins in vapor
A group of Portland State University researchers found that if you turn up the power on a vape to a level no human could tolerate, an inexpensive clearomizer would produce high levels of formaldehyde. Thinking they had struck anti-vaping gold, they rushed the information into a letter to the New England Journal of Medicine, which published it. The result? Headlines around the world like “E-cigarette vapor filled with cancer-causing chemicals, researchers say.”
“The conditions used to study the e-cigarette aerosol at the high voltage setting were unrealistic and under such conditions, a vaper would never be able to use the product,” wrote Dr. Michael Siegel, an M.D. and public health professor at Boston University. “This is because the wattage being used was so high that the vaporizer was overheated (for a conventional e-cigarette it would likely damage or burn the coils), creating a horrible taste which a vaper could not tolerate.”
Vapers call it a dry hit or dry puff. It happens by accident when an atomizer goes dry, or the wick can’t keep up with the vapor being produced. Measuring the toxins that result from it is a useless enterprise, since no one would ever inhale it for more than a split second.
There are other known toxins in e-cig vapor. But none of them are found in quantities likely to cause harm to the vaper. According to the Royal College of Physicians, “In normal conditions of use, toxin levels in inhaled e-cigarette vapour are probably well below prescribed threshold limit values for occupational exposure, in which case significant long-term harm is unlikely.”
We breathe and ingest toxins all the time — a fact often glossed over in the chemophobic articles and books we see every day. If they are found at low levels that the body can easily process, they don’t accumulate and cause health problems. There are a lot of studies on various vapor constituents that sound frightening, but they haven’t showed any definite harm. That doesn’t mean that some real threat may not be lurking, but the odds are against it.
Is nicotine safe?
Because of its association with smoking, nicotine has a bad reputation. But in reality it’s a fairly benign and mild stimulant, similar in effect to caffeine. It doesn’t cause cancer, and it doesn’t seem to cause other diseases either. Nicotine is probably safe for most people to use.
Like caffeine, it causes a temporary increase in heart rate and high blood pressure because it constricts the blood vessels when it’s absorbed. That might make vaping nicotine a poor choice for people with serious heart problems — but, as always, a better choice than smoking. Pregnant women should probably avoid nicotine altogether if possible, although the research that shows risks for the unborn child is questionable.
Nicotine is often described as being “as addictive as heroin,” but that is far from true. Smokers get a freebase blast of nicotine to the brain, combined with other substances that increase nic’s addictive potential. Other forms of consumption, like NRT or smokeless tobacco, release the drug slowly into the body. Vaping may be somewhere between the two, but is probably closer to the latter than the former.
There is one safety concern that is not debatable: nicotine is absolutely not safe for young children to drink. E-liquid should be kept in child-resistant bottles and locked away from curious kids.
Are vape batteries safe?
The risk of a catastrophic battery failure is small if you take simple precautions. Unless you’re an expert, use regulated mods with good quality batteries and the proper charger, never carry batteries loose in pockets or purses, and don’t leave charging batteries unattended. Using common sense and following simple battery safety guidelines will prevent most battery issues.
Is vaping safe? Why do you ask?
If you still want to ask if vaping is safe after understanding that it’s safer than smoking, we can explore some potential sources of risk. But remember, no one ever says that vaping — or anything — is “safe.” The best we can say is that it offers relative safety.
If you’re not already a smoker, we recommend that you stay away from vaping, especially if you have concerns about safety. The risks and benefits of vaping should always be considered in relation to the dangers of smoking. It’s almost certain that vaping is safer than smoking. But it’s unlikely to be as safe as breathing clean air.
Those who have weighed all of the medical evidence have concluded that the potential of serious vaping risks is probably very low. Both the Royal College of Physicians and Public Health England suggest that doctors recommend vaping to smokers who are unable to quit by other means. A prestigious Cochrane Review found in both 2014 and 2016 that current evidence supported
And that’s about the best we can offer. If there are major risks to vapers, they haven’t shown themselves yet, or been proven by science. If you’re not a smoker, why start inhaling anything into your healthy lungs? But if you are a smoker, the relative safety of vaping is the exact reason you should give vaping a chance.