Ask the Pharmacist

Q) Vaping seems to be on the rise. Can you tell me if it is safe?

A) Vaping seems to be getting a lot of attention these days and for very valid reasons. The number of participants, in particular young people, seems to grow exponentially by the month (the US surgeon general reported their use had increased by 900% in 2015!). As of right now it is estimated that about 1 in 7 high-schoolers reported using them last month.

Traditionally, self-reporting results tend to be lower than the actual incidence rate. As such, if these products do indeed cause harm, they have the potential to ruin a lot of lives and cost our already over-burdened health care system billions of dollars.

To begin with, we should start with a brief description of just what vaping is. To best describe vaping (also known as Juuling named after the best known manufacturer of e-cigarettes), a device known as an e-cigarette (also called e-cigs, e-hookahs, vapes, mods…) is used to heat a liquid into an aerosol form. It does this via a battery located within the e-cigarette. The liquid comes in the form of a pod and typically contains nicotine, propylene glycol, flavourings and other chemicals.

Now that we have the basics done with, the original question remains; Is vaping harmful to your health? The truth is we do not know for certain what the long term effects are but we do have mounting evidence that it is not a safe habit to indulge in. As of last week, American hospitals had reported 1,600 cases of lung injuries related to vaping and 34 deaths.Ā Ā Canadian hospitals have not been tracking this information until recently but September brought the first Canadian case of a vaping related illness and at least one Ottawa area doctor alleges the numbers are far worse than that.

So why might vaping be bad for you? The first reason is that there are many chemicals that make up the vapour (such as lead and formaldehyde) and we donā€™t really understand how they might affect our physical health over the long term. There is a chance they will prove to be benign but there is a large potential borne out by the cases cited above that they are probably not safe. As well, e-cigs contain nicotine. Sometimes lots of it (but not always, as some brands have very low amounts or no nicotine at all). In fact, one ā€œpodā€ can have more nicotine than a pack of cigarettes.

Nicotine is of course a highly addictive substance causing you to crave the chemical and to suffer from withdrawal reactions when you cannot access it. It also raises your bloodĀ pressure and adrenalin which in turn can increase your heart rate putting a strain upon your heart. As well, nicotine alters brain development. It can affect cognitive function, memory and attention when used while the brain is still developing into the mid-20ā€™s.

With respect to the lung injuries, some of them severe, the causative chemical is unknown. Typically, cases have involved symptoms that seem to develop over a few days to several weeks and have included cough, shortness of breath, chest pain, nausea, vomiting, fatigue, fever and weight loss. American lung Associationā€™s believes that the damage to the lungs represented by these symptoms can be both severe and irreversible.

One confounding factor however, is that a majority of the cases of lung injury involve so called ā€œblack marketā€ products that contain THC in the vaping liquid. The use of THC oil (an ingredient of cannabis) can lead to the development of lipoid pneumonia which occurs when fat particles from the oil enter the lungs. This type of pneumonia can be very severe, lead to irreversible lung damage and is even fatal at times.

So, while experts do believe that vaping is harmful for you, the fact that so many of these cases also involved the use of THC has made a strong case that further study on legal e-cigs is still badly needed.

Now, despite all of this negative rhetoric, no one is stating that e-cigs are more dangerous than regular tobacco cigarettes. Regular cigarettes contain more than 7,000 chemicals many of which have been proven to be toxic both in the short and long term. There is virtually nothing you can do that is worse for your health than smoke cigarettes. As such, switching to vaping products from cigarettes would absolutely be an improvement.

However, the evidence indicates that this is unfortunately not the case despite the fact that some health care associations do support their use in smoking cessation programs. A recent study found that most people who intended to use e-cigarettes to kick the smoking habit ended up continuing to smoke both traditional and e-cigarettes. Perhaps more incriminatingly, there is preliminary evidence that suggest that youths who use e-cigarettes are in fact more likely to smoke tobacco and use cannabis at a later age than youths who have never vaped.

All in all, while the complete book on the safety of vaping has yet to be closed, there is enough evidence to, at the very least, say that the use of e-cigarettes is likely to be harmful to at least some of those who inhale them which begs the question, why bother starting the habit?Ā  For more informationĀ about this or any other health care questions, contact your pharmacist.