I used to smoke like my life depended on it. For more than 15 years, smoking was absolutely one of my most favourite things (probably the most), to be enjoyed not just with a whiskey or a coffee or after a meal, but at half-time of Sunday soccer or following a good walk or a jog. I was in my early thirties before I really gave any serious consideration to quitting which I did partly through the self-help book, Easy Way to Stop Smoking by Allen Carr, and partly through swapping my nicotine addiction for that of long-distance running—through which I wound up with a broken hip!
Quitting cigarettes is among the most difficult endeavours that an average Joe will ever undertake, and succeeding is something to be supremely proud of. Non-smokers might, quite understandably, scoff at such hyperbole, but numerous studies have compared nicotine addiction with that of heroin. For some years now, vaping—the ‘smoking’ of e-cigarettes—has been touted as the best way to beat the cigs, but a rising concern is that many non-smokers—especially teens—are taking to vaping, with e-cigarettes themselves then proving difficult to kick.
The Making of Vaping
In 1963, the year before the USA’s surgeon general released the historic Smoking and Health report that linked smoking and lung cancer, a Pennsylvanian scrap metal dealer by the name of Herbert A Gilbert invented the world’s first electronic cigarette. Named ‘Smokeless’, it worked through the heating of a liquid that created a vapour to be inhaled. Available in flavours such as mint, rum or cinnamon, it was billed by Gilbert as allowing users to “smoke their favourite food”, but no firm was interested in mass-manufacturing it.
Today, the vaping industry is worth a cool $15 billion globally, but Gilbert’s patent has long since expired and he hasn’t made a dime. “The only substantial thing I received was the satisfaction of saving millions of lives,” the magnanimous 87-year-old told Smithsonian Magazine last December.
E-cigarettes come in all shapes and sizes: some replicate cigars, some arrive in replica traditional cigarette boxes that store the flavour cartridges, while others boast a disposable design like a regular cigarette. You can even smoke a ‘hookah pen’. Rather than inhale the noxious gases of burning tobacco, e-cigarettes allow users to ‘smoke’ a vaporised liquid that forms a mist. Today’s designs, though more technically advanced than Gilbert’s, riff heavily on his invention that relied on users to draw a breath through the cartridge, moistened with a flavouring agent, that then allowed flavoured air to pass though a heating element and into their mouth.
Now replaceable inhaler cartridges are infused with a mixture of either vegetable glycerine or polyethylene glycol, flavouring and nicotine. The heating chamber—or ‘vaporiser’—sits either in the main body or the inhaler and is activated by a rechargeable lithium-ion battery. A sensor triggers the vaporiser with each inhalation, allowing a mist to be drawn at the business end, while an LED at the other end glows to simulate burning.
Made in China
The modern e-cigarette was patented in China by pharmacist Hon Lik in 2003, and introduced to the Chinese market the following year. Hon developed the device to aid his own cessation of an addiction that also killed his father. In 2013 the pharmacist controversially sold his patents to Imperial Tobacco, though sees no conflict between one of the ‘big five’ tobacco companies owning the rights to his device, saying that using existing distribution channels “is the best way for consumers to access e-cigarettes”.
So, Safe to Vape?
One of the main ingredients of the flavoured cartridges is polyethylene glycol, which is approved by the USA’s Food and Drug Administration, and found in many consumer goods. However, in 2009, a study by the FDA found e-cigarettes to contain “detectable levels of known carcinogens and toxic chemicals to which users could potentially be exposed”.
Four years later, the journal Tobacco Control concluded that the toxins produced by e-cigarettes occur at levels nine to 450 times lower than regular cigarette smoke, and since then, evidence has been mounting that vaping is not only far less harmful than smoking, but an effective means of quitting nicotine for good.
In 2017, both the Royal College of General Practitioners and the British Medical Association released reports extolling the benefits of swapping regular smokes for e-ones (for the purpose of quitting), while a study published earlier this year in the New England Journal of Medicine found vaping nearly twice as effective as the likes of nicotine gum and patches in helping smokers stop. According to lead researcher Peter Hajek of London’s Queen Mary University, although many smokers have successfully ceased thanks to vaping, health professionals have hesitated to recommend it because of lack of clear evidence from controlled trials, but “this is now likely to change”.
Here in New Zealand, the Asthma Respiratory Foundation “acknowledges that the use of e-cigarettes… may assist some people [to quit]” but still lacks “long-term, robust cause and effects studies” to endorse them outright. The Ministry of Health is also cautiously optimistic, stating “vaping products have the potential to make a contribution to the Smokefree 2025 goal” and, though expert opinion “is that vaping products are significantly less harmful than smoking tobacco”, they are “not completely harmless”.
Don’t Smoke? Don’t Vape!
In a recent New York Times piece titled ‘Vaping is Big Tobacco’s Bait and Switch’, Jeneen Interlandi warns that e-cigarette companies are cleverly encouraging teenagers to vape in the same way that big tobacco ensured generations past got hooked on their products. New York cardiothoracic Dr Brendon Stiles and Steve Alperin, CEO of cancer information media outlet SurvivorNet, also warn of past lessons learnt too late concerning the evidence linking cigarettes to cancer. Writing in the Guardian in March, they note that we still remain “shockingly ignorant” about the ingredients within e-cigarettes and, significantly, their long-term effects: “There are few things as heartbreaking as seeing the regret and self-blame of a former smoker newly diagnosed with lung cancer… Let’s not repeat those mistakes and regrets with e-cigarettes and vaping.”