E-cigarettes
Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.
More about the experts All content is checked by medical journalists.E-cigarettes are considered an alternative to traditional cigarettes. You don't burn tobacco. Instead, they heat a liquid, which is then inhaled in vapor form. Mostly it is mixed with nicotine and aromas. Find out here the risks of e-cigarettes, whether they are at least safer than tobacco smoldering sticks and whether they can help you to quit smoking.
Are e-cigarettes harmful or not?
To be able to assess exactly how harmful e-cigarettes are to health, the current study situation is still too thin. In particular, it is not yet possible to say with certainty what long-term damage the consumption of e-cigarettes can have on health. The products have not been on the market long enough for that.
But they are not harmless - scientists and experts already agree on this.
Toxic steam
Most liquids contain nicotine, which damages the heart, brain and lungs. It also increases the risk of cancer. In Germany, the alkaloid is limited to 20 milligrams per milliliter as a liquid additive, but this does not change the health-damaging effect.
Do e-cigarettes without nicotine also harm?
The scientists attribute further damage to health from e-cigarettes to the toxic chemicals (above all glycerine and propylene glycol) that result from the evaporation of the liquid.
This means that even e-cigarettes without nicotine are dangerous.
In terms of oxidative stress, inflammation, and endothelial function, they could even be more harmful than nicotine e-cigarettes.
E-cigarettes - physical consequences
E-cigarettes have a number of harmful effects on the body:
Effects on the respiratory system
Among other things, e-cigarettes are harmful because they put a strain on the airways: even in the short term, they can cause irritation there and probably also cause inflammation of the bronchi.
In addition, the nicotine from e-cigarettes has long-term effects on the lungs. It interferes with the self-cleaning of the airways. As a result, typical smokers' coughs can also occur when consuming e-cigarettes: the lungs try to get rid of the pollutants that have accumulated.
Effects on the heart and blood vessels
Even a single so-called "vaping episode" (one-time use of an e-cigarette) is enough to get the heart rate up, stiffen the arteries and impair the function of the endothelium. the latter is the cell layer on the inside of the blood vessels, which is responsible for their expansion and constriction and also controls inflammation and blood clotting processes.
According to recent studies, consuming e-cigarettes increased the risk for
- Heart attack (by about a third),
- coronary heart disease (by about a quarter) as well as for
- Stroke and
- Vascular occlusions.
E-cigarettes and cancer
E-cigarettes can also cause cancer. The mostly contained nicotine can, like conventional cigarettes, directly damage the genetic material of the cells. So it is involved in changes in DNA changes and mutations.
E-cigarettes promote skin problems and allergies
Because steam has the ability to attract water molecules to its surroundings, e-cigarettes can cause skin problems such as dry flaking or redness and dry out the mouth. In addition, the ingredients of the liquids can trigger allergies.
Deaths in the United States
In the United States, numerous unexplained lung diseases and even deaths have occurred after using e-cigarettes.
The alleged cause of this is said to be vitamin E acetate - an oily liquid that is obtained from vitamin E and which can be dangerous if it evaporates due to its molecular structure. Products with the intoxicating cannabis active ingredient THC are also said to have played a role.
In Germany, however, these additives are prohibited in liquids for e-cigarettes. However, doctors warn against obtaining liquids from dubious sources.
Are e-cigarettes healthier than tobacco cigarettes?
Many smokers hope to reduce their health risks by switching to e-cigarettes. In fact, only traditional cigarettes burn tobacco. The smoke contains numerous carcinogenic, poisonous substances, which arguably cause the majority of illnesses and deaths in smokers.
This is not the case with e-cigarettes. The liquid evaporates at lower temperatures and therefore no combustion pollutants develop. That is why experts consider e-cigarettes to be “probably less harmful” than normal tobacco cigarettes - but that only applies to the risk of cancer.
However, your vapor contains enough other dangerous substances that can harm the body.
E-cigarettes are addicting too!
This is, among other things - but not only - related to the nicotine they contain. In addition to the numerous harmful effects of the alkaloid on the body, there is also a risk of becoming addicted to e-cigarettes.
Do e-cigarettes help you quit smoking?
Maybe so - at least initially. In a British study published at the beginning of 2019, 18 percent of the subjects who had become smoke-free with e-cigarettes were still “abstinent” after one year, while the figure was only nine percent for users of nicotine replacement products (patches, chewing gum ...).
However, the Federal Center for Health Education “does not recommend e-cigarettes as a means of quitting smoking”. Especially when someone tries to get away from the classic glowing stick with the help of nicotine-containing liquids, the basic nicotine dependence remains.
The habits associated with smoking are not changed either. Therefore, the likelihood of using a normal cigarette again is high.
Are e-cigarettes the first step into smoking for teenagers?
The liquid vaporizers are popular with young people. Doctors warn that e-cigarettes could become a new “gateway drug” because they are easy to consume and bind young people at an early age. In addition, a US study suggests, the fruity and sweet aromas of the liquids particularly appeal to young people.
This is why a new law on the protection of minors came into force in Germany in 2016, which prohibits the distribution of e-cigarettes to young people under the age of 18. However, it remains to be seen whether e-cigarettes actually encourage adolescents to smoke more often. Because, so the argument of some scientists, why should someone who is used to sweet aromas switch to the bitter tobacco smoldering stick?
E-cigarettes and pregnancy
Expectant parents and breastfeeding women often underestimate the risks of e-cigarettes for their (unborn) child. Nobody thinks e-cigarettes are really healthy. In a US study, however, half of the women surveyed who vaped during pregnancy admitted to doing so because they thought it was less harmful than smoking tobacco cigarettes. One in four of them did not know that their e-cigarette contained nicotine. An active ingredient that can harm the child in many ways. Even after the birth.
It is considered certain that young mothers can pass on nicotine to the child through breast milk. It has not yet been clarified whether they also pass on the pollutants of nicotine-free liquids from e-cigarettes to the child through breastfeeding. But if you want to be on the safe side, you should avoid e-cigarettes during pregnancy and breastfeeding.
Is passive vaping harmful too?
E-cigarettes are unhealthy - even if you don't vape yourself. There are hardly any (meaningful) studies on the subject of “passive vaping”. However, an investigation by the Bavarian State Office for Health and Food Safety showed that carcinogenic and allergy-causing particles were detectable in the air in a room in which e-cigarettes were vaped for two hours.
Above all, the fog fluid propylene glycol, which is released on exhalation, was detectable in the air. The substance is irritating to the eyes and the respiratory tract. If the particles penetrate deeper into the lungs, they can cause inflammation there and impair lung function in the long term.
In asthma sufferers, “passive vaping” can make symptoms worse and possibly trigger seizures if they inhale the vapor from e-cigarettes.
Long-term inhalation of e-cigarette vapor increases the risks, especially for children and pregnant women.
How do e-cigarettes work?
There are different versions of e-cigarettes that look more or less similar to “real” glow sticks. Apart from their appearance, they all work in a similar way: Inside the body there is a tank into which the user fills the liquid, as well as a battery-powered vaporizer. This is a heating element that heats the liquid and allows it to evaporate.
The mouthpiece is usually located behind the tank, and users never pull on it like a conventional cigarette and inhale the vapor. With some models, he has to press a switch on the body to start the evaporation process.
Ingredients of e-cigarettes
Depending on the composition, the liquid for e-cigarettes contains different ingredients. The carrier substance is usually propylene glycol or glycerine. These two substances are considered to be harmless as food additives (E1520 and E422). When heated, however, formaldehyde and acrolein can form, which are toxic in higher concentrations.
Often nicotine is added to the liquid, sometimes not. Flavors, such as apple, cinnamon or vanilla, have been added to some liquids.In the EU, labeling is mandatory for all ingredients, but many substances can simply be treated as "aromas" without describing exactly what is hidden behind them.
Toxic ingredients in liquids
Scientists have already found nicotine in liquids as well as nicotine
- nickel
- silver
- aluminum
- Diacetyl and pentanedione (both can cause bronchitis, e.g. the so-called popcorn lungs)
Difference between e-cigarettes and tobacco heaters
In addition to e-cigarettes, there are also so-called tobacco heaters. Both look similar, but their working principle is different: In an e-cigarette, a liquid is heated and evaporated; it sometimes contains nicotine, but no tobacco. The user inserts a tobacco stick into a tobacco heater and heats it up.
Both products have one thing in common: So far, there have been only a few independent studies on the risk potential. It can only be assumed that neither tobacco heaters nor e-cigarettes are healthy in the short and especially in the long term.
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