Is Vaping Worth Saving?

Less than two months ago, President Trump joined in on the public health crisis/moral panic/general circus around vaping by urging the FDA to please ban flavored vape products. “We can’t allow people to get sick, and we can’t have our youth be so affected,” he said, referencing the outbreak of lung illnesses and deaths that was just beginning to blossom in early September. Trump’s insistence on a federal-level ban seemed somewhat drastic, especially considering his complete inaction on more pressing things like, oh, gun violence, but suited the vibe, at the time: Several municipalities and entire states had already enacted bans of their own; the CDC was telling people to stop using e-cigs altogether; long-time smokers had begun jumping back to cigarettes; and JUUL, the vaping monolith that controls the vast majority of the vape market, basically went into crisis mode.

But now Trump has retreated; he’s avoiding pursuing any sort of vape ban, out of fear that even a soft policy that still allows the sale of some flavors would adversely affect his chance at reelection, according to reporting by the Washington Post. On a Nov. 4 flight, the Post says, advisers told the President that a vape-related ban would cause serious job losses, and upset an unexpected chunk of voters who’ve united for the preservation of vaping under the campaign, “I Vape, I Vote.” The extremely vocal pro-vapers say no cause is more important to them than maintaining the right to vape flavors—something they still believe to be a healthier, better alternative to smoking combustible cigarettes.

The science on that—and there’s been a lot of science—remains fuzzy. The CDC is zeroing in on the probable cause of the illness that makes people very sick, very fast, but the long-term health consequences of e-cigarettes remain unknown. Depending on which study you read, vaping is either saving the lives of smokers, or just wreaking new havoc on lungs. It’s currently just impossible to know what vaping’s “deal” is, hence the continuing flow of research. No matter what, vaping has gone from a sorta douchey hobby to a full-blown voting issue in a matter of months. The “I Vape, I Vote”-ers are riled up in defense of vaping, which they view as a public Good. But… should they? Is vaping worth saving, or is all this fervor just further proof to the power of nicotine addiction? Are any of absolute evils of e-cigarettes worth the relative good of helping people quit actual cigarettes?

To keep track of all the rapidly published science, this story will be continuously updated with all the updates on vaping’s virtues (or lack thereof).

The (relatively) pro-vape science

• A month-long study of 114 smokers shows switching from cigarettes to e-cigarettes may reduce risk of heart failure and stroke. Researchers maintain that vaping isn’t “safe,” but their findings support the argument that vapes could very well be a healthier alternative to traditional cigarettes (which was JUUL’s entire marketing tactic, until the company ditched the “Make the Switch” slogan in late September). The study’s short timeframe also suggests that health benefits of switching from cigarettes to vapes appear pretty quickly. Nov. 16, 2019
• A trial found that people randomly assigned to use e-cigs quit smoking at nearly double the rate of people assigned to use nicotine replacement therapy, suggesting that vaping nicotine might actually be a highly effective way to stop smoking. Feb. 14, 2019
• Researchers looked for answers in pee, and found that e-cig users’ pee contains more signs of carcinogen exposure and heavy metals (my god??) than non-vapers, though their pee was ultimately healthier than traditional cigarette smokers’. Dec. 14, 2018
• After reviewing more than 800 existing studies, a panel of experts reports that e-cigarettes have fewer health risks than smoking, and found strong evidence that switching to vaping cuts down on a smoker’s exposure to cancer-causing chemicals. Jan. 23, 2018

The anti-vape science

• Two studies presented at the meeting of the American Heart Association separately suggest vaping is actually worse for the heart than traditional cigarettes. In one study, researchers found that vapers had higher levels of unhealthy LDL cholesterol than non-smokers. The second study found that e-cig users’ hearts had a harder time pumping blood during exercise in rest, similar to smokers. “”It’s evidence that there’s something wrong with the blood flow regulation in smokers and maybe even more so in e-cigarette smokers,” study author Florian Rader told NBC News. “These products are marketed as healthy alternatives, and yet we see more and more evidence that they’re definitely not healthy.” Nov. 11, 2019
• People who use flavored tobacco products (like flavored vapes or e-cigs) are more likely to become lifelong tobacco users, according to a study published in JAMA Open Network. Oct. 23, 2019
• Researchers at Duke found inordinately high levels of pulegone—a chemical that’s banned as a synthetic food additive—in mint and menthol e-cig liquid. Pulegone is known to be carcinogenic, and cause liver toxicity. Sept. 16, 2019
• A study suggests that e-cig use may harm fertility by making it more difficult for embryos to implant in the uterus, and vaping while pregnant may cause lifelong development abnormalities. Sept. 5, 2019
• E-cig users are at risk of heart-disease, just like regular smokers, according to a study published in JAMA Cardiology. Feb. 1, 2017
• A research letter published in the New England Journal of Medicine asserts that, when used at high voltages, e-cigs release higher levels of formaldehyde-releasing chemicals than traditional cigarettes. The letter suggests the lifetime risk of cancer is between 5–15 times higher among e-cig users than smokers. Jan. 22, 2015