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Vaping still safer than smoking, reiterate health officials amidst fresh concerns

Public health officials have reiterated that regulated e-cigarettes carry a 'fraction' of the risk of smoking, after a series of reports highlighting potential dangers.

It follows a recently reported case in which a boy in the UK almost died in 2017 after vaping due to a severe reaction in his lungs, prompting doctors to warn against e-cigarettes.

Concerns have also been raised by a team of German cardiologists whose research found that vaping continues to cause heart damage in smokers who have switched from cigarettes.

But Public Health England has said while vaping is 'not completely risk free' it is still not as harmful as smoking tobacco.

In a study published in the European Heart Journal, the study of 20 healthy smokers by the group of cardiologists found that one vaping episode increased heart rate, caused the arteries to stiffen, and damage to the endothelium.

Study leader Professor Thomas Münzel pointed out that there is a lack of data on the long-term effects of e-cigarettes.

He said: ‘The e-cigarette epidemic in the US and Europe, in particular among our youth, is causing a huge generation of nicotine-addicted people who are being endangered by encouragement to switch from traditional cigarettes to e-cigarettes.’

The study comes in the same week as UK doctors reported a rare case from 2017 in which a boy nearly died after vaping set off such a severe reaction in his lungs that he ended up attached to an ECMO machine.

Writing in the Archives of Diseases in Childhood, doctors at Nottingham University Hospitals NHS Trust said he had developed hypersensitivity pneumonitis as a result of vaping.

The doctors consluded: ‘There are two learning points. The first is always to consider a reaction to e-cigarettes in someone presenting with an atypical respiratory illness. The second is that we consider e-cigarettes as “much safer than tobacco” at our peril.’

But Dr Alex Bobak, a GP in Wandsworth with a special interest in smoking cessation, highlighted the patient had an extremely rare sensitivity.

‘I get GPs asking me about this. We have to reassure patients that vaping is far far far safer than smoking. It’s all about relative risk.

He added: ‘The problems seen in the US, are not just happening in the UK, which is a completely different e-cigarette environment, with better regulation. If there was a problem we would be seeing it.’

There have now been more than 2,000 cases of e-cigarette, or vaping, product use associated lung injury (EVALI) reported across the US, with 39 deaths and one man receiving a double lung transplant.

The US's Centers for Disease Control and Prevention recently confirmed the problems may be down to vitamin E acetate – a chemical reportedly used in vaping products that contain tetrahydrocannabinol.

Scientists found traces of the substance in all 29 lung samples they analysed offering the first direct evidence of a link between it and the lung disease they have been seeing.

The message from UK officials remains that while not without harm, vaping remains far safer than smoking but that non-smokers should not vape.

In a statement, Public Health England said: ‘We continue to keep the evidence under review, including all safety and health concerns reported to the e-cigarette regulator, the MHRA.

‘However smoking kills half of life long smokers and accounts for almost 220 deaths in England every day. Our advice remains that while not completely risk free, UK regulated e-cigarettes carry a fraction of the risk of smoked tobacco.

‘This view is held by many across the world, including the Royal College of Physicians, Cancer Research UK, the British Medical Association and the National Academy of Sciences in the US.’

A version of this article was first published by Nursing in Practice's sister publication Pulse

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