Researchers to probe long-term health effects of vaping

Electronic cigarettes, also known as vapes or e-cigarettes, have become popular since they were first developed in the early 2000s.

Whether it be in the comfort of their own homes or on the patio of a restaurant or office block, adults and adolescents alike are choosing to vape, leaving only a fruit-scented aroma in their wake.

There has been little research into the long-term health effects of vaping, and the common narrative is that they are safer than smoking tobacco cigarettes. This may be about to change. The Manchester Metropolitan University in the UK announced earlier this month that it will be conducting an 18-month study into the long-term impact of vaping on health.

While researchers believe that the long-term effects of vaping are lower than those of smoking, the study will look into the effect that regular vaping has on the cardiovascular system. It will involve measuring the elasticity of blood vessels (the higher the elasticity, the healthier) among non-smoking, smoking and vaping participants, as well as fitness tests to determine cerebral blood flow and each person’s ability to take in oxygen.

The study follows reports that government ministers in the UK are set on banning disposable vapes after local councils, paediatricians and public waste campaigners called for making the sale of these devices illegal due to health and environmental factors.

The UK is not alone in this endeavour, with Australia, Germany and New Zealand having passed legislation that prohibits use of e-cigarettes in various forms. France has also announced its plan to ban all disposable vapes.

In an article published by Manchester Metropolitan University highlighting the details of the research, Dr Maxime Boidin, a senior lecturer in cardiac rehabilitation at the university, says clinical experts have already seen some short-term symptoms of vaping, such as coughing, lung dysfunction and chest infections.

“We hope that our findings will help to inform guidelines and regulations on the sale of e-cigarettes in the future. We also hope to help the general population better understand what they are putting in their bodies and any potential risks that come with that.”

Vapes work by heating a liquid that usually contains nicotine, flavourings and other chemicals that produce an aerosol. This is inhaled into the lungs and like cigarettes, bystanders might smell or breathe in the second-hand aerosol when it is exhaled by the user. The devices can also be used to consume cannabis and other forms of drugs.

Nurse and specialist wellness counsellor Samantha Heald’s research into the effects of vaping is not encouraging: “Vapes contain chemicals such as formaldehyde, which is linked to cancer, and acrolein, a weed killer that’s known to be linked to irreversible lung damage. They often contain THC (tetrahydrocannabinol), CBD (cannabidiol) and other chemicals that give a flavour. Ultrafine particles can also be found in them and even heavy metals such as nickel, tar and lead.”

The appeal of these battery-operated devices for adults and youth has been found to differ greatly, with many grown-ups making the switch from traditional cigarettes to vapes to assist them in quitting smoking.

Heald refers to a citation by the UK’s National Health Service that states “vaping has been associated with a positive process of withdrawal from smoking and if used to reduce nicotine intake, vaping has been suggested to be more effective than nicotine patches and gum”.

Stacey-Claire is in her early 30s and has made this transition after making the decision to quit smoking. She says she has tried to use many other methods such as cutting down and going cold turkey, which failed.

“I found the habit of having something in hand to smoke or being out in social circumstances [helpful] and always used smoking as an anti-anxiety thing. I decided to switch to a vape and the plan was to cut down the nicotine percentage of the vape to eventually get myself off smoking completely.”

She highlights that one of the benefits of vaping for her is an increase in productivity. “I was taking a lot of time out of my day like during work time to sit outside and smoke whereas now I vape inside. I don’t vape all day but I don’t have to leave my desk to go and smoke.”

While Stacey-Claire works from home, vaping is generally not permitted in many corporate offices.

Trendy habit

For teenagers and young adults however, vaping is a trendy habit that has spread throughout SA and the world, with many consumers having little awareness of the effect this could have on their health.

“Smoking cigarettes is seen as an ‘old-people thing’ and it smells,” says Zanele* (17), in response to why the youth are more attracted to vapes than cigarettes. “There’s a lot of research into the side effects and what could happen to your body but there isn’t that type of research on vaping because it’s such a new thing. Also, it tastes nice and they look cool.”

Zanele is one of many under 18s who have jumped onto the vaping bandwagon. A questionnaire conducted by the University of Cape Town pulmonary division and the UCT Lung Institute in nine high schools across three provinces, both private and government, found alarming statistics. With the average age of initiating vaping at 15, the habit among learners ranged from 6.2% for grade 8s to 26.5% for those in matric.

Fitting into a new school environment was one of the reasons Zanele started vaping in the first place. “At school, people would smoke in the toilets. It was a way of socialising and making more friends. I was struggling at my [new] school to make friends, I had none and I was getting bullied so I joined in because vaping is social.”

Sarah*, a 17-year-old matric pupil, shares similar reasons for acquiring the habit. “It was just this thing that everyone did and people at school asked me if I would try it. It’s just so normalised.”

This ties in closely with Heald’s view of why teenagers feel the need to vape. “Social pressure has contributed and continues to contribute to many social behaviours in teens and young adults and this is driven by the need to belong. This translates into the likelihood of engaging in the same behaviour as other peers such as ‘if my group of peers vape, I’m more likely to vape’ and ‘If I’m exposed to the normalised behaviour of smoking and vaping, I’m more likely to also vape’.”

Perhaps due to teenagers’ inherent need to belong, vaping industries play on this vulnerability by mostly targeting the adolescent demographic. The World Health Organisation reports that “the tobacco industry relentlessly targets young people with tobacco and nicotine products, resulting in e-cigarette use increasing and nine out of 10 smokers starting before the age of 18”.

These concerns, as well as topics regarding the advancement of tobacco control, will be discussed among delegates representing 182 countries next month in Panama City at the WHO Framework Convention on Tobacco Control.

The Guardian reports a leaked email reveals that the tobacco and vaping company responsible for the production of Marlboro cigarettes, Philip Morris International, has planned to wage “a big lobbying campaign to prevent countries from cracking down on vapes and similar products” during the convention; this despite tobacco companies receiving no invitation to participate.

Marketing in SA is similarly geared to appeal to the young demographic. Though cigarette-makers aren’t allowed to advertise, a vape store in Vanderbijlpark marketed itself on Instagram through a 10-ticket giveaway for a matric celebration at a local establishment. The requirement was to follow the page and tag two friends in the post to stand a chance of winning. Similarly, UberEats used the same platform to post an ad for Vape Hub SA, stating “Vape Hub SA, Cape Town to your door!”

No IDs

Zanele and Sarah say they have bought their own vapes many times and have never been asked for an ID at their local stores. “You just go to the till at the grocery store and buy it,” Zanele says.

Zanele and Sarah admit they have found vaping to be very addictive. They have each attended long-term rehabilitation programmes for behaviour related to substance abuse. Zanele says she was having difficulties at home and found that vaping eased her anxiety.

For Sarah, vaping seems like an almost insignificant habit compared to using drugs. “I feel like it’s not a good decision to do it with or without [a history of] addiction. I don’t really see the point in vaping but it’s fun, I enjoy doing it and it’s not as harmful as doing drugs. It’s like drinking cooldrink.”

The questionnaire conducted by UCT found that of the adolescents vaping, more than half (54.5%) had attempted to quit but expressed a need for further resources to help with anxiety (39%) and cravings (19.8%) in these attempts.

Zanele says she decided to stop vaping after eight months because she could feel that it was damaging her lungs. “Before, I didn’t really care if I died young, that’s the reason I was OK with vaping. But then I started gaining more lust for life; I started thinking, what does motherhood and old age have to offer [me]?”

With very little legislation about vaping in SA, research such as the Manchester Metropolitan University study might yield results that could lead to global developments in this uncertain space. Heald has encouraged further research into the potential epidemic and says, “We need to see what’s coming.”

* Not their real names.