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Largest study ever confirms reduced harm from vaping

Posted on December 26, 2018

The largest study on vaping safety to date has confirmed that vapers are exposed to far fewer toxic chemicals than smokers.

The study of 5,105 adults was published this week in JAMA Network Open by a group of leading researchers, led by Maciej Goniewicz. Levels of tobacco toxins were measured in the urine in four different groups:

  • Exclusive vapers (vaping only)
  • Exclusive smokers (smoking only)
  • Dual users (smoking and vaping)
  • Never-smokers

The researchers tested 50 of the most important toxins normally found in tobacco smoke which cause most of the smoking-related disease, including TSNAs (tobacco-specific nitrosamines), PAHs (polycyclic aromatic hydrocarbons), metals and VOCs (volatile organic compounds). Many of these chemicals are carcinogens or are toxic to the cardiovascular, lung or reproductive organs.

The key finding of the study was

Vapers had a 10-98% lower concentration of toxins compared to smokers for the toxins measured

All levels were lower in vapers except for most metals and 3 VOCs (toluene, benzene and carbon disulfide). Vapers had higher exposure to passive smoking so some of the toxins may have come from secondhand smoke. Also, some chemicals such as metals stay in the body for years and may have originated from past smoking or other sources.

Never smokers (those who did not smoke or vape) had toxin levels that were 19-91% lower than found in vapers.

The study results were similar to other previous studies as summarised in the 2018 US National Academies of Medicine, Science and Engineering report

Conclusion 5-3. There is substantial evidence that except for nicotine, under typical conditions of use, exposure to potentially toxic substances from e-cigarettes is significantly lower compared with combustible tobacco cigarettes.

The UK Royal College of Physicians estimates the long-term risk from vaping due to this exposure to be no more than 5% of the risk of smoking.

Dual users

Most studies, for example by McRobbie, O'Connell, Piper and Pulvers, have found that dual users (who smoke and vape) reduce the number of cigarettes smoked per day and are exposed to significantly lower toxin levels.

Surprisingly, in this latest study, dual users had higher levels of many toxins than 'exclusive' smokers. However, those who reduced their smoking, had significantly lower levels of toxins. Another study by Shahab found that dual users had the same level of toxin exposure as smokers. The reason is that in both of these studies, the dual users smoked the same number of cigarettes as the smoking-only group.

The message to vapers who are also smoking is to reduce your cigarette intake and you will reduce your exposure to harmful toxins

It is common for vapers to go through a transition stage of dual use, but they should try to stop smoking altogether as soon as they are able. The greatest benefits occur from a complete switch to vaping

Key lessons from this study

Switching to vaping reduces exposure to harmful chemicals

Smokers who switch to vaping will substantially reduce their exposure to the toxins which cause disease from smoking

Non-smokers should not vape at all. Vapour still contains low levels of toxins and is best avoided unless switching from smoking.

Dual users should reduce their cigarette intake as much as possible and transition to exclusive vaping as soon as they are confident of avoiding relapse.

An accompanying editorial points out that it is safer to use lower powered devices. Higher powered vaping devices generate more heat which can create more toxins. Low powered pod-models with a high nicotine content (pictured) can provide a satisfying nicotine dose with less toxin exposure and may therefore be less harmful.

Posted by Colin Mendelsohn,

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