Clearing the air: Five common misconceptions about vaping

More Singaporean youth are picking up vaping, or the use of e-cigarette.

According to a CNA report from earlier this month, the number of e-vaporiser or vape cases handled by the Health Sciences Authority (HSA) has increased significantly in recent years.

HSA has dealt with 7,593 vape cases in 2021, as compared to 2,477 cases in 2019.

The increase in the use of e-cigarettes worldwide could be due to the misconception that vaping is a healthier alternative to smoking. Some also believe that vaping can help curb smoking habits.

With so much smokescreen surrounding vaping available online, here are five common misconceptions about vaping that we are here to debunk.

Some e-cigarettes come in fruity flavours, which can give the false impression that they are healthy or harmless.

This is untrue as e-cigarette users can also experience mild upper respiratory irritation, like cough or sore throat, or a more serious lung disease where the lungs experience damage similar to adult respiratory distress syndrome.

In some severe cases, users might also suffer from lung damage and require an invasive mechanical ventilator to help with breathing. The more severe phenomenon has been termed e-cigarette, or vaping, product use-associated lung injury (EVALI) or vaping induced lung injury.

While it is true that e-cigarettes do not emit smoke like a lit cigarette, the aerosol created when an e-cigarette heats up is still harmful to users and others exposed to it.

E-cigarette aerosols contain many harmful substances. One of such is benzene, a component found in gasoline. It is often linked to diseases like leukaemia, bone marrow failure and increased risk of cancer.

Another is diacetyl, a chemical linked to severe lung disease, especially in children as their lungs are still developing.

Heavy metals like nickel, tin, lead and cadmium are also found in e-cigarette aerosols. These can cause inflammation in the oral cavity, oral cancer and neurodegeneration.

Other cancer-causing chemicals such as formaldehyde, acetaldehyde, and nitrosamine are also found in the e-cigarette vapour.

A common misconception is that there is no nicotine present in e-cigarettes.

In fact, unlike cigarettes, the nicotine content in e-cigarettes is not regulated and benchmarked to an industry standard. For e-cigarette users, upon inhalation, nicotine is vapourised and absorbed rapidly into the bloodstream.

There is no conclusive evidence proving their efficacy in aiding one to quit smoking. Studies have shown that e-cigarette users are twice as likely to attempt smoking cigarettes than non-users.

The duration of use presents another point of concern. Unlike tobacco cigarettes, e-cigarettes do not burn out. As such, users might end up taking in more nicotine than they would with a cigarette.

Nicotine raises blood pressure, adrenaline level, heart rate, and narrow blood vessels, and can cause a heart attack or stroke. Nicotine use has also been shown to affect brain development, which is especially concerning for youth.

E-cigarettes may actually pose a more serious environmental threat compared to typical cigarettes.

When used e-cigarette pods and devices are not properly disposed of, it can cause chemicals such as lead, mercury, heavy metals, and nicotine salts to leach into waterways and soil. E-cigarette parts and batteries also pose a choking hazard to marine life, animals, and birds.

Additionally, empty e-cigarettes, pods, cartridges and refills are not biodegradable. They break down into microplastics and chemicals when left in the environment, polluting our waterways and environment.

The act of vaping itself also produces aerosols with even more harmful compounds generated during the vaporisation process. These contribute to air pollution.

E-cigarettes have been banned in Singapore since Feb 2018. Anyone found guilty of possessing and using a vape can be fined up to $2000.

It is also an offence to sell, possess for sale, import, or distribute e-vaporisers and their related components. Under the Tobacco (Control of Advertisements and Sale) Act, anyone convicted of these can face a fine of up to S$10,000 and up to six months in jail.

With these misconceptions cleared, hopefully it is now easier to see the true dangers vaping poses. Vaping is far from being a safe alternative to tobacco-containing products.

Anyone keen to wean off vaping or tobacco cigarettes can seek advice from a qualified smoking cessation consultant via retail pharmacies, public healthcare institutions, the iQuit programme, or call the toll-free QuitLine at 1800 438 2000.

This article was written by Senior Pharmacists Shaun Eric Lopez and Chu Shen Onn from Tan Tock Seng Hospital.