Misleading labels fuel false belief that vaping is safer for smokers

SHAH ALAM - Smokers perceive vaping as a safer option due to its lack of tar and carbon monoxide.

However, this belief may be influenced by inadequate labelling of vape products and a lack of guidance on safe usage.

Smokers often perceive vaping as a less harmful alternative to traditional cigarettes, attracted by its reputation for being free of tar and carbon monoxide.

This perception has led many to switch to e-cigarettes in the belief that they were making a healthier choice.

However, the reality was more complex and understanding the true risks of vaping required careful consideration and accurate information.

Consultant Public Health Specialist Professor Dr Hematram Yadav said vaping was generally perceived to be less harmful than smoking cigarettes.

"Smokers often believe that vaping is a better alternative because it does not expose users to tar and carbon monoxide.

"E-cigarettes work by heating nicotine, flavourings and other chemicals to create an aerosol for inhalation.

"In contrast, traditional cigarette smoke contains over 7,000 chemicals, many of which are toxic.

"However, in January 2018, the National Academies of Sciences, Engineering and Medicine published a comprehensive study report that reviewed over 800 studies.

"The report unequivocally stated that using e-cigarettes poses health risks, as they contain and emit several potentially toxic substances.

"The report also indicated moderate evidence that youth who use e-cigarettes are at a higher risk of experiencing cough, wheezing and aggravated asthma symptoms," he said.

Yadav also said study from the University of North Carolina revealed that the two primary ingredients in e-cigarettes, propylene glycol and vegetable glycerin; were toxic to cells, with increased toxicity correlating to a greater number of ingredients in the e-liquid.

"E-cigarettes also produce several harmful chemicals, including acetaldehyde, acrolein and formaldehyde.

"These aldehydes can lead to lung disease, lung injury and cardiovascular disease.

"Additionally, acrolein, a herbicide used to kill weeds, is present in e-cigarettes and can cause acute lung injury, COPD and may contribute to asthma and lung cancer," he said.

Yadav also emphasised that vaping can lead to sudden cardiac arrest and death.

"The presence of vegetable glycerin and propylene glycol, common in nearly all vape products, has been found to induce heart arrhythmias and disrupt cardiac conduction in animals.

"Switching from smoking to vaping does not eliminate the risk of lung diseases and heart issues.

"Despite appearing safer on the surface, vaping introduces numerous other problems due to the chemicals involved.

"Both the US Surgeon General and the National Academies of Sciences, Engineering and Medicine have cautioned about the dangers of inhaling secondhand e-cigarette emissions.

"These emissions, exhaled by e-cigarette users, contain a harmful chemical cocktail," he said.

Yadav also noted that vaping was relatively new compared to cigarette smoking, so the long-term effects remained uncertain.

"However, we do know that vaping is not a risk-free alternative, as it is linked to an increased risk of several diseases.

"In 2016, the Surgeon General reported that secondhand emissions from vaping contain harmful substances, including nicotine, ultrafine particles, flavourings such as diacetyl (a chemical associated with severe lung disease), volatile organic compounds like benzene (found in car exhaust) and heavy metals such as nickel, tin and lead.

"The Food and Drug Administration has not found any e-cigarette to be safe and effective in helping smokers quit," he said.

Concurring with Yadav’s views, Universiti Kebangsaan Malaysia (UKM) Public Health Medicine Specialist Professor Dr Sharifa Ezat Wan Puteh said the perception among smokers that vaping was less harmful than smoking cigarettes may stem from improper labelling of vape contents and devices.

"Currently, few people have the knowledge to advise on safe usage or harm reduction, unlike with conventional cigarettes.

"Consequently, users may unknowingly use incorrect concentrations and harmful ingredients, leading to significant health risks.

"Moreover, illegal distributors often target youths by enticing them with cheap, disposable vapes that are easy to conceal, further exacerbating the problem.

"Some individuals misuse vaping devices to deliver drugs directly into the lungs, including synthetic substances that can be more effectively administered this way. This misuse adds a sinister dimension to vaping, dramatically increasing its risks," she added.

Sharifa also said deaths related to vaping may be caused by the contamination of vape e-liquids with microorganisms, adulterants like drugs and vitamin E acetate (VEA).

"In Malaysia, the lack of quality control exacerbates the risks for vapers, creating a dangerous environment.

"This absence of regulation fosters a black market for illegal vape products and cigarettes, which are often sold at low prices and are especially appealing to middle and lower-income populations.

"On the risk spectrum and according to toxicology reports, alternative nicotine products (ANPs) are safer compared to traditional cigarettes and have proven effective in helping people quit smoking.

"This is why countries such as the UK, Japan, US, Australia, New Zealand and Sweden have adopted various types of ANPs to reduce smoking rates," she said.