You're listening to Science Versus, the show where we pit fact against fad. I'm Wendy Zuckerman, and on today's show, electronic cigarettes. Are they a breakthrough in the battle to help people quit smoking? Or will e-ciggies create a new generation of nicotine addicts?
Researchers have been celebrating a breakthrough. A few weeks ago, this was a breakthrough. I'm covering the since-to-sick virus across the world. The idea of electronic cigarettes is that they are the new and safe cigarette.
You know, for the modern smoker. It's time smoking changed forever. Welcome to tomorrow. You know that feeling you get?
When something's great, you can touch it. Hold it. Now you can taste it. The perfect option.
First time, every time. E-cigarettes and e-liquids. Got to be assured since 2009. E-cigarette?
Well, electronic cigarettes or e-cigarettes use a battery to heat up a liquid, which is usually probably glycol or glycerol. And inside the liquid is nicotine and your choice of flavors. Yes, that's the stuff that now you can taste it. When the liquid is heated up to a point, it turns into an aerosol that can be inhaled, giving the nicotine buzz of a cigarette without critically burning tobacco.
And that's why it's argued that these devices are a lot safer than conventional cities. Because when you burn tobacco, thousands of chemicals are produced. And so it's said, it's those chemicals that are the ones that damage your body. Using electronic cigarette versus smoking is tens of thousands less harmful in terms of toxicity.
This is Simone Davis, and she works at Liberty Flights, a company that makes e-cigarettes. Now, she says that even though there is nicotine in e-cigarettes, that's not a problem. Nicotine is demonized. If you look at the size, nicotine isn't necessarily bad for you.
And that's part of, I think, the methyl misconception by consumers. Simone says that many people who find it very difficult to quit smoking conventional cigarettes move to the electronic stuff and... So the experience is generally profound. We have people talking to her saying, you don't know how this has helped me.
I no longer wake up with an elephant on my chest. My cough has gone. So that's what the electronic cigarette companies say. But then, there's science.
Today, we're going to explore whether e-cigarettes are safe. And if they are, whether they can help people stop smoking tobacco. Now, even if you're not a smoker, the world of e-cigarettes is really important because after decades of anti-tobacco messages... Smoking doesn't just give people lung cancer.
It increases the risk of cancer in the mouth. ...and non-smoking laws. Electronic cigarettes are fast becoming big business. Cancer in the pancreas and cancer of the bladder.
Not to mention coronary heart disease. Data out this year from the Centre of Disease Control in the US found that 2 million students over there have used them, meaning that in the United States now... There are more kids who are vaping than who are smoking. This is Simon Chapman, a professor of public health at the University of Sydney.
The smoking rates have been going down and down and down in the past. They're still going down, but they've been counterbalanced by vaping going up and up and up. And it's not just students in the States that are using e-cigarettes. New figures today show the number of people using e-cigarettes in the UK has travelled in two years to 2.1 million.
They're legal inside most public buildings, and you can even see people vaping in offices. 80% of people that come in here are like food to get their vapors, people who want to quit smoking, they saw a few... Okay, so that last guy, he refers to himself as a vapologist. And just clarifying, that's not a thing.
For two reasons. It's not a thing. And secondly, while the aerosol from an e-cigarette is often referred to as vapour, it's not scientifically correct. Vapour is the gassiest state of a substance.
Really? We're doing fart jokes now? Oh, man. While an aerosol is a mixture of fine particles of liquids and solids which are found in gas.
Now, in e-cigarettes, punters are sucking up both particles and gas. So, if anything, that guy is an aerosolologist. And just clarifying, also nothing. With that out of the way, first question.
Are e-cigarettes safer than cigarettes with tobacco? There's no question that taking a puff on an e-cigarette isn't as dangerous as taking a puff on a cigarette. That's Stanton Glantz, a professor of medicine at the University of California in San Francisco. And he is very well-placed to know about the health effects of e-cigarettes.
I was the co-author of the first major scientific review of the health effects of e-cigarettes that was prepared for the World Health Organization. Stanton says that in the dozen or so studies that have been conducted, the level of most cancer-causing chemicals are much lower in e-cigarettes than in cigarettes. Conclusion. E-cigarettes are safer than smoking tobacco.
But Professor Simon Chapman says that even if e-cigarettes are less dangerous, that doesn't mean they're safe, because the danger of cigarettes are so stratospherically high. It's like kind of comparing the 15th highest mountain in the world to Mount Everest. It's still pretty dangerous. Conclusion.
Climbing Mount Gaia Chung-Kang is pretty tricky. And that leads us to our next question. How safe are e-cigarettes? Could those chemicals found in them, even at lower doses than those found in conventional cigarettes, be harmful?
Professor Stanton Glantz says yes. You're inhaling a lot of toxic chemicals. So, for example, Stanton reckons that some of those flavors that are added to e-cigarettes can be quite dangerous. One of them is called diacetil.
It's a buttery flavor. It's used in a lot of food products that you eat. But if you breathe it in, it causes something called popcorn workers' lung. This is also known as bronchiolitis obliterans.
And people working around microwave popcorn, which uses diacetil as an additive, have been known to develop this serious and irreversible lung disease. E-cigarettes emit heavy metals, which boil off the heater. On top of this, when the liquid inside an e-cigarette gets heated up, along with the nicotine and the flavorants, it creates an aerosol of ultrafine particles that carry the nicotine deep into the lungs, where it's absorbed. Well, those ultrafine particles are themselves dangerous.
According to Stanton, these particles, which are so tiny, they're about 1 50th the width of a human hair, can go right through the air sacs in your lungs, right through the blood vessels and into your blood. And once they get into your system, Stanton says they trigger inflammation, kind of like when you cut yourself. And he says that that inflammation can trigger biological processes that change the blood and lining in your arteries and can even lead to a heart attack. And even if they don't, those processes are related to damage to your blood and your cardiovascular system.
But at the moment, we don't have the evidence that the tiny particles in e-cigarettes in particular cause any of these problems. It's extrapolating from what we know about ultrafine particles in general. And that's because there aren't a lot of studies into how e-cigarettes affect the human body and there are no long-term studies into this. Remember that ad?
Quality assured since 2009. Yeah, six years. Stanton says that when it comes to knowing how bad e-cigarettes are, if they are bad at all, it's going to take longer than that because cancer and heart disease take a long time to get. And so because e-cigarettes are relatively new, we're going to have to wait a long time to know precisely how bad they are.
But Dr. Lynn Dawkins, a psychologist and leader of the Drugs and Addictive Behaviors Research Group at the University of Ace London, notes that while there are harmful chemicals in e-cigarettes, we need to put that into perspective, particularly since they're likely to be less dangerous than conventional cigarettes. And just to note that in the past, Lynn has received funding from several electronic cigarette companies. There are harmful chemicals in everything.
In the air we breathe, in the food we eat, in the nail polish aroma that we put on our toenails. So there are likely to be harmful chemicals in e-cigarettes. But the question is, how harmful are these? To find out, in 2012, a team at the University of California in Riverside baked human cells in a petri dish with 35 liquid samples from various e-cigarette companies.
Now, they found that some of the chemicals in e-cigarettes were toxic to human cells. And how toxic they were depended on the flavor and how much flavor was in the sample. So in this study, cinnamon was highly toxic, while bubblegum was pretty benign. But before you go inhaling bubblegum, and bubblegum, really?
The researchers said that there was variation even among samples provided from the same company. So one butterscotch sample was highly toxic, while two other butterscotch samples from the same company had low toxicity. They also wrote that even products found to be non-toxic, quote, may produce different, possibly stronger effects when used repeatedly at full-strength doses, end quote. For example, propylene glycol, which is used to make the smoke-like effect in e-cigarettes, is, quote, generally regarded as safe, end quote.
And it wasn't toxic in this study. But the researchers noted that theater workers, who often inhale this stuff because it's also used in fog machines, are found to be at an increased risk of getting respiratory, throat, and nasal problems. So, just lots of unknowns here. Plus, the effects of a chemical on a cell in a petri dish, that's very different to a working human body.
And when I asked Simone, who works for an e-cigarette company, how they choose safe chemicals in the face of all of this uncertainty, she said, There is research that talks about the different temperatures and the heating of the fluids and the effects. None of the devices on the market today that we're selling heat to an extent that they're going to have potential harm. Choosing flavors that are potentially risky, you know, you don't manufacture, it's the same to organizations. We don't know, we don't know the flavors that might be risky, there's no long-term studies.
How do you pick the flavors when there's so little data here? Where they're picking what's currently approved in the marketplace for human consumption. But, that's approved for human consumption, not inhalation. Which, according to Professor Simon Chapman at Sydney University, is very different.
Look, these have not been approved for inhalation, let alone 200 times a day, 365 days a year. There's also a debate going on about whether nicotine in itself is dangerous. So some, like Dr. Lynn Dawkins say, Well, nicotine is a mild stimulant, kind of like caffeine ready.
While others, like Professor Stanton Glantz say, It actually changes the physiology of the brain and inhibits a lot of normal neurodevelopments. According to Simon Chapman, it's hard to say whether nicotine is all that harmful because a lot of the people who have sucked up high levels of nicotine over long periods of time are smoking tobacco. So how do you tease apart the effects of nicotine versus those other chemicals in tobacco smoke? We can't really.
And that's why Simon says, Huh, Simon says. We really don't know enough to know if nicotine is self-dangerous. But one thing we do know about nicotine is that it's very addictive. Something that Samoa, who works for an e-cigarette company, is all too happy to acknowledge.
Nicotine is a highly addictive substance. Is there a concern, though, that if in 20 years we find that some of these chemicals that are put in e-cigarettes are harmful and then coupled with the nicotine within that, it is going to create a new generation of problems? I understand that question. But again, I would say today it is still a much better alternative than smoking.
Conclusion. We won't know how dangerous e-cigarettes really are for possibly decades. Meanwhile, nicotine is highly addictive. So there's that.
Next question. If you're already smoking cigarettes and you want to quit, can e-ciggies help you out? In order to determine this, we really need to use the gold standard in quitting smoking research. Here's Dr.
Lindorffins again. Which is a randomised control trial, so people are randomly allocated to use an e-cigarette or to another condition, do nothing, or use another product. And because these trials are so costly and time-consuming, we only have two such trials so far, one from Italy and one from New Zealand. A man who conducted the study in New Zealand is Professor Chris Bullen at the University of Auckland.
Now, he told me there isn't any doubt that e-cigarettes can help people quit smoking. They can help people quit smoking. Our studies have shown that they're able to be at least as effective as nicotine patches. There's also the concern that for people who aren't really trying to quit cigarettes but kind of think that they should, well, that those people will keep on smoking thanks to e-cigarettes, and that's because they'll be sucking on e-cigarettes inside and smoking outside.
This is what Stanton Glantz thinks is happening. The most dangerous thing we know about e-cigarettes is that they keep people smoking cigarettes. To make his case, Stanton uses studies, including his own, showing that smokers who use e-cigarettes are less likely to quit smoking tobacco. According to Stanton, part of this problem could be because of lax regulations in countries that let people use e-cigarettes in places where they couldn't smoke tobacco, like indoors.
One of the things that really helps people quit smoking is smoke-free lives and smoke-free homes and smoke-free rules at workplaces. Conclusion. And on a population-wide level, it doesn't look like e-cigarettes are pulling many people away from tobacco. Our next and final question.
What effect are e-cigarettes having on non-smokers? Because they're being advertised as pretty much perfectly safe. Laxionic cigarettes. Eat better.
So are these products encouraging a new generation of people to be addicted to nicotine? Here's Simone Davis again, who works for an e-cigarette company. That fear has not been evidence-based by any research to back that up. Indeed, current research shows that a very small proportion of non-cigarette smokers have tried or used e-cigarettes.
For example, a survey of more than 5,800 Britons who don't smoke found that only 0.1% of them tried and still use e-cigarettes. But, at a glance, he uses different figures to argue that this is an emerging issue. For example, he sites a Polish survey which found a rising number of students who had never smoked tobacco now using e-cigarettes regularly. So, do e-cigarettes stack up?
They are better for your health than conventional cigarettes, but long-term use of these products is unlikely to be safe. And I say unlikely because we don't have the data for sure. For people who are actively trying to quit smoking, e-cigarettes are likely to help some of you. But for the general population of smokers, e-cigarettes might give you smoking when you otherwise would have tried to quit.
And perhaps I'll leave the last words here to Professor Simon Chapman. E-cigarettes could be a revolutionary breakthrough in smoking cessation, but at the moment, the evidence on cessation is pretty disappointing. Then nothing like the hype is suggesting. So, when it comes to science versus e-cigarettes, that's science zero.
Because science can't capture what's going on here. And in the meantime, the mixed messages aren't really helping. And e-cigarettes, unless you're already a smoker using them to quit, I'm saying zero too. That's it for science versus next time, the gay gene.
Is our sexuality determined by our genetics? We only know about genes that cause homosexuality. We know they're there. Thank you for listening, and we are a podcast, so you can subscribe to us using iTunes, SoundCloud, or your favorite podcast app.
A big thanks to my co-producer, Caitlin Sori. And if you like this podcast, you might like some other fancy podcasts that Caitlin makes. One is called Confession Group, where performers confess their secrets live on stage, and there's Rum, Rebels, and Ratbags, which is an irreverent take on Aussie history. That's Confession Group and Rum, Rebels, and Ratbags.
Check them out. I'm Wendy Zuckerman. Back to you next time.