Smoking is the country’s number one preventable killer, and millions have been ditching cigarettes for vapes.
But more than 6.6million Brits continue to puff on the deadly sticks each day, in spite of a review by Public Health England that estimated e-cigarettes are 95 per cent less harmful than tobacco cigarettes.
Nevertheless, the battery-powered cigs, also known as vapes, have been booming in popularity and many have managed to kick the pernicious habit because of them. The very same 2015 review found that almost all of the 2.6m adults using vapes in Great Britain were current or ex-smokers.
In recent years though, there has been a worrying rise in vaping among teens who have never smoked regular cigarettes. Walking down any busy street, it’s not uncommon to be hit by clouds of blueberry and bubblegum from a giggling group of schoolchildren.
Teachers are finding their students meeting in toilets to vape, and parents are coming across brightly coloured plastic sticks in school bags. Terrifying reports exist of youngsters being hospitalised from vaping with ‘popcorn lung’ – a name used to describe rare disease bronchiolitis obliterans, which causes damage to the air sacs. One 18-year-old died after her lung collapsed. Her doctors blamed vaping.
The grave concerns last week saw Prime Minister Rishi Sunak announce a ban on disposable vapes. However, experts fear it will have a profound effect on the nation’s health and drive people back to smoking. Meanwhile, MPs are set to vote in Parliament this month on a smoke-free generation, which will see the Government raise the legal age every year so that eventually, smoking would become extinct in this country.
So how dangerous are vapes? And how do they compare to smoking? Here, The Mirror speaks to experts, charities and those with first-hand experience…
Smoking vs vaping
Tobacco smoke contains over 5,000 chemicals, including addictive nicotine. They contain tar too, which after years of smoking, builds up inside the lungs and darkens them. A Public Health England video showing an experiment between the effects of vaping and smoking using cotton wool vividly explains the effect the sticky substance has (which can be viewed further down).
Many of the poisonous chemicals can cause 15 types of cancer. When you smoke, these chemicals damage your lungs and can pass into your blood and spread through your body, meaning smoking can affect every part, from your skin to your brain.
It can also cause over 100 different diseases, including chronic obstructive pulmonary disease (COPD), obstructive sleep apnoea (OSA), pneumonia, and dementia. It also causes heart attacks, strokes, skin ageing, erectile dysfunction, and infertility. On average, smokers live 10 years less than non-smokers.
Consultant chest physician, Professor Matthew Evison, who is the lead in lung cancer at Wythenshawe NHS Hospital told the Mirror: “The harms from smoking tobacco are hard to do justice to in words. Two in every three people who smoke will die because of smoking.
“The harms of smoking tobacco disproportionately affect the communities living in the highest levels of deprivation and therefore drives health inequalities in our society. In short, smoking tobacco is the single biggest cause of death, illness, disability and inequality.”
Speaking of how powerful nicotine is, Ann McNeill, professor of tobacco addiction at King’s College London explained: “When people smoke a cigarette it delivers nicotine to the brain in about 15-20 seconds, which is faster than if it was injected intravenously, and is very reinforcing.
“Cigarette smoking is very addictive, and a relatively recent review indicated that two-thirds of those who smoked a single cigarette became daily smokers at least for a short period of time. So cigarette smoking addiction can set in very quickly and once it sets in, it can be hard to stop.”
With e-cigarettes, a liquid containing nicotine and flavourings is heated to become a vapour people breathe in. Crucially, they don’t produce tar or carbon monoxide, and neither do they contain tobacco, which is the harmful part of cigarettes that causes cancer.
Vaping products generally provide lower nicotine levels to users than smoking does. However, people who are experienced vapers can inhale nicotine levels similar to or greater than people who smoke, while it is also easier to vape throughout the day compared to lighting up a cigarette.
The British Heart Foundation (BHF) says more research is needed on the long-term impact of vaping on the heart and blood vessels and advises against non-smokers starting vaping. While many UK experts call for more studies, a smoking cessation expert, Dr Andrew Pipe, chair of Canadian charity Heart & Stroke, says vaping carries numerous health risks including damage to the function of blood vessels, along with increased blood pressure and heart rate.
“Many studies have found e-cigarette use to be associated with inflammation, oxidative stress, and haemodynamic imbalance, which are noted precursors of cardiovascular risk,” he added. Some potentially harmful chemicals are found in e-cigs, and what is in illegal vapes is another story.
A BBC investigation found that illegal vapes confiscated at a school in Worcestershire had high levels of metals, including more than twice the safe level of lead, nearly 10 times the safe level of nickel and high levels of toxic formaldehyde. A separate investigation last year by the Mirror uncovered a store in County Durham selling counterfeit vapes, which left one man fearing for his life after he suffered a collapsed lung.
Alex Gittins, 31, thought he bagged himself a bargain when he bought a six-pack of fake Crystal Bar vapes for £20, but ended up in hospital just hours later. The builder said: “I noticed an awful chemical taste in the back of my throat, then five to 10 minutes later I felt what was like a stitch. Next thing you know I’m laying in A&E thinking I was going to die.”
It is apparent there are hotspots for illegal vapes, as from April 2022 to March 2023, roughly 374,000 illegal vapes were seized by Trading Standards officers in Greater Manchester – about half of the 750,000 seized in the whole of England during that time.
How safe is vaping?
Professor Matthew Evison summarises it as: “Ultimately nicotine vapes are an effective treatment for tobacco dependency with a strong evidence base behind this. Nicotine vapes pose a fraction of the risk of smoking tobacco.
“They are not risk-free and young people or non-smokers should never vape. However, there are numerous myths and misunderstandings that vaping is as harmful as smoking tobacco that can prevent uptake and prevent the substantial reduction in risk that vaping can deliver.”
One widely criticised ‘myth’ he talks of is popcorn lung – a lung disease caused by exposure to diacetyl (butterscotch flavouring), first identified in workers in a popcorn factory. The term is often stated as a risk of vaping, though cigarettes have substantially higher levels of diacetyl and have never been linked to popcorn lung, Mr Evison states.
When it comes to heart health, a 2019 study from the University of Dundee, funded by the British Heart Foundation, suggested that vaping may be less harmful to your blood vessels than smoking cigarettes. Within just one month of switching tobacco for electronic cigarettes, measures of blood vessel health, including blood pressure and stiffness of their arteries, had started to improve.
The study looked at 114 people who had smoked at least 15 cigarettes a day for at least two years. The BHF highlighted however that a relatively small number of people were involved, saying that the study “does not prove that vaping is completely safe.”
But Public Health England’s tobacco control programme lead, Martin Dockrell, emphasises it’s as good as it can get currently as an alternative to deadly cigarettes. “We know that e-cigarettes are probably not completely safe, but that’s not the issue.
“The question is, are e-cigarettes safer than the alternative?… It’s really important that smokers understand how much safer e-cigarettes are, compared to smoking”. Analysis suggests almost every minute of every day someone is admitted to hospital because of smoking, and up to 75,000 GP appointments could be attributed to smoking each month – equivalent to over 100 appointments every hour.
A doctor sitting on the other side of the fence and warning Brits to tread with caution over vaping is Dr Andy Whittamore, Asthma and Lung UK’s clinical lead. When he’s not advising the charity, he works as a GP in Portsmouth for the rest of the week.
Every day, he sees the damaging effects of smoking, seeing “lots of people” with either cancer, lung disease, infections or chest infections. And he also has patients walk through his door complaining of lung problems due to vaping. The 47-year-old told the Mirror: “Anything we breathe in can irritate our lungs, and for some people, vaping is something that definitely irritates them.
“Lots of things are going on in people’s lives, changing of the weather, viruses, pollution levels. But in some people, they notice a definite change when they start vaping. Similarly, people who are in environments where lots of people are vaping around them, it does set off asthma attacks. There is a definite link for some, harder for others. I think there should be some caution in that.”
He says that for any of his patients smoking cigarettes, he tries to persuade them to stop with the help of NHS services and the support of a smoking cessation clinic, along with nicotine replacement treatment. “The most effective thing is stopping people smoking,” he continued.
“For people who find that difficult or don’t want to do that, I sort of say, ‘well, vaping is an option. It’s safer than smoking, but it’s only a stepping stone to stopping completely.” But since e-cigarettes have only been on sale in the UK since 2007, long-term studies don’t yet exist.
“It is a relatively new thing, we don’t have those studies proving how it can affect the heart or blood vessels or lungs. That evidence is building over time. But with any habit like this, if we can stop children from getting into it in the first place, it will help to improve health outcomes,” he asserted.
“I see several times a day how smoking affects individuals and the people around them. I see how it stops people working, how it affects their mental health as well, and those bereaved from those who have died from smoking,” Dr Whittamore, who is fully supportive of the Government’s proposed ban, said.
“As a country, being smoke-free will be transformative. We will have people living healthier lives, there will be less strain on NHS and importantly, people won’t be dying so often from cancer and lung disease.”
One woman who has seen first-hand the devastating impact smoking can have on your health is Chloe Slasberg, who has COPD – chronic obstructive pulmonary disease. The 49-year-old asthmatic started smoking at 17 before becoming hooked on 20 a day.
She knew about the harm smoking could do, but naively carried on, never believing it would happen to her. When she started to become breathless at work, she tried ‘everything under the sun’ to quit her dirty habit, including vapes.
The former nurse said they made her feel “even worse”, as she started having coughing fits and would struggle to get her breath back when laughing. She experienced a ‘terrible tightness’ in her chest and reverted to tobacco cigarettes.
Her symptoms prevailed, and by the time she was 45, she was diagnosed with COPD. She eventually quit her 30-year addiction by going cold turkey and with the hope that she could rebuild her lung capacity with pulmonary rehabilitation.
However since the coronavirus outbreak, Chloe has lived a life of isolation, for fear of picking up an infection and becoming seriously ill. Now when Chloe, who is backing the Government’s proposals of a ‘smoke-free generation’ which is being voted on this month, she sees smokers, she feels disgusted and is particularly concerned for young people picking up vaping.
“A ban should have been introduced decades ago because knowing something is bad for you and being able to break an addiction are two different things,” she told the Mirror. In a message for smokers, she warned: “Please don’t leave it until you’ve got something like COPD to give up. Give up whilst it’s in your capability to live a full and healthy life. Living like this is hard.
“I’m a positive person but it is very easy to go the other way and I worry about the burden I am on friends and family as they have to do more and more for me because of my breathing. Don’t assume COPD is for 70 or over, I believe I was just under 40 when I started and didn’t want to accept it. I always had the thought that ‘it wouldn’t be me.'”
In another case, 26-year-old mum Jodie Hudson was rushed to hospital with vaping-related pneumonia last September after she found herself struggling to catch her breath while walking around her house. She had swapped cigarettes for vapes two years ago – but never suspected what she assumed was a less harmful alternative would lead to a hospital admission.
The council worker, who is mum to two-year-old Dillon Hudson, told the Mirror she was smoking her vape “anywhere and everywhere” – and had no immediate plans to quit before becoming unwell. She has since sworn off the “highly addictive” vapes for fear her toddler would grow up without a mum.
In the US, health experts are much more vocal about the prevalence of popular e-cigarettes and their possible health outcomes. Dr Robert Shmerling, advisory board member of Harvard Health Publishing from Harvard University Medical School, suggests vaping should be viewed as a “lesser of evils” for current cigarette smokers.
“Until we know more, think twice about vaping,” he warned before penning the chilling message: “Our lungs were meant to inhale clean air and nothing else. It took many years to recognise the damage cigarettes can cause. We could be on a similar path with vaping.”
Vaping among young people
Worried parents up and down the country have spoken about the fear they have over their children’s addiction to vaping. In one case, a parent said their child can’t concentrate in school without it, and while the internet says the bars are meant to last five days, they were puffing through a single one in half a day.
Addiction professor Ann McNeill says there are concerns that nicotine may affect the developing brain if used during adolescence. “Research has shown this to be the case in animals, but exactly how this translates to humans is unclear as most studies examining this have looked at smoking rather than nicotine in isolation,” she told the Mirror.
“Although there is a relationship between smoking and mental health, the effect of nicotine on mental health is as yet unclear.” She believes that for a long time, vaping didn’t appeal to youngsters, therefore she is confident at linking the recent rise in youth vaping with the arrival of disposable vapes on the market, drawing children in with their attractive colours, shapes, flavours and packaging.
Speaking at a school on the day the disposable vaping ban was announced, Mr Sunak said: “You talk to any parent or teacher, they’ll talk to you about the worrying rise in vaping among children,” he said.
“Children shouldn’t be vaping, we don’t want them to get addicted, we still don’t understand the full long-term health impacts of vaping. So it is right we take strong action to stamp this out.”
A secondary school teacher in London says that children vaping has been on his radar for the past few years. He hears of incidents of students meeting up in the toilets to smoke and has found it is usually among children of a lower socioeconomic background or those with issues at home.
“Last year, there were problems with students as young as Year 8, around age 12 and 13,” the teacher, who wished to remain anonymous, revealed to the Mirror. “This year, I know in my form alone there have been issues with three or four kids, and they are 14.
“It is something that is impacting the school, but I can’t say it’s having an impact on their concentration as so many factors are at play. All the teachers are worried about it, but there are concerns about other things – if not vapes, drugs, alcohol. Five years back, cigarettes were an issue.
“It’s another item of contraband to be worried about going around the school. In some ways, it can be a lesser of evils, but it is a big problem.” While he argues they have bigger issues at his school such as vulnerable kids involved in county lines, vapes could also be used to coerce children into criminal activity in a twisted parallel, a charity has warned.
Girls Out Loud founder Jane Kenyon told the BBC on Thursday about the alarming rise of e-cigarettes being used to lure vulnerable children into sexually exploitative relationships. In just one case, 14-year-old Chloe, whose identity is protected, was groomed by an older man online and agreed to meet up with him over the promise of him buying her e-cigarettes.
Ms Kenyon said that young girls don’t always know they’re engaging in a relationship with someone when they accept the vapes. “It can lead to all sorts of criminal activities,” she said. “So they might be recruited into county lines [drug-dealing] or into criminal gangs that might sexually exploit them. And that can happen very quickly.”
So how many children are really vaping? According to NHS Digital, one in five 15-year-olds vaped in 2021 yet the current figure is expected to be higher. Last April, the proportion of children experimenting with vaping had grown by 50 per cent year on year, from one in 13 to one in nine.
Use among younger children is also rising, with 9 per cent of 11 to 15-year-olds now using vapes. According to the YouGov study by Action on Smoking and Health (ASH), the reason for 11 to 17-year-olds vaping because ‘others do’ has grown, while those saying they ‘like the flavours’ has remained the same.
But they could be smoking vapes that aren’t what they seem, with potentially life-changing consequences. In recent months, some vapes have been found to be laced with the zombie drug Spice.
On January 29, emergency services were called to an incident in Eltham, South East London, where five schoolchildren aged between 14 and 16 suffered symptoms including a reduced level of consciousness, vomiting and confusion. One was put into an induced coma.
The five teens, who have since recovered, reportedly used a rechargeable vape pen containing blue liquid. The Mirror can also reveal two young people were harmed after using a Spice-laced vape in a separate incident earlier last month in Merton, South West London.
A mum who knows what it feels like to lose a child in what is believed to have been from vaping is Rachel Howe. In 2015, in what will be 10 years before the disposable vape ban finally comes into force, her 18-year-old daughter Rosey Christoffersen’s lungs collapsed and she died on Valentine’s Day 2015.
Her death was from a condition known as bilateral pneumothorax, and they believe it was due to vaping. Rachel told the Guardian that when she asked one of the emergency doctors whether her prolific vaping may have been a factor, they reportedly said: “We don’t know what we are dealing with, with e-cigarettes,” he told her. “We’ll know in 10 years’ time the damage we are doing.”
She had started smoking cigarettes when she was 16, and began with e-cigs in September 2014, just a few months before her untimely passing. Rachel told the Guardian: “All of her friends were vaping. I hated it because she was on it all the time. I believe she became more addicted to vaping than she was ever addicted to cigarettes. She started having chest pains and having a bit of trouble breathing.”
Dr Whittamore says he sees young people and teens walk through his door complaining of chest problems from vaping. “We see young children with second-hand smoke effects and teens and young adults – we do see they’re more likely to get chest infections or have asthma symptoms. We see that on a relatively common basis,” he revealed.
“Having more asthma attacks when vaping is definitely a risk factor for them.” He added: “A lot of smokers put their chest symptoms down to the fact they do smoke, and they normalise that, so by the time they come to us, they’re having a full-on infection and asthma attack. Smoking increases inflammation in the airways and then that allows bugs to latch in.”
He hopes the disposable ban will see a reduction in the cases he has coming into his practice. Last year, the Royal College of Paediatrics and Child Health (RCPCH) was just one organisation that called for the ban to be introduced.
Vice-president and paediatric respiratory consultant Dr Mike McKean was quoted at the time speaking to the Guardian saying: “It took decades to understand the relationship of cigarette smoking to cancer and respiratory illnesses – my worry is we could be sleepwalking into a similar situation here.
“We’re not seeing lots of highly damaged lungs yet, but there are cases reported where the inflammatory response is overwhelming and causes permanent scarring.” Speaking with the Mirror today, he reiterates reports of young people being hospitalised as a result of vaping, however his statement errs more on the side of caution in vindicating vapes.
“This is of course worrying, but remains a very small number in terms of wider vaping figures,” he said. “Vapes can be one of many tools to stop smoking and early data does suggest legal and regulated vapes are safer than cigarette smoking. However, safer does not mean safe and no child should pick up a vape.”
Dr Evison begs to differ on the damage seen in young people from vapes. He cites a mystery outbreak of EVALI (e-cigarette or vaping use-associated lung injury) in the US, with vitamin E acetate identified as the cause – a condensing agent in vaping products.
“EVALI is not related to nicotine vapes. Outside of a case report of hypersensitivity pneumonitis (a rare immune system disorder that affects your lungs), we are not seeing damage or death from nicotine vapes in young people.”
For more information on smoking and vaping and how you can quit, you can head to the NHS’s Better Health campaign. Meanwhile, you can tell your MP to make smoking history | Asthma + Lung UK (asthmaandlung.org.uk).