Víctor and his friends had just completed their university entrance exam and, to celebrate, they bought a few beers to drink at the beach. The store also carried vaping devices, so they decided to try one. Since then, it has become essential for him every time he goes out to party. “I know it’s bad for my health, but I think I can control it. I would never smoke tobacco, I’m more intimidated by it,” he admitted.
E-cigarettes and vaping devices (both used to inhale an aerosol with various substances, with or without nicotine) are proving to have more and more harmful effects, from the damage caused in the respiratory system by the inhaled microparticles to cardiovascular diseases and an increased risk of cancer. However, as the effects of vaping have not been studied for long, the evidence does not equate it to traditional tobacco, one of the biggest public health problems in the world.
These devices have become quite ubiquitous: they are promoted at music festivals, there are social media campaigns with influencers that reach a very young demographic, and they can be found in all kinds of stores, adorned with attractive colors and candy-like scents.
One of the arguments of the vaping and electronic cigarette industry (which is often also the same as the tobacco industry) is that the devices are mostly designed for people who already smoke — to help them quit, even — and not to attract new users. Spain’s Union of Vaping Promoters and Entrepreneurs (UPEV), which represents 600 small and medium-sized companies and which in 2022 registered record earnings of more than $100 million, claims that they work to help smoking cessation and that, among its best practices, they “try to discourage non-smokers from purchasing a device, even when they request that it be nicotine-free.”
Blu, a subsidiary of Imperial Tobacco that describes itself a leader in the e-cigarette sector, told EL PAÍS that its products are aimed exclusively at adult consumers, adding that “many smokers have decided to reduce or abandon conventional tobacco thanks to vaping.” Meanwhile, Blu’s social media campaigns include influencers that target a very young audience and who promote electronic cigarettes.
Beyond the explicit promotions, the devices can be seen in all kinds of contents that help normalize its consumption, with streamers with millions of followers, many of them underage, vaping on YouTube or Twitch.
Beatriz Arranz, a specialist in Health Prevention and Promotion from the Spanish Association Against Cancer, explained that the industry employs an old technique that seems to work very well: “They associate it with young, attractive, cool people. The social signifier is the same as that of tobacco: I smoke because I think it’s cool, because people I admire do it, because it helps me flirt and make friends, because in my group it is seen as something positive. I associate it with sensations that will help me relax.”
Carla, 19, who started smoking and vaping simultaneously when she was about 15, explained: “In times of high stress I vape more. And even though I know it isn’t healthy, to me it seems less dirty than tobacco, which smells worse.” If she had to choose only one, she pointed out, she would only vape, due to the “smell and convenience.”
Scientific societies and anti-tobacco platforms state that the regulations should treat these devices the same as tobacco, restricting their promotion and points of sale. “Just like in the 1960s (the 1980s for women) a generation of smokers started without knowing the dangers well and then regretted it a few decades later, if we do nothing, in 20 years we could be regretting that one in three tumors is related to vaping,” Arranz said.
What we know about the health effects of vaping
Contrary to tobacco, which emits a foul-smelling smoke that leaves the body and clothing of those who smoke it (and those around them) stinking, these devices generate a vapor of supposedly pleasant aromas. However, Arranz pointed out that “it is misleading,” as they are actually aerosols that contain carcinogens, heavy metals and various particles that are harmful to the body — even if they do not contain nicotine.
The short-term effects of these devices on the respiratory tract are “similar to those of tobacco,” according to a 2022 report from the Ministry of Health of Spain that reviews all the scientific evidence in this regard. “Carcinogenic substances have been found in liquids and aerosols from electronic cigarettes. Numerous poisonings and adverse effects related to these products have been described, some of them severe. Their use generates emissions of propylene glycol, PM 2.5 particles [minuscule particles that penetrate the body], nicotine and carcinogenic substances that can contaminate closed spaces, with the consequent risks due to passive exposure,” the report concluded.
It is true that we are still decades away from really knowing the long-term effects of these devices. However, scientific societies agree that doing nothing and waiting all that time to find out, given the obvious risks that are already known, would be unreasonable.
Even more controversial is the extent to which they can really be used to stop smoking, one of the arguments used by the industry to defend the product. “Electronic cigarettes may reduce the desire to smoke and other characteristic symptoms of smoking cessation. However, although some smokers may temporarily switch to these products, a very low proportion appears to achieve sustained cessation. According to the available data, neither the duration of the change in consumption nor the complete cessation are clear in the long term,” according to the study.
Experts from Spain’s Ministry of Health do warn of the dangers of promoting these products, as “they could create new nicotine addicts.” For many young people and teenagers, more than a way to quit tobacco, vaping is the gateway to smoking.
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