Vaping is a rage among teenagers and young adults. The popularity of vaping is a global health concern as many of its dangers are still unknown since it’s a recent phenomenon. Image Credit: Matheus Bertelli/Pexels

Vaping is the new smoking. Worse, vape users think it’s less harmful than smoking. It’s clean nicotine, they say. That’s not exactly true, but that’s the general feeling among vapers in the UAE, according to doctors. This has resulted in the proliferation of smokers.

Dr Saheer Sainalabdeen has seen an annual growth in the number of vapers among his patients in Dubai. The pulmonologist at the Medeor Hospital feels that the general misconception of safety is driving up the number of vapers.

Nicotine from vaping can impact the brain, leading to learning issues, memory loss, seizures and mental health problems.

- Dr Saheer Sainalabdeen, pulmonologist, Medeor Hospital, Dubai

The growth of vaping has been staggering. In 2021, 55 million people vaped worldwide, while it has crossed 82 million now. Although there’s not enough data on vaping in the UAE, a study published in the International Journal of Environmental Research and Public Health last year found that about a quarter of college students used an e-cigarette in June. The numbers continue to climb as vaping has become cool. So cool that even schoolchildren are said to be among the new vapers.

Can vaping kill?
It can. E-cigarette product use associated lung injury (EVALI) has killed 68 people in 2019 and 2020 and put thousands in hospital. EVALI is a severe lung condition caused by vaping, leading to extensive lung damage.

Vaping a threat to teenagers’ health

“Some, mainly teenagers, tend to use it for an experience, searching for fun, searching for new flavours, to be social with people who are vaping,” Dr Samah Ahmed, a consultant pulmonologist at Burjeel Medical Centre, Al Shahama, Abu Dhabi, says.

Teenage vaping is a big worry, Dr Sainalabdeen says, adding that nicotine inhalation can lead to stunted development.

“Human brain continues to develop until the age of 25. Nicotine from vaping can impact the brain, leading to learning issues, memory loss, seizures and mental health problems,” he adds.

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Dr Samah Ahmed concurs. “It can also result in cardiovascular diseases and heart attacks. And respiratory illnesses like asthma, chronic bronchitis, chronic obstructive airway disease, interstitial lung disease, and cancers of the lung, stomach, pancreas, cervix and other sites. Vaping among pregnant women can also result in miscarriage, low birth weight of newborns and infant death,” she says.

This runs counter to the vapers’ belief that e-cigarettes are less dangerous. “Some of my patients who vape tell me that vaping is harmless. Others say it’s less harmful. Another group of people says they vape to quit smoking, but they continue to remain vapers,” Dr Sainalabdeen says.

Mona Z. fits the description. A smoker, the British expat switched to vaping to cut down on cigarettes, believing that vaping is less harmful.

Vaping helped me quit smoking: Dubai expat

Mona Z., operations specialist at an education firm in Dubai

The Dubai expat insists there hasn’t been much evidence to say it’s [vaping] harmful.

“I know it has a few chemicals, a bit of nicotine, but in my eyes, it’s a lot better than smoking cigarettes,” she says.

“I started vaping around December. There are different flavours when you opt for vaping, and that was appealing to me. I eventually cut down on cigarettes and quit smoking them once I took up vaping,” the operations specialist at an education firm says. “I don’t feel the need to quit vaping. I am not harming anybody, and I don’t smoke as much.”

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The 39-year-old feels that the chemicals in cigarettes are more harmful and it’s smelly. “I always smelled of smoke too. I had to always go outside a building or the balcony to smoke a cigarette, but with vaping, you can do it anywhere. I can sit at home or be with friends and vape without stepping out anywhere,” she says, adding that it hasn’t impacted her health.

“I love cycling long distances. When I used to smoke, I found that I couldn’t ride for long, and I had a chesty cough. I found it difficult to breathe. With vaping, I can cycle for hours, and I even take a break to vape,” Mona says.

Origins of vaping

A vape or an e-cigarette is used for vaping. Vaping devices have several names: e-cigarettes, e-hookahs, mods, vape pens, vapes, tank systems, and electronic nicotine delivery systems (ENDS). These electronic devices heat a nicotine-laden liquid to produce vapour inhaled by the user. So the term vaping comes from vapour.

Although the electronic cigarette patent was granted to Joseph Robinso in 1930, it was never commercialised. The first commercially successful electronic cigarette took shape only in 2003 when Beijing pharmacist Hon Lik developed a vaping device after his father, a heavy smoker, died of lung cancer.

Vaping works
Image Credit: Vijith Pulikkal/Gulf News
What are heated tobacco products?
Heated tobacco products (HTPs) like IQOS and Eclipse differ from e-cigarettes and other vaping devices. They do not heat nicotine-laden liquids. Instead, these products heat tobacco to produce a vapour for inhalation. The impact of HTPs on health is still unknown, but available data show they contain harmful and potentially harmful ingredients.

By then, the harmful effects of smoking were widely known, and many smokers migrated to vaping. Most of them proclaimed the virtues of clean nicotine while others used it as a crutch to quit smoking, although the World Health Organisation in 2008 said the e-cigarette is not a legitimate smoking cessation aid.

[Vaping can lead to] respiratory illnesses like asthma, chronic bronchitis, chronic obstructive airway disease, interstitial lung disease, and cancers of the lung, stomach, pancreas, cervix, and other sites.

- Dr Samah Ahmed, consultant pulmonologist, Burjeel Medical Centre, Al Shahama, Abu Dhabi

The US Food and Drug Administration website too has similar advice.

“Many studies suggest e-cigarettes and non-combustible tobacco products may be less harmful than combustible cigarettes. However, there is not yet enough evidence to support claims that e-cigarettes and other electronic nicotine delivery systems (ENDS) are effective tools for quitting smoking,” it says.

But the UK’s National Health Service website says vapes can help quit smoking, and thousands have managed to stub out the habit. That ties in with Dr Samah Ahmed’s observation that most people vape as an alternative to cigarette smoking or use it to transition to quitting smoking.

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An expat’s journey from smoking to vaping

Abdullah (name changed on request) is one such vaper. The Egyptian expat feels he’s on track to quit vaping soon after switching from smoking to vaping four years ago. “The smell of cigarettes made me switch to vaping; I feel the effect is the same, and you will get the needed amount of nicotine,” he says.

A senior executive in public relations, Abdullah feels there’s a lack of awareness of vaping juice (liquid). “I believe both traditional and electronic cigarettes and vape lead to (heated tobacco) products like IQOS. It is a better option than vaping, and it really helps to quit both traditional cigarettes and vaping,” he adds.

The 38-year-old doesn’t think vaping is safer than cigarettes. “Nothing is safe in smoking. There is no clear evidence from a trusted source that talks about the disadvantages of vaping,” Abdullah said.

Vape juice
Image Credit: Vijith Pulikkal/Gulf News

Doctors agree with Abdullah’s assertion about the lack of awareness about the vaping liquid. They say most vapers are ignorant of not just the contents of the juice but also its side effects. Nicotine addiction is well-known, and the nicotine levels in vape liquids can be several times higher than in traditional cigarettes. This results in sudden dopamine spikes and crashes, leading to more vaping.

The flavouring agents in the vape liquids can be hazardous, Dr Sainalabdeen says. “Substances that are used to flavour food are used in vape liquid. They are heated and inhaled through the lungs. Instead of being processed by our digestive system, these substances are passed into our bloodstream through the respiratory system. And heating could change their chemical composition. We don’t know how harmful that is,” the pulmonologist adds.

Vaping side effects
Image Credit: Vijith Pulikkal/Gulf News

That’s a scary thought. More scary are the long-term effects. Because they are largely unknown since vaping is essentially a new craze. Mouth dryness, vapour’s tongue (loss of sensation), saliva reduction, recurrent cough, breathing difficulty, increased blood pressure and heart rate and gastric issues have been reported.

Doctors fear the long-term effects may include recurrent chest infection, lung injury, constriction of airways, lung scarring (popcorn lung or bronchiolitis obliterans), seizure, stroke, heart attack, and oral and lung cancers. The highly addictive nicotine in the vaping liquid can harm the heart and brain, narrow blood vessels and raise blood pressure.

Check before you vape: Vaping control
Vapers beware. Check before you puff when you are on holiday. Several countries have banned vaping, and more than one in six countries have regulations against it. So vapers could face hefty fines and imprisonment.
According to the Global Centre for Good Governance in Tobacco Control, 37 nations have banned the sale of e-cigarettes, while there are restrictions in 73 countries. That includes Australia, where nicotine vaping products can only be purchased with a doctor’s prescription since October 1, 2021.
In other countries, including the UAE, it’s legal to sell and use e-cigarettes.

How to quit vaping

Quitting vaping is similar to quitting smoking. It’s a process that will take time. There are no shortcuts. Here are some suggestions from two doctors that could help kick the habit.

Dr Saheer Sainalabdeen’s advice:

Break the vaping routine with the following steps. When you feel like vaping, do one of the following, which will help you avoid it.

  1. Find a distraction.
  2. Take a deep breath and exhale slowly
  3. Go for a walk
  4. Talk to a friend or a relative
  5. Engage in any activity, like playing a game on the phone

Dr Samah Ahmed’s advice:

  1. Find the triggers of vaping and make plans to overcome them.
  2. Find motivation to quit. Some of them can be health concerns, risk factors and the need to be free from addiction.
  3. Timing. Set a date to quit vaping.
  4. The plan to beat vaping should include distraction and physical activities like aerobic exercises.
  5. There will be withdrawal symptoms and cravings.
  6. Seek support from society, programmes for smoking and doctors. The five ‘A’s in medical support are:
  • Ask. We ask about your health status and health education
  • Advice: To quit smoking.
  • Assess: Health status, readiness to quit vaping, and vaping behaviour
  • Assistance: Use nicotine replacement therapy or non-nicotine replacement therapy
  • Arrange follow-up visits to the doctor: To get help in avoiding craving and withdrawal symptoms. Relaxation techniques to help avoid stress include yoga, meditation, breathing, and physical exercise.

Inhaling any tobacco product can’t be a good thing, doctors say. Vaping may eliminate the dangerous carbon monoxide of smoking, but more dangers lurk in the vaping juice.

To quote Dr Sainalabdeen, the unknowns of vaping pose the biggest danger.