Learning from mistakes 

This article first appeared on Medicine Malaysia

The recent ‘victory’ for vapers may be the start of a long journey against its ill effects. Cigarette smoking had an eerily similar start with its perceived safety and the false promotion of ‘the’ lifestyle. That has since been debunked in 1964 after the announcement of the Dr Luther Terry, the Surgeon General’s report on the ill effects of smoking. [link]

Vaping has had a relatively short history. We attempt to look at the evidence thus far.

Marini S1, Buonanno G2, Stabile L3, Ficco G3., Short-term effects of electronic and tobacco cigarettes on exhaled nitric oxide, Toxicol Appl Pharmacol. 2014 Jul 1;278(1):9-15. doi: 10.1016/j.taap.2014.04.004. Epub 2014 Apr 13

This article looked at the short term respiratory effects of e-cigarettes versus conventional cigarettes. They measured exhaled nitric oxide (eNO) as a representation of the average particle deposited in the alveolar and transbronchial region of the lungs. Vaping and conventional cigarettes had similar effects and was, as expected, higher than controls. So vaping certainly does not do less harm to the deeper regions of the lungs.

Tierney PA1, Karpinski CD2, Brown JE1, Luo W2, Pankow JF3., Flavour chemicals in electronic cigarette fluids, Tob Control. 2015 Apr 15. pii:tobaccocontrol-2014-052175. doi: 10.1136/tobaccocontrol-2014-052175. [Epub ahead of print]

This looked at the content of e-cigarette fluids. Many had aldehydes, known lung irritants and other formulations/chemicals which are of toxicological concern. The concern is the poor regulations surrounding the production of these fluids and many of them are unlabelled. Many are also self-produced by those trading with these fluids.

There are still many unknowns with vaping. The long term effects will likely be better known in many years to come, especially when more people pick this habit up. It is unfortunate that we are likely to repeat the past and the errors of judgement and deceit prevalent during the heydays of cigarette smoking. Pro vapers have used the notoreity of cigarette smoking to justify their existence, without truly understanding the safety surrounding vaping.

Giroud, de Cesare, Berthet, Varlet, Concha-Lozano, Favrat, E-Cigarettes: A Review of New Trends in Cannabis Use, Int J Environ Res Public Health. 2015 Aug 21;12(8):9988-10008. doi: 10.3390/ijerph120809988.

Vaping apparatus opens up a new method of ‘smoking’ illicit drugs. It brings a dark parallel to the days of opium smoking. There is nothing dissimilar in this episode. Malaysia’s fight against drugs could take an unfortunate turn with the acceptance of vaping. It will create a new environment where the battle against drugs could get complicated and more widespread.

We should not succumb to a still small numbers of pro-vapers, and sacrifice the future of generations to come, just to score a few brownie points. There is no harm stopping it in its tracks while a more detailed study is done.

Let history be our guide and let’s not make the same mistake twice!