Do not vape

In 2019, a Health Promotion Board (HPB) survey with 600 respondents found that almost 7 in 10 young people didn’t know that e-cigarettes contained harmful chemicals[i][ii]. E-cigarettes have many names and are also known as e-cigs, vapes, or Electronic Nicotine Delivery Systems (ENDs).

Maybe, like 70% of the respondents in the survey, you do not realise that e-cigarettes are harmful. In fact, you’re curious about vaping. You’ve seen videos of people doing vape tricks on YouTube or Instagram and think it looks really fun.

You’ve also heard that vaping isn’t as bad as smoking. You’ve been told that people use e-cigarettes to quit smoking, and unlike cigarettes, which everyone knows are bad for you, e-cigarettes are not supposed to be addictive… so what’s the harm, right?

Stop. It’s about time we got real about vaping. Here are 8 reasons why vaping is a bad idea.

1. Vaping is linked to at least 60 deaths

As of 4 Feb 2020, vaping has been linked to at least 64 deaths and over 2750 cases of respiratory illnesses in the United States.[iii] The Centers for Disease Control and Prevention (CDC) in the US has called this outbreak EVALI, or E-cigarette or Vaping product use-Associated Lung Injury. EVALI started as early as June 2019; and the youngest fatality, on 9 January 2020, was a 15 year-old in Texas in the US[iv].

While scientists and doctors are still investigating the exact causes, the CDC has identified vitamin E acetate, an additive, as a “chemical of concern”. Vitamin E is usually not harmful when ingested or applied to the skin; however, the oil could cause respiratory issues when inhaled.

While it appears that vitamin E acetate is strongly linked to the outbreak, the evidence is not sufficient to rule out the contributions of the harms from other substances. The substances and product sources are still being investigated and it is likely that there could be more than one cause associated with EVALI.

To be safe, the CDC has asked people to refrain from using and obtaining from sources such as friends, family, or online sellers.  

2. Is Vaping as harmful as cigarettes?

Contrary to what you may have read and/or heard, vaping isn’t the less harmful indulgence you’ve been led to believe. Recently, scientists at the University of Tasmania have found that vaping is just as harmful to humans as cigarettes are, and that it can even cause cancer[v].

In fact, the World Health Organisation (WHO) has declared that e-cigarettes are “undoubtedly harmful” and that they are not safer alternatives to regular cigarettes.[vi]

This is because just like traditional cigarettes, e-cigarettes expose the user to a combination of harmful chemicals.[vii][viii] For example, they often contain nicotine, the same substance found in traditional cigarettes that makes them so highly addictive. Nicotine is also used in pesticides and can affect brain development.

Even if the vapes do not contain nicotine, harmful chemicals can be generated when it is aerosolised as it’s heated. These compounds may be “harmless” on their own, but when mixed and heated, they can generate damaging vapours that the user ends up inhaling deep into their lungs.

One of these chemicals is benzene, commonly found in car exhaust, fuel and detergents. Benzene can cause cancer, infertility and leukaemia.  Another is formaldehyde, a highly toxic chemical found in embalming fluid. That’s right, the same fluid used in mortuaries to preserve dead bodies. Formaldehyde is known to cause infertility.

If you see “food safe” compounds in the vapes,[ix][x] you might mistakenly believe that the products are safe for use. However, “food safe” simply means these compounds are safe for consumption – not inhalation. The vaping process heats and vapourises these compounds, which can turn them from “safe” into something dangerous.

3. Vaping is habit-forming and addictive

As you have read earlier, vapes contain a highly addictive chemical, nicotine. When inhaled, nicotine is quickly absorbed into the bloodstream and within seconds, activates certain chemical reactions in the brain, giving the user a pleasurable “high” and making them crave more.[xi]

Vaping can be habit-forming when used as a coping mechanism during times of stress or when it becomes a part of a regular ritual where it is associated with a particular activity. For example, some people might vape after every meal, or, whenever they hang out with a certain group of friends or colleagues.

E-cigarettes do not burn out like traditional cigarettes and so users could end up vaping more than they realise.

4. Vaping isn’t proven to help you quit cigarettes.

E-cigarettes are not proven to be an effective aid in quitting smoking. According to the US FDA, e-cigarettes deliver nicotine at the same levels as traditional cigarettes, which continues the nicotine addiction instead of breaking it.[xii] In fact, many people who use e-cigarettes to quit smoking end up using both traditional and electronic cigarettes instead.

A study conducted among young people in Poland found that e-cigarettes could be even more addictive than traditional cigarettes.[xiii] Researchers looked at participants’ levels of physical addiction to nicotine and found that participants who only smoked e-cigarettes had more than twice the nicotine dependence of participants who smoked conventional cigarettes only. According to the study, “the use of e-cigarettes carries a great risk of addiction and the risk of addiction maybe even higher than that from smoked tobacco cigarettes, at least among young adults.”[xiv]

5. Vaping can be a gateway to trying traditional tobacco

Studies in the US and globally show evidence that e-cigarette use could have a gateway effect amongst young people.[xv][xvi][xvii]

A US study found that students who vape are “almost twice as likely to have intentions to smoke conventional cigarettes.” In other words, students who have vaped are more likely to pick up smoking compared to those who had never vaped before.[xviii]

Other studies show that e-cigarette users are three to four times more likely to become cigarette smokers compared to non-users.[xix]

6. Big Tobacco tactics you should know about

Vaping is popular with young people for a variety of reasons. However, the primary reason is because they’re being targeted by e-cigarette companies.[xx]In November 2019, Juul, the largest vaping company in the US, was sued by the States of New York,[xxi] California,[xxii] North Carolina[xxiii] and federally,[xxiv] for misrepresenting the safety of its products and for their deceptive marketing practices targeting underage people.[xxv][xxvi]

An example of this was when a Juul representative told students at a school that Juul was “99% safer than cigarettes”, and that it was “totally safe”. Juul’s packaging and outreach efforts were also deemed to be targeted at young people.

Like their traditional tobacco counterparts, e-cigarette companies prey on young people so they end up as future customers. They make vaping seem cool by creating and endorsing a certain sort of vaping lifestyle made popular in vaping magazines, and by vaping influencers on social media.[xxvii]

Vape juice comes in all sorts of enticing scents or sweet flavours. These are designed to appeal to a younger crowd[xxviii] and to give the impression that the products are “safe”.

As a tobacco company representative once said, “It's a well-known fact that teenagers like sweet products…"[xxix]

7. Vaping is illegal in Singapore

That’s right. You basically can’t do anything related to vaping without breaking the law[xxx].

Whether it’s buying, selling, possessing or even sharing photos or videos of vaping on social media—if you do any of these, you’re breaking the law.

It is an offence under the Tobacco (Control of Advertisements and Sale) Act (TCASA) to sell, use, possess for sale, import or distribute imitation tobacco products. This includes e-cigarettes/vaporisers and anything else that resembles a smoking device. The TCASA covers everything—from confectionery and food products, to any toy, device or article:

  • That resembles, or is designed to resemble, a tobacco product;
  • That is capable of being smoked;
  • That may be used in such a way as to mimic the act of smoking; or
  • The packaging of which resembles, or is designed to resemble, the packaging commonly associated with tobacco products.

Sellers can be fined up to $10,000 and/or imprisoned for up to 6 months for first offences. For second or subsequent offences, sellers can be fined up to $20,000 and/or imprisoned for up to 12 months.

Promoting your vaping products for sale is also illegal, as it would come under the prohibition against “advertisements or promotions which would encourage or promote the use of tobacco products and imitation tobacco products which includes posting of smoking/vaping photos on social media platforms.”

In September 2019, Chong Weisheng, a 35-year-old Singaporean man was fined $99,000 by the Health Sciences Authority (HSA) for selling electronic vaporisers.[xxxi] This is the harshest vaping-related penalty imposed since 2014, when an offender was fined $64,500.

What if you own a vaping device?

Please throw it away. It is illegal to possess, purchase or use electronic vaporisers. If caught you could be fined up to $2,000. Since the ban, which came into force in February 2018, 465 people have been caught for owning vapes.[xxxii]

8. Singapore is not the only country that has banned vaping

More than 40 countries[xxxiii] have banned e-cigarettes and other Emerging Tobacco Products, with more and more countries either heavily regulating or considering a ban, as the harms of vaping become increasingly known.

Within the South–East Asia and Western Pacific region, Nepal, Sri Lanka, Thailand, Timor-Leste, Brunei, Korea (Democratic People’s Republic), Cambodia and Australia have banned ENDS.

Vaping – just don’t try it

There are really no benefits to trying e-cigarettes. Vaping is harmful to one’s health, and can lead to an addictive and costly habit. Not to mention the fact that it is also illegal in Singapore. 

Because of its illegal status, there is no way of telling what is actually in the vapes and vaping products that are being sold. You could end up inhaling unknown substances that may be even more toxic than you realise.

If you are looking to quit smoking, why not sign up for the Health Promotion Board’s I Quit 28-Day Countdown challenge. It utilises effective, proven methods to support smokers to quit smoking.


Reference

[i] Wong, Wendy. “7 in 10 Youths Unaware of Cancer-Causing Chemicals in e-Cigarettes: HPB.” Channel News Asia, Mediacorp Pte Ltd., 26 Jan. 2019, www.channelnewsasia.com/news/health/7-in-10-youths-unaware-of-cancer-causing-chemicals-in-e-11170058.

[ii] Heng, Melissa. “Nearly 7 in 10 Youth Unaware of E-Cigarette Dangers: HPB Survey.” The Straits Times, Singapore Press Holdings, 27 Jan. 2019, www.straitstimes.com/singapore/health/nearly-7-in-10-youth-unaware-of-e-cigarette-dangers-hpb-survey.

[iii]Centers For Disease Control And Prevention, 2020, https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed 16 Jan 2020.

[iv] Grady, Denise. "Vaping Kills A 15-Year-Old In Texas". Nytimes.Com, 2020, https://www.nytimes.com/2020/01/09/health/teen-vaping-death.html. Accessed 16 Jan 2020.

[v] “Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products | Electronic Cigarettes | Smoking & Tobacco Use | CDC.” Centers for Disease Control and Prevention, U.S. Department of Health & Human Services, 21 Nov. 2019, www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html.

[vi] WHO Exposure to Benzine, A Major Public Health Concern, 2010. Geneva: World Health Organization; 2010. WHO: Exposure To Benzine, A Major Public Health Concern. World Health Organization, Geneva, 2010, https://www.who.int/ipcs/features/benzene.pdf. Accessed 22 Nov 2019.

[vii] “E-Cigarettes.” Health Hub, Ministry of Health Singapore, www.healthhub.sg/programmes/153/vaping. Accessed 1 Nov. 2019.

[viii] “Why Singapore Bans E-Cigarettes.” Today Online, Mediacorp Pte Ltd., 31 Jan. 2019, www.todayonline.com/commentary/why-singapore-bans-e-cigarettes.

[ix] Southeast Asia Tobacco Control Alliance. Cigarette Smoking Kills; Vaping E-Cigarettes Kills, Too. Southeast Asia Tobacco Control Alliance, Bangkok, 2019, https://seatca.org/dmdocuments/SEATCA%20Briefing%20paper%20on%20ENDS%20and%20HTPS_28Sep2019.pdf. Accessed 22 Nov 2019.

[x] Johnson, Jon, and Kevin Martinez. "Side Effects Of Vaping Without Nicotine". Medical News Today, 2019, https://www.medicalnewstoday.com/articles/326489.php.

[xi] "Nicotine Addiction Explained". Quit.Org.Au, 2019, https://www.quit.org.au/articles/nicotine-addiction-explained/.

[xii] Southeast Asia Tobacco Control Alliance. Cigarette Smoking Kills; Vaping E-Cigarettes Kills, Too. Southeast Asia Tobacco Control Alliance, Bangkok, 2019, https://seatca.org/dmdocuments/SEATCA%20Briefing%20paper%20on%20ENDS%20and%20HTPS_28Sep2019.pdf. Accessed 22 Nov 2019.

[xiii] Jankowski et al. "E-Cigarettes Are More Addictive Than Traditional Cigarettes—A Study In Highly Educated Young People". International Journal Of Environmental Research And Public Health, vol 16, no. 13, 2019, p. 2279. MDPI AG, doi:10.3390/ijerph16132279. Accessed 22 Nov 2019.

[xiv] Jankowski et al. "E-Cigarettes Are More Addictive Than Traditional Cigarettes—A Study In Highly Educated Young People". International Journal Of Environmental Research And Public Health, vol 16, no. 13, 2019, p. 2279. MDPI AG, doi:10.3390/ijerph16132279. Accessed 22 Nov 2019.

[xv] Chatterjee, Kshitij et al. "Is Vaping A Gateway To Smoking: A Review Of The Longitudinal Studies". International Journal Of Adolescent Medicine And Health, vol 30, no. 3, 2016. Walter De Gruyter Gmbh, doi:10.1515/ijamh-2016-0033. Accessed 22 Nov 2019.

[xvi] Soneji, Samir et al. "Association Between Initial Use Of E-Cigarettes And Subsequent Cigarette Smoking Among Adolescents And Young Adults". JAMA Pediatrics, vol 171, no. 8, 2017, p. 788. American Medical Association (AMA), doi:10.1001/jamapediatrics.2017.1488. Accessed 22 Nov 2019.

[xvii] Berry, Kaitlyn M. et al. "Association Of Electronic Cigarette Use With Subsequent Initiation Of Tobacco Cigarettes In US Youths". JAMA Network Open, vol 2, no. 2, 2019, p. e187794. American Medical Association (AMA), doi:10.1001/jamanetworkopen.2018.7794. Accessed 22 Nov 2019.

[xviii] "More Than A Quarter-Million Youth Who Had Never Smoked A Cigarette Used E-Cigarettes In 2013". CDC, 2014, https://www.cdc.gov/media/releases/2014/p0825-e-cigarettes.html.

[xix] "Review Ban Against E-Cigarettes As Alternative For Long-Term Smokers". Ministry Of Health Singapore, 2019, https://www.moh.gov.sg/news-highlights/details/review-ban-against-e-cigarettes-as-alternative-for-long-term-smokers.

[xx] Weeks, Carly. "How The Vaping Industry Is Targeting Teens – And Getting Away With It". The Globe And Mail, 2019, https://www.theglobeandmail.com/canada/article-vaping-advertising-marketing-investigation/.

[xxi] "Attorney General James Sues JUUL Labs     | New York State Attorney General". New York State Attorney General, 2019, https://ag.ny.gov/press-release/2019/attorney-general-james-sues-juul-labs.

[xxii] "Attorney General Becerra And Los Angeles Leaders Announce Lawsuit Against JUUL For Deceptive Marketing Practices Targeting Underage Californians And Endangering Users Of Its Vaping Products". State Of California - Department Of Justice - Office Of The Attorney General, 2019, https://oag.ca.gov/news/press-releases/attorney-general-becerra-and-los-angeles-leaders-announce-lawsuit-against-juul.

[xxiii] "Attorney General Josh Stein Takes E-Cigarette Maker JUUL To Court - NC DOJ". NC Department Of Justice - Attorney General Josh Stein, 2019, https://ncdoj.gov/attorney-general-josh-stein-takes-e-cigarette-make/.

[xxiv] "FDA Warns JUUL Labs For Marketing Unauthorized Modified Risk Tobacco Products, Including In Outreach To Youth". U.S. Food And Drug Administration, 2019, https://www.fda.gov/news-events/press-announcements/fda-warns-juul-labs-marketing-unauthorized-modified-risk-tobacco-products-including-outreach-youth.

[xxv] "Juul Faces Mounting State Lawsuits In US". BBC News, 2019, https://www.bbc.com/news/business-50479063.

[xxvi] "Juul 'Ignored Law' In US E-Cigarette Adverts". BBC News, 2019, https://www.bbc.com/news/business-49640283.

[xxvii] Jackler, Robert K. et al. JUUL Advertising Over Its First Three Years On The Market. Stanford University School Of Medicine, Stanford, California, 2019, http://tobacco.stanford.edu/tobacco_main/publications/JUUL_Marketing_Stanford.pdf. Accessed 22 Nov 2019.

[xxix] "Youth Cigarette - New Concepts (Memo To Brown & Williamson Regarding Ideas For A “Youth” Cigarette) 1972, Bates". Legacy.Library.Ucsf.Edu, 1972, http://legacy.library.ucsf.edu/tid/ons56b00.

[xxx] Singapore Attorney-General's Chambers. Tobacco (Control Of Advertisements And Sale) Act. Government Of Singapore, Singapore.

[xxxi] Ang, Prisca. "35-Year-Old Man Who Sold E-Vaporisers Fined Record $99,000". The Straits Times, 2019, https://www.straitstimes.com/singapore/courts-crime/35-year-old-man-fined-99000-for-selling-e-vaporisers-highest-amount-in-past-5.

[xxxii] Teh, Cheryl. "Parliament: HSA Continues Efforts To Fight Illegal Vape Culture, 465 People Caught For Owning Vapes Since Ban". The Straits Times, 2019, https://www.straitstimes.com/politics/parliament-hsa-continues-efforts-to-fight-illegal-vape-culture-465-people-caught-for-owning.

[xxxiii] "E-Cigarette Ban & Regulation: Global Status As Of October 2019 - Global Center For Good Governance In Tobacco Control". Global Center For Good Governance In Tobacco Control, 2019, https://ggtc.world/2019/11/07/e-cigarette-ban-regulation-global-status-as-of-october-2019/. Accessed 22 Nov 2019.