Vaping nicotine is beneficial to young people at a population level

Posted on July 24, 2023 By Colin

UNDERAGE VAPING continues to dominate the media and drives public policy in Australia. Daily, alarmist headlines feed the anxieties of parents, teachers and public health officials and have created a full-blown moral panic. However, the fear of youth vaping greatly exceeds the objective threat it poses—and benefits are almost universally overlooked.

In fact, vaping nicotine is beneficial to young people overall

That is a controversial statement in the current emotional debate. However, policy on vaping should be driven by evidence, not moral panic, opinions and ideology.

So what is the evidence? How harmful is vaping really, and what are the benefits? Importantly, what is the net impact of vaping on youth health and wellbeing?

What are the harms of youth vaping?

The young people who are most at-risk of harm from vaping are those who have never smoked, as vaping can expose them to new and unnecessary health risks. However, most vaping by never-smokers is experimental and short-term. Exposure to toxicants and the risk of harm are low with this pattern of vaping.

• Nicotine dependence
  Vaping can cause nicotine dependence in non-smokers. However, this is a minority of cases—not, as the media and policymakers often claim, a “whole new generation addicted to nicotine.” Nicotine dependence is unpleasant and can make quitting vaping difficult but it is not life-threatening.
• Harm from nicotine
  Nicotine itself is relatively benign in the doses used in vaping. It does not cause cancer or lung disease. However, it does have minor cardiovascular effects.
• Respiratory effects
  Vaping involves inhalation of trace amounts of other chemicals besides nicotine. It has effects on the lungs in cell and laboratory tests, but studies have so far failed to identify any clinically-important respiratory symptoms from vaping in young people. And there is certainly no evidence that vaping nicotine causes the misnamed serious lung disease “E-cigarette or Vaping Associated Lung Injury” (EVALI), and it does not cause spontaneous pneumothorax (ruptured lung).
• Brain harm
  High doses of nicotine can harm the adolescent brain in rodent studies, but there is no evidence of harm to the human adolescent brain. Studies have not found differences in IQ, educational achievement or cognitive abilities in adults who smoked in the past compared to those who never smoked, so vaping is very unlikely to have any significant effect.
• Seizures
  Vaping does not cause seizures.
• Burns and explosions
  There is a rare risk of burns and injuries from lithium-battery explosions, as with mobile phones, laptops and hoverboards.
• Long-term harm
  Long-term vaping may cause cardiovascular and respiratory effects, and ongoing monitoring and long-term studies are essential to detect any emerging problems. However, as vaping is far less harmful than smoking, serious harm is likely to be very uncommon even after decades of vaping. People who smoke cigarettes but quit by the age of 35 have a full recovery and a normal life expectancy.

What are the benefits?

• Quitting smoking
  Like adults, some young smokers vape to quit smoking. While it is best to do neither, vaping is a far safer alternative to deadly cigarettes.
• Diversion from taking up smoking
  Some young people who would have smoked have never started because of vaping. In fact, those who vape first (before smoking) are less likely to smoke later, compared to those who smoke first.
  The evidence is clear now that vaping is diverting young people away from deadly smoking. Increases in youth vaping have been accompanied by accelerated declines in smoking in the United States, the United Kingdom and New Zealand.
  The "gateway theory" has been debunked. If there is a small gateway effect for some youth, it is outweighed by a much larger number moving from smoking to vaping.
• Positive benefits
  Many people experience positive effects on mental health from vaping nicotine. Nicotine creates pleasure, reduces anxiety and relieves depression. Nicotine also improves attention, working memory and cognitive function and is beneficial for young people with attention deficit hyperactivity disorder and schizophrenia. Vaping nicotine can assist with weight control and is used by some for this purpose. Other benefits are social acceptance and enjoyment.
• Parental quitting
  Adults who quit smoking with vaping have improved health and live longer, removing the trauma and grief of losing a parent to a smoking-related disease. As vaping is less costly than smoking, there is more money for the family budget and reduced financial stress. Kids grow up without secondhand smoke. And parents who switch to vaping are also no longer smoking role models, so their children are less likely to start smoking.

The overall impact of vaping on youth

Young people who do not smoke should generally be advised not to start vaping, due to its small potential health risks.

However, at a population level, the evidence suggests an overall benefit from vaping nicotine for young people, particularly from reduced smoking rates

References

Mendelsohn CP. It’s Time to Change the Way We Look at Youth Vaping. Filter 14July2023

Mendelsohn CP, Hall W. What are the harms of vaping in young people who have never smoked. Int J Drug Policy 2023

What does the evidence say about youth vaping? Blog, 30May2023