Published on 09. July 2021

E-cigarette – way out or dead end?

Dr. Katrin Vitzthum, psychologist and smoking prevention expert on the risks of e-cigarettes.

Fewer young people are starting to smoke, but many young people and smokers are trying alternative products such as the e-cigarette, tobacco heaters or shisha. How can this be explained?

Dr. Katrin Vitzthum: Health awareness has increased among the population over the last few years. Smoking is no longer "hip"; studies showed a good twenty years ago that 80 percent of smokers in Europe want to quit or wish they had never started. But only 17 percent actually try to quit each year in Germany. At the same time, tobacco companies tell people that e-cigarettes, for example, are "healthier. These products come in many different designs and flavors, and that probably makes people curious.

So are they healthier?

E-cigarettes do not burn tobacco, but harmful substances are still produced. The tobacco is replaced by a (nicotine-containing) liquid that is nebulized via a heating coil and a vaporizer. The harmful substances enter the body through the respiratory tract. What health consequences this can have is still being scientifically researched; especially in the case of pre-existing diseases of the lungs or vessels that have already been attacked by tobacco smoke. On the one hand, this takes time because new products are constantly coming onto the market, and on the other hand, there are still no long-term studies available. The European Association of Lung Physicians therefore clearly advises against its use.

How does the tobacco heater differ from the conventional cigarette?

In the cigarette, the tobacco is burned at about 800 degrees, in the tobacco heater only heated, as the name suggests. Nevertheless, in both cases, carcinogenic pollutants are inhaled during consumption in addition to nicotine. The addiction-typical behavior patterns, such as smoking during stress or with coffee, remain.

How can a common person know which pollutants on this list have particularly serious consequences for the body?

These analyses are very time-consuming and cost-intensive, and with the abundance of products it is difficult even for experts to keep track of them; e-cigarettes are just as carcinogenic and damage cells and tissue, they can irritate the respiratory tract, destabilize blood flow, promote inflammation. They increase the risk of emphysema, the destruction of alveoli in the lungs, and of so-called adenocarcinoma. Even industry data on the tobacco heaters themselves suggest that inflammation and infection are caused. Some harmful components have even been detected in higher concentrations than in cigarette smoke.

Why have e-cigarettes been on the rise since 2009 despite the risks?

Keeping up after quitting smoking is difficult for many ex-smokers, and many would like to take a shortcut to avoid failure or defeat. For many, switching to e-cigarettes sounds like the lesser of two evils; e-cigarette vaping is more socially accepted and sometimes even takes place indoors again as a matter of course – this is a very worrying development in my view. Between 2009 and 2014, consumption increased massively. Users consider consumption less dangerous, perceive the smell as more pleasant. Instead of quitting smoking, there are an increasing number of people who are dual users or switch – so the e-cigarette is not becoming a mere quitting aid, as assumed. Again and again, there are people who become even more dependent, since it is much more difficult to control consumption than with a pack and larger amounts of nicotine are inhaled due to a higher temperature.

The tobacco industry itself now advertises alternatives to the conventional cigarette, what is to be made of this?

As long as the tobacco industry continues to grow tobacco, produce and sell cigarettes, one should not be fooled by alleged prevention programs that aim to ensure the industry's profits. Those who want to quit should rather choose proven and promising methods and seek advice from neutral experts instead of switching to a different package.

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