WARNING!
This is an older article that may not reflect Dr. Mercola’s current view on this topic. Use our search engine to find Dr. Mercola’s latest position on any health topic.
Smoking conventional tobacco cigarettes takes a large toll on health. They contain thousands of toxic chemicals that are released into your lungs and the air with every puff. The Centers for Disease Control and Prevention1 calls it the “single largest preventable cause of death and disease in the United States.”
Traditional combustible cigarettes kill more than 480,000 Americans every year. In addition, smoking-related illness creates a financial burden of more than $300 billion, including direct medical care and lost productivity.
According to the CDC,2 if cigarette smoking continues at the current rate, 5.6 million of those younger than 18 currently living in the U.S. will die early from a smoking-related illness. That is approximately 1 in 13 Americans aged 17 or younger currently alive.
Following the publication of the first surgeon general's report in 1964,3 traditional tobacco use gradually declined. By 2004 it had reached its lowest level in 67 years. In 1965, 41.9% over the age of 18 smoked, but by 2005 prevalence had dropped to 20.9%.
In 2003, Chinese pharmacists revolutionized the design of an e-cigarette, enabling smokers to inhale nicotine without combustion. Over the next 16 years, e-cigs enjoyed a near meteoric rise in popularity and sales. In 2017, traditional cigarettes among high school students had declined, but e-cigarettes use had increased.4
Past research has demonstrated e-cigs deliver an appalling amount of heavy metals to the user,5 along with high levels of highly addictive nicotine. The substances in the e-liquid have also been found to deactivate protective cells in your lungs.6
Study Find E-Cigarette Liquid Contains Fungus
A new study7,8 found 27% of the 75 single-use and refillable vaping cartridges tested contain microbial agents and 81% contain glucan, a substance found in the cell walls of most fungi. Exposure to these impurities has been associated with asthma, chronic obstructive lung disease, reduce lung function and inflammation.
Dr. David Christiani, senior author of the study, and Elkan Blout, professor of environmental health at Harvard T.H. Chan School of Public Health, commented:9
"Airborne Gram-negative bacterial endotoxin and fungal-derived glucans have been shown to cause acute and chronic respiratory effects in occupational and environmental settings. Finding these toxins in e-cigarette products adds to the growing concerns about the potential for adverse respiratory effects in users."
The products tested were segmented into four flavor categories: tobacco, menthol, fruit and other. They were then screened for the presence of endotoxin and glucan. Researchers found endotoxin concentrations were higher in the fruit flavored products, suggesting raw materials used in production may have been the source of contamination.10
They hypothesize the cotton wicks used in the cartridges could be a potential source, as both endotoxin and glucan may be found in cotton fibers. Christiani believes public education about the potential health consequences needs to be a larger part of the e-cigarette conversation and development of public policy. He told NBC News:11
“I don’t think e-cigarettes are safe for anyone, especially kids. Parents should be very concerned. For one there is nicotine delivery that is very addictive and can lead to use of combustible tobacco products. Two, people may be inhaling biological toxins and carcinogens unknowingly.”
Getting Teens Hooked on Nicotine Is Likely Big Tobacco’s Goal
Data from the 2018 National Youth Tobacco Survey12,13 by the CDC show 3.6 million middle and high school students currently vape, an increase of more than 1.5 million from 2017.14 The meteoric rise of those vaping has overshadowed tobacco use in teens. In the age group of 18 to 24-year olds, 40% had not been smokers before using a vaping device.15
There's a perception that e-cigarettes are harmless, since unlike combustible cigarettes the vapor is often odorless making it difficult to detect. As a result, while the number of those smoking traditional cigarettes has been dropping,16 the number of teens vaping has steadily risen.
In 2018, the San Francisco-based Juul Labs rapidly overtook the U.S. e-cigarette market with sales skyrocketing nearly 800%. According to Nielsen data, the company has captured a 71% share of the market with a $15 billion valuation.17 The device is now so popular among young adults, the practice of using it is known as Juuling.18
Morgan Stanley analyst Pamela Kaufman told investors,19 "Juul's success underscores the potential for disruptive technology to undermine U.S. tobacco's reliable business algorithm." With the rising number of youths using Juul devices and then transitioning to traditional cigarettes, outgoing Food and Drug Administration (FDA) Commissioner Scott Gottlieb warned:20
"You're going to be at overall tobacco use among children in this country, of 40, 45 percent … That is simply intolerable. I went back and looked at data back to 1950, and we haven't seen that level of tobacco use among kids. And e-cigarettes are a tobacco product."
High Level of Nicotine Is Addictive
The rising popularity of Juul products may be the result of several factors, not the least of which is the highly addictive nature of Juul’s nicotine salts. Surveys found 56% of youth and young adults who have used a Juul or a cigarette were younger than 18 when they first tried it, and nearly half tried it because their friends used it.21
An assortment of fruity flavors also attracts young people and is listed as the second most popular reason for picking up a Juul. As a result, Nielsen reported22 October 2018 Juul sales — as a percentage of all e-cigarettes sales — were a whopping 75%, compared to 24% of all e-cigarettes sales the year before, in August 2017.
Juul presents its products as a "genuine alternative to cigarettes,"23 and the devices are described as delivering "a nicotine hit that's much more like smoking a cigarette than other e-cigs."24 The company's patented JuulSalts’ approach to nicotine delivery involves the use of nicotine salts, which have been shown to be highly addictive. Science reporter Rachel Becker explains in The Verge:25
"These nicotine salts are less harsh to inhale than the straight-up, 'freebase' nicotine used in most regular nicotine vapes — the same kind of nicotine you get from smoking the air-dried tobacco used for pipes and cigars. Freebase nicotine can be absorbed through your mouth — but it's also much less pleasant to inhale because of its 'greater physiological (throat and chest) impact and toxicity,' according to a report for the tobacco industry from the 70s."
JuulSalts make the nicotine easier to access for the body and Juul says a single cartridges contains as much nicotine as a pack of cigarettes.26 However, Vox said:
“ … [B]ut tobacco experts told me the precise equivalency is difficult to determine because not all the nicotine released in the cigarette smoke is inhaled, and some is trapped in the filter. Juul also contains three times the nicotine levels permitted in the European Union … Juul ramped up the nicotine levels on purpose … [with] … a liquid that contains nicotine salts.”
The built-in battery is charged through a magnetic USB adapter27 and lasts for 200 puffs, or one full day of regular use.
Another Lie by Tobacco Companies
As Big Tobacco continues to promote vaping as a harmless method of quitting smoking, research data do not support their claims. Additionally, after the FDA attempted to ease regulations28 on the e-cigarette market in 2017 to “encourage development of more products that could help adults quit smoking,” the move did not do enough to prevent children from purchasing products like Juul.
The history of the tobacco industry has demonstrated that advertising to children younger than 21 was directly aimed at getting a new generation addicted to nicotine, to ensure new customers would be available to replace those who died.29 These allegations were made in 199930 by the U.S. Government in a lawsuit against large tobacco companies.
In 2006, a judge found tobacco companies violated civil racketeering laws and ordered them to tell the truth in paid advertising.31 The industry was able to delay this order through court proceedings for over 11 years, but in 2017 they were finally forced to publish corrective statements in 50 newspapers and on major broadcast Networks.32
In the words of Truth Initiative, the court ruled the companies33 "systematically defrauded the American people by lying for decades about, among other things, the health effects of smoking and their marketing to children." However, Big Tobacco is aware a large percentage of teenagers do not see ads in newspapers or on television as they consume most of their news and entertainment online.
Movement From E-Cigarettes to Traditional Combustible Cigarettes
In one study,34 researchers evaluated a national sample of American adolescents and young adults. They determined the use of e-cigarettes at baseline and found it was associated with an evolution to combustible cigarette smoking, which the researchers believed supports regulations to limit sales and decrease the appeal to adolescents and young adults.
From a general standpoint, e-cigarettes appear to be a positive step away from traditional combustible cigarettes. However, according to the National Institute on Drug Abuse,35 in addition to the known health effects, evidence suggests they serve as an introduction to other tobacco products.
In another study,36 students who vaped by the time they reached ninth grade were more likely to start smoking traditional cigarettes within the next year. Interestingly, the reverse was not true. In other words, students who smoked cigarettes were not likely to report using e-cigarettes.
In an animal study37 from the University of Pennsylvania, researchers found rats exposed to nicotine during adolescence grew up to drink more alcohol than unexposed rats. They concluded exposure at a young age changes the neurological circuitry within the reward center of the brain, thereby increasing the risk for addictive behavior.38 Nicotine exposure during adulthood did not appear to alter the function of the midbrain circuitry as it does during adolescence.
Vaping Toxins Are Dangerous to Bystanders
Toxins from e-cigarettes are not only dangerous to users, but to bystanders as well. Researchers found those exposed to secondhand vapor have similar levels of cotinine in their blood as those exposed to traditional secondhand cigarette smoke.39 Cotinine is a measure of the amount of nicotine absorbed in the body.
Researchers are unable to explain this discrepancy. The vapor also contains acetylaldehyde and formaldehyde, both known to be carcinogenic.40 At least one brand had 10 times more than found in traditional combustible cigarettes. The FDA has also detected the antifreeze chemical diethylene glycol in e-cigarette cartridges, a chemical also linked with cancer.41
According to Americans for Nonsmokers Rights, secondhand vapor may contain at least 10 chemicals identified on California's Proposition 65 list of reproductive toxins and carcinogens.42 Probably the most well-known of these is diacetyl, an artificial flavor used by popcorn makers43 to add buttery taste to microwave popcorn.
The chemical is linked to respiratory damage and permanent scarring of the airway.44 In an evaluation of 51 e-cig flavors, Harvard researchers found 47 contained flavoring chemicals, including diacetyl.45
Steps to Making Quitting Smoking Easier
I believe the secret to quitting smoking is to get healthy first, making quitting mentally and physically easier. Exercise is an important part, as research shows people who engage in regular strength training double their success rate at quitting smoking compared to those who don't exercise.46 Healthy eating is another crucial factor to improve your health and strengthen your ability to quit.
- Read through my comprehensive free nutrition plan to get started eating right.
- Develop a well-rounded exercise regimen — This is your ally to fighting disease and to quitting smoking. Strength training is an important part, but also remember to incorporate high-intensity interval exercises such as the Nitric Oxide Dump, core-strengthening exercises and stretching and regular nonexercise movement (like walking and cutting back on sitting).
- Find a healthy emotional outlet — Many use exercise, meditation or relaxation techniques for this, and these are all great. I also recommend incorporating Emotional Freedom Techniques (EFT). This can help clear emotional blockages from your system (some of which you might not even realize are there), thus restoring your mind and body's balance and helping you break the addiction and avoid cravings.
Once you are regularly doing these three things, then you may begin to think about quitting smoking as you have developed a foundation on which you can rely during the process. At this point many are ready to try quitting "cold turkey."
If you need a distraction, these six things to do instead of smoking may help. Finally, if you're a parent, talk with your children about the risks of smoking, smokeless tobacco and e-cigarettes. The easiest path to not smoking is to avoid starting in the first place.