Michael Mosley addressed his questions regarding e-cigarettes, the questions public asks about e-cigarettes, to several experts among which Dr Marcej Goniewicz and Dr Mark Travers (Roswell Park Cancer Institute, USA) or Dr David O’Reilly, who granted BBC access to the British American Tobacco scientific department that he is leading.
BBC’s documentary is accessible (depending on your location) on this page : http://www.bbc.co.uk/programmes/b07c6ll4
If you’re not able to play the video from the BBC’s website, a user (outis110) on Youtube made it available :
Does the e-cigarette really help smokers to quit?
Yes, says the expert. It can be seen as a “fancy NRT” that may help combat urges to smoke.
Volunteers, all smokers, made an attempt to quit smoking. Seven of them attempted quitting cold turkey (success: 2/7), an identical amount with NRT (success: 7/7) and the same with e-cigarettes (success:7/7). The conclusion of this test was that even if the success can also be due to chance given the small sample considered, the physiological tests do reveal an overall enhancement of health after only 4 weeks of abstinence. A glance of hope for smokers who are concerned by their health.
But what does the e-cigarette do to non-smokers?
Michael Mosley, as a non-smoker but a devoted journalist, turned to vaping for the needs of the documentary, puffing on a third generation device supplied with nicotine e-liquid.
Beneficial effects of nicotine were found by researchers on certain groups, for example people with Alzheimer disease, who exhibited better performances under treatment with nicotine. But it is almost the only positive medical aspect of this molecule since almost no research has currently been carried out on this molecule among non-smokers.
Experts concede that the addictiveness of nicotine is exacerbated by its combination with other substances present in cigarette smoke and the action of smoking itself. Alone, in e-liquids, nicotine is much less addictive than in tobacco cigarettes and the journalist says that it won’t be hard for him to kick the habit of vaping after the end of the footage.
His second observation is that nicotine did not affect his overall performances in terms of responsiveness or for any other intellectual skills. No change compared to the base line. To explain the effect of nicotine, he suggests that lacking nicotine is like lacking caffeine: after a shoot, one feels better than before but not better than the others.
From a social aspect, he ironized that vaping is not as easy as it may appear, especially when there is a ban on vaping in working areas. Going outside the office to vape may reveal itself painful and, he noticed, leads to puff much more in a shorter period than under normal circumstances, if it had been authorized to vape at work, for example. A call to lift vaping bans indoors?
But there comes the problem of second-hand vaping.
Second-hand vapor is shown by the documentary to be very variable both in quantity and quality. Dr Mark Travers, for example, was surprised by the level of particles recorded in a test chamber occupied by experienced vapers using their Mods compared to what he is used to with vapers using disposable e-cigarettes for the same test. Hence, depending on which type of device is used, one cannot exclude second-hand vaping but compared to second-hand smoking, its level is much less, if nicotine concentration is considered, says the researcher.
Michael Mosley underwent medical tests in order to evaluate the potential benefit of vaping on himself. The most striking result was an increase in expired nitric oxide, a marker of the inflammation of his aerial tract. His inflammation was diagnozed by NO but confirmed by the presence of numerous macrophages in sputum samples, as the consequence of a stress that is induced by each puff on his device.
The journalist briefly explains that too many macrophages in the lungs are detrimental because they produce enzymes that may damage the lung itself instead of being used to protect the body from exogenic substances. Nevertheless, a return to normal is expected for subjects in good health, within a couple of weeks after they stopped vaping.
The specialist highlights the crucial need not to consider e-cigarette as a substitute for smoking in places where it is forbidden and to quit smoking altogether when starting vaping. It is a real health concern, he says, because it weakens human defense system to external agressions.
What conclusion can be made from this experience?
His conclusions are that whether e-cigarettes are good news or not, finally depends on how they are used and that it would be stupid for a non-smoker to start vaping. In turn, for smokers, it is something that may help them stop smoking, that has a low risk profile in the short term but whose long-term effects are not known.
Nevertheless, the documentary points out that if most smokers turned to become vapers, it would be a huge step forward for Public Health, saving lives of millions of smokers worldwide.
Update on 05/26/2016: