Five questions about vaping and e-cigarettes answered by pulmonologist Peter Merkus

There is a lot of debate at the moment around the use of e-cigarettes, also known as ‘vaping’. Peadiatric pulmonologist Peter Markus answers five questions about vaping, and how it affects our health. 

1.    What is vaping?

With an e-cigarette, also known as a vape or vaper, you inhale vapour, which contains all sorts of known but also unknown chemical substances. The most important and best-known of these is nicotine. Nicotine is highly addictive, more so than alcohol, hashish, cocaine, or heroine. In addition, manufacturers also add all sorts of chemical flavours to make their cigarettes taste even better. These flavours, such as fruit, coffee, sugar products, and herbs, are not addictive, but intended to make the product even more attractive. E-cigarettes do not burn any tobacco.

2.    Is vaping bad for you?

Yes. Inhaling the vapour can lead to irritation and damage to the airways, heart palpitations, and an increased risk of developing cancer. People who vape run the risk of developing a new lung disease, EVALI. This acronym that stands for ‘E-cigarette or vaping use-associated lung injury’. This lung disease is characterised by coughing, shortness of breath, chest pain, nausea, vomiting or diarrhea, and fever, and can ultimately lead to serious lung damage. These symptoms may result from often higher concentrations of nicotine in e-cigarettes compared to regular cigarettes. Vaping a few times will not make you ill, but it might make you addicted.

3.    What’s the difference between vaping and smoking?

E-cigarettes do not produce any tar or soot. Both e-cigarettes and regular cigarettes contain all kinds of chemical additives. Both e-cigarettes and regular cigarettes lead to upset and irritation for bystanders who are exposed to passive smoking. A ‘smoke-free zone’ is therefore also understood to mean a vapour-free zone.* 

4.    What's in an e-cigarette?

The harmful substances in e-cigarettes include nicotine, propylene glycol, glycerol, aldehydes, nitrosamines, and metals. Nicotine is generally known to be highly addictive. As a result, users tend to use ever higher concentrations of nicotine, which in turn further intensifies the addiction. It is often unclear what other ingredients are included in e-cigarettes, which are available with dozens of different additives that we know little about.

5.    Is vaping addictive?

Vaping is at least as addictive as regular smoking. This is due to the nicotine. In our work as paediatric and regular pulmonologists, we see that manufacturers are continuously developing new flavours, which of course also attracts new ‘vapers’. And the younger you are when you start vaping, the easier it is to become addicted in the long run. It is also easier to switch from vaping to traditional smoking. 

People who are addicted to nicotine have real problems overcoming their addiction, a process that usually requires good guidance. Your GP can play a role in this context.

As pulmonologists, we luckily see that people do manage to quit smoking, but it is better to never start in the first place.

For more information about smoking, e-cigarettes, and our smoke-free campus, see here (Dutch). You can also consult the Trimbos Insitute for more information.

* The Radboud university medical center grounds are completely smoke and vapour-free.

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