VAPING HEALTH AND SAFETY: ULTIMATE GUIDE

In a few decades, people might look back on the advent of vaping and call it the most important public health development of this century. Don’t believe us? According to the World Health Organization, smoking kills 7 million people each year. That’s 13 people every minute. Public Health England, meanwhile, says that e-cigarettes can “help you quit smoking for good” and cites the expert opinion that e-cigarettes are up to 95 percent less harmful than tobacco cigarettes. If vaping is that much less harmful than smoking, just imagine the implications it could have for the world’s leading preventable cause of death.

You’ll notice that people use the phrase “less harmful” – not “harmless” – when talking about vaping. Nicotine is one of the most addictive chemicals in existence, and no one would ever dare call it safe in absolute terms. If you don’t already use nicotine, please don’t ever start. If you already smoke, though, we believe that vaping represents the best path toward quitting.

This article is our comprehensive guide to vaping health and safety. Whether you’re a current smoker about to make the switch – or you already vape and simply want to know how to vape in the safest way possible – you’ll find the vaping safety information you need here.

Table of Contents

E-Liquid Safety

E-Liquid Handling Safety

Handling E-Liquid Safely

Most e-liquid contains nicotine, and nicotine is poisonous in large doses. By law, e-liquid ships in child-resistant bottles. For maximum safety, though, you should always keep your e-liquid and other vaping gear away from children and pets. Since e-liquid uses food flavourings, it often smells like food. Don’t allow anyone to make the mistake of ingesting it.

Nicotine can absorb through the skin. If you get e-liquid on your hands, wash it off promptly.

Handling Short Fill E-Liquid Safely

In the UK, all e-liquid makers and sellers must obey a set of regulations collectively called the Tobacco Products Directive (TPD). One aspect of the TPD is that no bottle of e-liquid containing nicotine can be larger than 10 ml. For many who vape, though, 10 ml isn’t enough e-liquid to last through even a day of vaping. Short fill e-liquid exists because the TPD bottle size limit doesn’t apply to nicotine-free e-liquid. When you buy short fill e-liquid, you’ll buy a large bottle of nicotine-free e-liquid and a small bottle of concentrated nicotine liquid. You’ll then mix the two together to make a finished bottle of e-liquid that’s ready to use.

There are very good reasons why you might want to buy short fill e-liquid. Doing so, though, may mean that you’ll have many extra bottles of e-liquid and nicotine around the house. Use extra care to ensure that all bottles are kept tightly closed and out of reach.

Propylene Glycol Allergies and Sensitivities

Propylene glycol (PG) is one of the most plentiful ingredients in e-liquid, and a few people have experienced sensitivities or allergic reactions when touching or inhaling it. The good news is that if you were allergic to PG, there’s a good chance that you’d already know. PG is a common ingredient in processed foods, air fresheners, soaps, eye drops, cosmetics, medications, deodorants and many other products – so if you’re buying mainstream brands, you most likely already encounter PG daily.

Though PG is extremely common in household products, there are a few people who have discovered PG allergies or sensitivities only after taking up vaping. If you are allergic or sensitive to PG in e-liquid, you may notice the following symptoms:

  • Itching
  • Eczema
  • Allergic contact dermatitis
  • Sore throat
  • Coughing

If you encounter those symptoms when vaping, try switching to an e-liquid using 100 percent vegetable glycerine (VG). You might also consider asking your doctor for an allergy test.

Note that “Max VG” and “100% VG” e-liquids are not the same thing. Many e-liquid flavours contain propylene glycol, and some “Max VG” e-liquids may use those flavours. If you have a true PG allergy, you should buy only e-liquids labelled “100% VG.” Those e-liquids should use only flavours set in glycerine or alcohol.

How E-Liquid Makers Keep You Safe

The TPD doesn’t just exist to make your life difficult; it also exists to ensure that you aren’t inhaling vapour with ingredients known to be toxic. Before being offered for sale in the UK, an e-liquid must undergo emissions testing. All manufacturers must test their e-liquids for acetaldehyde, acrolein and formaldehyde. Some e-liquids must also undergo testing for tobacco-specific nitrosamines, 2,3-pentanedione, diacetyl, ethylene glycol and diethylene glycol. Even nicotine-free e-liquids must undergo testing.

A Word About Diketones

Flavouring agents such as diacetyl and 2,3-pentanedione are called diketones because their molecules contain two ketone groups. Diketones create buttery and creamy flavours, and diacetyl is particularly well known because it is a common ingredient in artificial butter flavouring for products such as microwave popcorn. Diacetyl is also well known because long-term inhalation of concentrated diacetyl may lead to an irreversible lung condition called bronchiolitis obliterans or “popcorn worker’s lung.” Diacetyl occurs naturally during fermentation and is present in some beers and wines.

Although TPD emissions testing procedures include testing for some diketones, there may still be trace diketones present in any e-liquid with buttery or creamy notes. No vaper has ever been diagnosed with bronchiolitis obliterans. Nevertheless, you should decide for yourself whether vaping buttery or creamy e-liquid represents an acceptable risk.

Using Your Batteries Safely

Vaping Battery Safety

Vaping devices use lithium ion batteries capable of storing and releasing a considerable amount of energy. Although lithium ion batteries are quite safe in normal use, improper handling can potentially cause one to overheat and catch fire.

Charging Your Batteries

To prevent overheating when charging a vaping device, charge the device only using the equipment supplied by the manufacturer. If a device includes a standalone mains charger, use only that charger – even if you have another one that seems to fit. If the device includes only a USB cable, you can charge the device using any computer USB port. If you want to use a USB mains adapter, make sure that the adapter matches the manufacturer’s specifications. Don’t use a USB mains adapter for a tablet or mobile phone. The battery in your vaping device may not tolerate the higher current that a “quick charging” adapter supplies.

Don’t charge your vaping device while you’re sleeping or away from home. As reliable as lithium ion batteries are, they may still rarely overheat even under perfect charging conditions. If you’re in the home when that happens, you can take quick action to prevent property damage. If you notice an unusual smell while your vaping device charges – or the device feels abnormally hot to the touch – disconnect it immediately and bring it outside until it cools down. Stop using the device.

Using Your Batteries

Regulated Vaping Devices

Most vaping devices have internal electronics that monitor conditions such as atomizer resistance, battery voltage and internal temperature. If your device detects a condition that could make vaping unsafe, it’ll alert you with an error message or blinking light. Nevertheless, it is wise to familiarize yourself with Ohm’s law. Using Ohm’s law in conjunction with the resistance of your atomizer coil, you can determine the current that the coil would draw from your vaping device’s battery at a given wattage. Compare that number to the maximum continuous discharge rating of your battery to confirm that your atomizer coil and device settings are safe.

Unregulated Vaping Devices

Although most vaping devices have built-in safety features, there is also a second type of vaping device called a mechanical mod. Mechanical mods are vaping devices with no electronic components. With no internal electronics, a mechanical mod does nothing to keep you safe when you vape. You should not use a mechanical mod unless you’re comfortable checking battery voltage and atomizer coil resistance manually. Mechanical mods are for expert vapers who understand battery safety and are comfortable managing their own batteries.

Battery Damage

If you have a battery with any sign of structural damage such as warps, bulges or dents, discontinue using the battery immediately. If the battery has damage to its outer plastic wrapper, replace the wrapper or ask an expect to do it for you. Do not use a battery with a torn wrapper. The entire metal surface under the wrapper is conductive; even a tiny tear in the wrapper could potentially lead to a short circuit if something touches the metal underneath.

Storing and Transporting Your Batteries

If a metal object with little or no electrical resistance touches the positive and negative poles of a battery, that object will cause a short circuit. You should never carry a vaping battery in your pocket because objects such as keys and spare change can potentially touch the battery’s poles and start a fire. If you need to transport spare batteries, so do in a dedicated battery carrier that covers the batteries’ metal components and prevents damage to the wrappers.

Using Your Vaping Device Safely

As we’ll explain soon, one of the reasons why it is so difficult to ascertain the safety of vaping is because almost no one uses exactly the same combination of hardware and e-liquid. One thing we do know, though, is that most atomizer coils use cotton wicks, and cotton can burn if it’s dry. Getting away from combustion is most likely one of the primary reasons why you switched to vaping; the last thing that you want to do is inhale burning cotton. It is therefore crucial to ensure that you never allow your wick to go dry while vaping.

  • Don’t try to use your tank until it is completely empty. Refill the tank as soon as the e-liquid no longer covers the coil’s wick openings.
  • Watch your wattage settings. If you taste harshness at the end of a long puff, your wick is drying out. Lower your device’s wattage.
  • If you experience constant “dry hits” when vaping, your e-liquid may be too thick to flow efficiently through your atomizer coil’s wick openings. Use an e-liquid with a higher percentage of propylene glycol. “Max VG” e-liquids are only for rebuildable atomizers and atomizer coil assemblies with large wick openings.

Contraindications for Nicotine Use

Aside from the fact that it is powerfully addictive, nicotine is a relatively safe stimulant when you separate it from cigarettes and the products of combustion. There are, however, several health conditions that are contraindications for nicotine use. If one of these contraindications applies to you, you should not use nicotine at all. If you already use nicotine because you smoke, though – and you have been unsuccessful in your attempts to quit – you should evaluate your options with your doctor. If you would continue smoking either way, your doctor may conclude that it would be healthier for you to switch to vaping instead.

Diabetes

Medical professionals have long known of a connection between smoking and elevated blood glucose levels. In 2011, a presentation given at a meeting of the American Chemical Society suggested that nicotine is the component of cigarette smoke that increases blood sugar. In a study conducted by researchers from California State Polytechnic University, it was discovered that nicotine increased the haemoglobin A1c in human blood samples. Since HbA1c levels are a key health indicator in individuals with diabetes, you should not use nicotine at all if you have type 1 diabetes or are at risk of developing type 2 diabetes.

Heart Disease and High Blood Pressure

There is a well-established link between cigarette smoking and an increased risk of heart disease. It is unclear, though, whether using nicotine alone lowers that risk compared to smoking. We do know that nicotine increases heart rate and blood pressure while constricting the blood vessels. Since nicotine impairs blood flow, it can contribute to macular degeneration and reduce the body’s ability to heal injuries. It can also potentially contribute to heart disease or worsen symptoms in those with pre-existing heart conditions. You should not use nicotine at all if you have high blood pressure, chest pains, an irregular heart rhythm, arterial blockage or a prior heart attack.

Hypothyroidism

Cigarette smoking stimulates the production of thyroid hormones. A 2014 study suggests that the sudden decrease in thyroid activity can be so great after quitting smoking that doctors should monitor the thyroid activity of anyone who discontinues long-term nicotine use. Some people who stop using nicotine require supplemental hormones to maintain proper thyroid function.

There is an alternative viewpoint. A 1998 study suggests that nicotine is not the component of cigarette smoke that leads to an overactive thyroid. The study suggests that the smoke itself is what causes the overproduction of thyroid hormones.

If you have any thyroid condition or are taking medication to regulate thyroid function, you should talk to your doctor before switching to vaping.

Impaired Kidney Function

Studies suggest that nicotine causes progressively worsening symptoms in those with kidney damage or disease. If you have impaired kidney function, discuss vaping with your doctor.

Impaired Liver Function

A 2018 study published in “The Endocrine Society” examined the liver health of mice exposed to e-cigarette vapour. The mice were examined after 12 weeks and were found to have gene changes associated with abnormal circadian rhythms and fatty liver development. Although the study’s findings don’t necessarily indicate that vaping is harmful to the liver health of humans, it may be wise to discuss vaping with your doctor if you have any issues relating to hepatic health.

Lung Disease

Whether or not vaping causes lung disease is an unanswered question partly because, as a 2015 review published in “Lung Cellular and Molecular Physiology” points out, studying the effect of vaping on the lungs is like trying to hit a moving target because popular devices and e-liquids never stop changing. It is certain that e-liquid aerosol contains far less chemicals than cigarette smoke. It is also certain, though, that you should not use any inhaled form of nicotine if you already have chronic lung disease.

Pregnancy and Nursing

There is a well-established link between smoking during pregnancy and foetal damage. Smoking during pregnancy increases the risk that the child will have a low birth weight, and there also appears to be a link between low birth weight and lower IQ scores.

A study in India showed a link between smokeless tobacco use and stillbirth. In another study of mothers who smoked 20 cigarettes or more per day, more than 50 percent of new-borns involved in the study required intensive care treatment. Smoking increases the risk of foetal or infant death by 150 percent.

Nicotine use by the mother increases the chance that the child will one day use nicotine, perhaps in part because a small dose of nicotine is present in the mother’s milk. While the risks of vaping during pregnancy aren’t definitively established, it seems safe to say that pregnant and nursing mothers should not consume nicotine in any form – including vaping.

Prescription Medication Interactions

Nicotine causes known moderate interactions with a few prescription medications. We’ll describe those below.

  • Bromocriptine is a dopamine agonist used in the treatment of type 2 diabetes, Parkinson’s disease, pituitary tumours and many other conditions. It also constricts the blood vessels, and nicotine can amplify that effect.
  • Bupropion is an antidepressant used to treat clinical depression. It is also prescribed as a smoking cessation aid. Used in conjunction with nicotine, it can cause an unsafe increase in blood pressure.
  • Ceritinib is prescribed to patients with a specific form of lung cancer. If you use nicotine while taking it, your body may have higher than normal blood-nicotine levels.
  • Ergotamine is a drug that treats acute migraines by causing blood vessels to constrict. Nicotine can amplify the drug’s effect, leading to a dangerous reduction in blood flow. The related drugs dihydroergotamine and ergonovine – and any other ergot-based medications – carry similar risks when used in conjunction with nicotine.
  • Hydroxyprogesterone is a synthetic progestin used to prevent preterm birth and miscarriage. It is also prescribed for birth control purposes. It may reduce the concentration of nicotine in the blood.
  • Telotristat is prescribed to prevent diarrhoea in those suffering from carcinoid syndrome. It may reduce the concentration of nicotine in the blood.
  • Varenicline is a drug that assists with smoking cessation by reducing the pleasurable effects of tobacco use. When used in conjunction with nicotine, the likelihood of side effects such as nausea, vomiting and dizziness is increased.

If you take any prescription medications – particularly the ones listed above – you should consult with your doctor before switching to vaping. The above listed medications are only the ones known to have moderate interactions when used in conjunction with nicotine. Nicotine also has known mild interactions with many other prescription medications.

Ulcer

Chronic nicotine use stimulates stomach acid production, which can aggravate ulcers. If you have an ulcer, you should not use nicotine – particularly if overproduction of stomach acid is the cause of your ulcer.