HOW DANGEROUS IS VAPING

In November 2015 BBC engineer Jonathan Keen was found dead at his flat. The verdict was suicide. But the most shocking thing about the case was how Keem had killed himself. Keem had drunk a toxic concoction of vaping fluid and alcohol. Vaping itself requires inhaling this liquid with each drag - prompting the question, can this craze kill?

Vapes, or e-cigarettes, are battery powered devices often prescribed to smokers as a substitute for cigarettes. They hold a liquid containing nicotine, other chemicals and synthetic flavorings. When users activate the device, the liquid heats up and becomes a vapour. Uniquely for a smoking device, it does not produce smoke when inhaled. This has led to the popular belief that it is much safer than smoking cigarettes. Government health bodies around the world - such as Public Health England - endorse them as a way to stop smoking. But this advice may be unwise in light of recent events. Increasingly horrible stories are emerging about vaping's side effects.

The American Lung Association warns, "There is no way for anyone - healthcare professionals or consumers - to know what chemicals are contained in e-liquids, or how e-cigarette use affect health whether in the short term or the long run." But despite this, figures from the Centre for Disease Control show that around 10% of American adults use an electronic-cigarette, rising to 15% for those under 40. Research by the Karolinska Institute shows the effects of Vaping or the body Scientists got 16 occasional smokers to puff on an e-cigarette just 10 times. Within an hour, subjects experienced a "rapid rise" in their levels of endothelial progenitor cells - this caused huge damage to the inner lining of their blood vessels. It does not end there. Dr. Frank Leone, Associate Professor of Medicine at the University of Pennsylvania, says the cocktail of chemicals in e-cigarette vapour could be covertly destroying human cells. Leone says, "Those chemicals have deleterious effects on the body that may be completely different from the carcinogens in regular cigarettes. We just don't know."

Then, a 2015 study at Harvard University found that chemicals in vaping liquid damage the lungs, creating scar tissue that can block air passages. This can lead to the fatal condition bronchiolitis obliterans. In severe cases, sufferers of this irreversible disease must undergo lung transplants as their ability to breathe becomes restricted. It is most common among veterans who have spent time around burn pits. These are open-air military areas where trash is set aflame, releasing noxious chemicals into the atmosphere. The study suggests that vaping can have the same effect as this.

There has also been an upsurge in vaping-related injuries and deaths in the last five years. These suggest that the impact of the habit may not yet be fully known. The devices themselves can be very dangerous. In January 2017 Idaho native Andrew Hall lost seven teeth and suffered second degree facial burns, when his vape exploded. Doctors had to prize chunks of it from the inside of his mouth and throat. Another victim, Joseph Cavins, lost an eye when his e-cigarette exploded and sent a piece of shrapnel hurtling into his cornea. A British man had a hole burned into his lung by an exploding vape. He had to be hooked up to an oxygen machine and life support. Despite this, he continued to smoke. This itself suggests that the long term effects of vaping as a way to quit smoking are limited.

Vaping liquid has also proved lethal. In 2014 a one year old boy was killed after ingesting the fluid. Stanton Glantz, Professor of Medicine and Director of the Center for Tobacco Control Research states that the vapour e-cigarettes produce is much safer for users than smoke. But Glantz also says a number of people become "dual users", where they continue both habits. This results in much more long term damage than just smoking tobacco. Indeed, vaping may actually reduce smoker's chances of quitting the habit. In one of Glantz's studies, he found that people who started vaping were 30% less likely to give up than those who went cold turkey.

However, the main risks of vaping remain unknown. As a relatively recent activity there remains much work to be done looking at the dangers it poses to users. The injuries that vape users have sustained have been in freak accidents. They are therefore not the standard side-effects of using the devices. Whatever its risks, vaping does appear to be less dangerous than normal cigarettes. In 2015 a Public Health England study found vaping was 95% less harmful than smoking. This is unsurprising given that cigarettes contain around 5,000 toxic chemicals. This is far higher than the three chemical substances found in e-cigarette liquid. A 2015 study of 200,000 Australian smokers revealed that over two thirds of smokers will die from causes linked to the habit. Experts from the American Cancer Society predict that this figure equates to over a billion people in this century alone. Its spokesman John Seffrin says this makes it "the biggest public health disaster in the history of the world, bar none."

We do not know how dangerous vaping is. It can cause agonising and potentially lethal damage to the lungs. The devices could be fatal, and the vaping fluid has claimed at least two lives. However, health scientists agree that vaping is much better for us than tobacco smoking. It may simply be that vaping has not been around long enough for us to have seen its long term dangers.