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SINCE e-cigarettes were launched just over a decade ago, their popularity has soared. Some 3.6 million people in the UK and more than 10 million in the US are vapers. But then came the horror stories. In the past few months, have been linked to e-cigarette use in the US, where health officials are now warning against vaping.

The US Centers for Disease Control and Prevention (CDC) says the only way to ensure you aren鈥檛 at risk while the problem is being investigated is by . But UK health bodies seem to disagree, with the statement that vaping is 鈥�95 per cent safer than smoking鈥� 鈥� taken from a report by Public 午夜福利1000集合 England 鈥� widely repeated. So how safe are e-cigarettes? Why has the UK not seen the same health problems as the US? And are we unnecessarily exposing another generation to nicotine addiction?

鈥淚t鈥檚 such a complex, rapidly moving landscape that it鈥檚 difficult for people to keep track,鈥� says Linda Bauld at the University of Edinburgh, who has advised the UK government on tobacco control.

E-cigarettes are handheld, battery-run devices that vaporise 鈥渆-liquids鈥�. These typically contain nicotine, along with other chemicals and sometimes flavourings, but they are free from the tar found in tobacco cigarettes.

Bauld highlights two key issues with e-cigarettes: the current rash of health problems and users鈥� age.

So far, every US state apart from Alaska has reported cases of lung injury linked to vaping. There is no specific test for such injuries, but symptoms include . Some people have developed a form of pneumonia caused by substances from e-liquids getting into their lungs.

鈥�2200
The number of recent lung injury cases linked to vaping in the US鈥�

E-cigarettes have been available for about 10 years, so why are we only seeing these health problems now? The cases may all be linked to a chemical typically found in illicit products, according to . Among a sample of 867 people diagnosed with vaping-related lung injury, 86 per cent reported having vaped tetrahydrocannabinol (THC) 鈥� the chemical that gives cannabis users a high. These THC-containing e-liquids were probably obtained from the black market, says Bauld.

It is unlikely that THC itself is to blame for lung injury 鈥� we haven鈥檛 seen the same symptoms in cannabis smokers, for instance. But other chemicals are often used with THC in e-cigarette liquids. The CDC has flagged vitamin E acetate, a synthetic form of the vitamin, as . In a recent investigation, it was found in taken from 29 people with vaping-related lung injury.

The eight cases of confirmed or probable lung injury related to vaping in Canada are likely to be connected to vitamin E acetate-containing products from the US, says Bauld. That might also explain why there hasn鈥檛 been the same spike in cases in the UK. Under EU law, many e-cigarette ingredients 鈥� including vitamins 鈥� are banned as a precaution.

That isn鈥檛 to say that no problems have been reported in the UK. Any suspected health effects must be passed on to the Medicines and 午夜福利1000集合care products Regulatory Agency. As of 15 November, the agency has received 74 notifications describing 216 health effects that may be linked to e-cigarettes, although these have yet to be confirmed. Most of them relate to breathing and lung disorders.

Regarding the age of users, in the US, most lung injuries have been in people under the age of 24. A recent survey estimates that . Manufacturer Juul Labs has come under scrutiny for developing flavours that might appeal to young people and marketing its products as being fashionable.

School advertising

In September, the US Food and Drug Administration , raising concerns about it having marketed its e-cigarettes in a school using terms like 鈥渢otally safe鈥� and 鈥�99 per cent safer than cigarettes鈥� without authorisation from the agency. Within a few weeks, the company鈥檚 CEO had stepped down, and the firm .

All of the researchers contacted by New Scientist agreed that e-cigarettes shouldn鈥檛 be used by young people or people who have never smoked. Researchers in the UK said that because e-cigarettes lack the tar found in tobacco cigarettes, they truly are 95 per cent safer, with the remaining 5 per cent of risk down to low levels of toxic substances in e-cigarette vapour, which may have long-term effects for health.

In the US, however, the CDC is warning that nicotine can harm the developing adolescent brain. And a US survey published last year found that . This trend hasn鈥檛 been found in the UK, however.

At the same time, there is evidence that e-cigarette vapour may be more harmful than it appears 鈥� for adults as well as young people. Robert Tarran at the University of North Carolina criticises the 鈥�95 per cent safer鈥� figure because it was based on a comparison of the number of chemicals in e-cigarette vapour and tobacco smoke. 鈥淭he number of chemicals is irrelevant,鈥� he says. 鈥淣o one knows what concentration these chemicals are reaching in the lungs.鈥�

Tarran鈥檚 team has found markers of . He says these markers are the same as those found in the lungs of people with emphysema, a condition that causes shortness of breath and shortens life expectancy. 鈥淚f you vape over a lifetime, you probably have a high chance of getting it,鈥� says Tarran. 鈥淔rom everything I鈥檝e seen in the lung, it doesn鈥檛 seem to be safer than smoking.鈥�

E-cigarettes haven鈥檛 taken off among young people in the UK as they have in the US. A survey published in June suggests that 84 per cent of young people in the UK . Over half who have used them have done so just to 鈥済ive it a try鈥� 鈥� only 1 per cent said they did so because it 鈥渓ooks cool鈥�.

The difference may come down to the image of e-cigarettes. In the US, Juul Labs has marketed them as a trendy lifestyle product.

But in the UK, young people are more likely to consider e-cigarettes as an aid to quitting smoking, says Bauld. That might have something to do with the EU imposing much stricter rules on their advertising. Television, radio and magazine ads are banned, for instance.

鈥淓very US state apart from Alaska has reported cases of lung injury linked to vaping鈥�

There is an argument that classifying vaping products as medical devices could shift their image in the US, too 鈥� although this may bring other problems (see 鈥�Medical e-cigs鈥�).

In the meantime, e-cigarettes may be a useful tool for people who are trying to stop smoking. An influential study published earlier this year concluded that the use of e-cigarettes seems to . And, in the UK at least, it appears to be cheaper than these other techniques, too, says Sarah Jackson at University College London, who conducted .

Epidemiologists think that smoking rates are falling faster in the UK than in Australia at least in part thanks to the popularity of e-cigarettes in the UK. They are banned from being made or sold in Australia.

So, for smokers, switching to e-cigarettes as a way to give up smoking seems like a sensible choice. But anyone else might want to consider the unknown health risks of vaping. 鈥淭here鈥檚 a lot we don鈥檛 know,鈥� says Tarran.