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Know what you’re inhaling: Key differences between these smoking alternatives

If you’re a smoker, you’re probably already tired of being told about lung cancer statistics and smoking dangers.

As technology advances, so has the smoking industry. There are many alternative methods now, giving smokers’ choices for how they want to inhale nicotine, or gradually move away from it. 

Personal choices aside, what’s most important is that smokers stay educated on the various tools and methods available to them, and the respective differences. In this article, we’ll be taking a look at cigarettes, vapes & e-cigs, heat-not-burn devices, as well as shisha & hookah.

A. Cigarettes

1. The tar in cigarettes do not have the same chemical origins as road tar.

Some would assume that tar in a cigarette is the same as road tar, but this is untrue. When a combustible cigarette is lit and tobacco is burned, tar forms within the toxic smoke, which contains most of the harmful chemicals in a cigarette.

When inhaled, these toxic chemicals coat the cilia (used to keep airways clear in lungs) and that contributes to lung diseases such as chronic bronchitis and lung cancer.

In light of the concerns of tar in cigarettes, some companies have opted to sell Light or Mild versions of combustible cigarettes, which contain less tar in them. However, tests from the National Cancer Institute suggest that Light cigarettes are still as harmful as normal cigarettes.

2. Smoke from the cigarette is the most harmful, not the nicotine

When you smoke a combustible cigarette, you are exposed to up to 7,000 other chemicals such as Acetaldehyde (found in glues), Acetone (found in solvents), Ammonia (found in cleaners), Cadmium (found in batteries), and Lead (found in metal). By lighting up a combustible cigarette, the harmful chemicals and carcinogens will then be released from the smoke.

On the other hand, nicotine, which is found in tobacco plants, is an addictive substance. It can be absorbed into the bloodstream of smokers in 15 seconds. And once absorbed, it stimulates the central nervous system, creating a temporary rush of adrenaline for alertness.

Nicotine by itself is not the primary cause of smoking-related diseases like lung cancer, emphysema and so on. But due to its addictive nature, it keeps the smokers hooked onto cigarettes.

B. E-Cigarettes & Vaping

Topping up the e-liquid of a dripper / Image Credit: VapeClubMY on Unsplash

Both e-cigs and vapes are non-combustible devices. While these two terms are used interchangeably, there are slight differences between them.

In the early days of e-cigarettes, their shape and form resembled cigarettes and in some cases, they were single-use devices too. Some manufacturers even made devices that physically burn combustible cigarettes.

However, e-cigarettes have slowly been transitioned out in favour of vaping devices. Vaping devices come in a few forms but they’re commonly found as cartridges, pods, drippers or tanks. 

A pod device uses pods or cartridges to carry e-liquid, whereas a tank device uses a tank to carry the e-liquid. For drippers, e-liquids are added directly onto the device itself and can be used a few times before needing to be refilled.

3rd from left: Pods are more used nowadays due to their convenience / Image Credit: CDC

1. E-liquids have nicotine, but do not contain tobacco

Pods are usually not refillable and have limited flavours, whereas a tank or a dripper allows the vaper to use the e-liquid of their choice. E-liquids do not contain tobacco. However, e-liquids may contain nicotine.

E-liquids generally contain a mix of ingredients such as water, vegetable glycerine (VG), propylene glycol (PG) and flavourings. 

While nicotine is not present in some e-liquids, other chemicals within e-liquids such as Formaldehyde (found in many household products), Acrolein (created when glycerol is burned), and Benzene (used in lubricants), can still have negative effects on the body.

For example, in 2019, there was an incident in the US that led to the hospitalisation of 2.8k Americans. This outbreak was caused by illicit e-liquid cartridges sold on the black market containing tetrahydrocannabinol (THC) and Vitamin E acetate, which triggered lung inflammation when inhaled.

2. Different types of nicotine in e-liquids.

While both use liquid to store the nicotine, freebase nicotine (used in e-liquids) and nicotine salt (used in pods/cartridges) are different. Nicotine salt can be naturally found in tobacco leaves, while freebase nicotine is nicotine in its purest form.

Freebase nicotine creates a strong throat hit, which mimics the inhale of combustible cigarettes, whereas nicotine salts feel smoother to the throat when inhaling. Thus, pod users might not feel the harshness of nicotine even when used at higher levels, leading to more nicotine intake compared to tank users.

C. Heat-Not-Burn (HNB) Devices 

1. HNB devices do not burn tobacco.

Unlike e-cigarettes, HNB devices are devices that resemble regular cigarettes, but they do not go through the process of burning tobacco. 

Combustible cigarettes burn at 600 degrees Celsius or higher, while HNB devices simply heat the tobacco at a maximum temperature of 350 degrees Celsius. 

2. HNB devices are less harmful than combustible cigarettes.

While the process of smoking is similar, HNB devices claim to be better than combustible cigarettes. Without the process of burning, tobacco is heated in a HNB device which then delivers nicotine vapour to the user. And when users exhale, only vapour is visible, with no smoke.

As most cancer-causing chemicals can only be found when a cigarette is burned, studies show that HNB devices are less harmful than combustible cigarettes.

According to PMI who supported the writing of this article, Dr Thomas McGrath, the global head of professional channels at PMI said studies have shown that as the temperature of tobacco increases, the levels of harmful and potentially harmful constituents also increase.

So, by eliminating combustion and reducing the temperature at which the tobacco is heated to, it will significantly reduce the overall levels of harmful and potentially harmful constituents. In the tobacco heating system aerosol, the levels of these harmful and potentially harmful constituents are on average reduced by 90-95% compared to cigarette smoke.

D. Shisha/Hookah 

1. Shisha & hookah can be more harmful than combustible cigarettes.

A used charcoal on a hookah / Image Credit: Wesley Balten on Unsplash

Some people see hookahs as an alternative to smoking. However, hookah uses charcoal to burn tobacco and this creates a high level of carbon monoxide, and produces cancer-causing chemicals through its smoke. Hookah can also contain nicotine.

Some studies show that a typical hookah session can have up to 1.7x more nicotine exposure and up to 9x more carbon monoxide exposure compared to a single cigarette.

Smoking Is Still Harmful

Despite the many options that are now available for smokers in e-cigs, vape and HNB devices, smoking is still harmful to your health as you are still inhaling chemicals into the body. 

Ultimately, the best option for smokers is to quit. But if you are a smoker who doesn’t want to quit and wants to explore alternatives, it is crucial to know the differences between the alternative tools available to you.

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(UEN 201431998C.)

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