In recent years, the rise of vaping and e-cigarettes has created a new frontier in the battle against smoking. While traditional cigarette use has seen a decline from 21.3% in 2022 to 19% in 2023 [i], the allure of e-cigarettes and vaping devices has captivated a younger audience, nearly doubling from 9.8% in 2017 to 14.9% in 2022 [ii]. This shift, however, is not without consequences—both for the smoker and those around them. The shift from conventional cigarette smoking to vaping and e-cigarettes comes with a cost; whilst there’s no direct link to lung cancer, e-cigarettes contain acrolein which can cause acute lung injury, popcorn lung, asthma and Chronic Obstructive Pulmonary Disease (COPD). Acrolein has been linked to changes in cellular Deoxyribonucleic acid (DNA) that can increase the risk of cancer but does not prove that people who vape necessarily will develop lung cancer.
Associate Professor Dr Kow Ken Siong, Clinical Associate Professor, Consultant Respiratory and Internal Medicine Physician at Sunway Medical Centre, Sunway City and School of Medicine and Life Sciences, Sunway University discusses the dangers of smoking, vaping, and e-cigarettes, highlighting the risks to both smokers and their loved ones through secondhand and thirdhand exposure.
Vibrant Flavours and Colours Bring Hidden Dangers of Vaping Among the Young
The increase in vaping and e-cigarette use among young people is concerning. These sleek devices are often promoted as safer alternatives with various flavours, making them appear harmless and trendy. However, this perception is dangerously misleading, leading many into a trap.
However, Prof Dr. Kow is quick to dismantle this facade. He explains. “Vaping and e-cigarette devices heat nicotine extracted from tobacco, along with flavourings and other additives, and users inhale this aerosol into their lungs. While it may eliminate some harmful combustion byproducts, it introduces a new array of chemicals, including various unregulated chemicals from questionable sources ranging from cleaning agents to pesticides and even methanol, one of the main ingredients for rocket fuel, which may also be very harmful.”
Recent studies have also linked vaping and e-cigarettes to severe lung injuries, increased risk for tobacco and other substance use, mental health problems, pulmonary and cardiovascular disease, and unintentional injuries among adolescents [iii].
Prof Dr. Kow emphasises that starting smoking young has greater health impacts, as lungs mature at about 20-25 years old. “With vaping, we are treading on dangerous grounds where youths unwittingly are guinea pigs in this uncontrolled experiment,” Prof Dr. Kow asserts.
Secondhand Smoke from Cigarettes, E-Cigarettes or Vapes Could Silently be Risking your Loved One’s Health
“Many young smokers and vapers operate under the misconception that their choices affect only themselves. However, the reality is starkly different. Secondhand smoke are silent assailants, infiltrating the lungs of those around them,” shares Prof Dr Kow
Secondhand smoke, a combination of smoke from the burning end of a cigarette and the smoke exhaled by smokers, contains over 7,000 chemicals, hundreds of which are toxic and about 70 that can cause cancer [iv]. Vaping, often marketed as a safer alternative, isn’t exempt from scrutiny. “E-cigarette vapour contains nicotine, ultrafine particles, and volatile organic compounds,” Prof Dr Kow explains. “While it might lack some harmful chemicals found in traditional cigarettes, it’s far from benign.”
Children and pregnant women are particularly vulnerable to the effects of secondhand smoke, which can lead to respiratory infections, sudden infant death syndrome (SIDS), and poor cognitive performance [v]. Prof Dr Kow emphasises, “Imagine a child developing asthma or an elderly family member facing cardiovascular issues, all because of passive exposure. It’s heart-wrenching.”
The Lingering Menace of Thirdhand Smoke
Furthermore, the often-overlooked threat of thirdhand smoke extends beyond the immediate dangers of secondhand exposure. This residue, which contains nicotine and chemicals, clings to surfaces for months, releasing toxins and carcinogens [vi].
“Thirdhand smoke embeds itself in carpets, furniture, and even clothing. Over time, these residues can react with indoor pollutants, forming carcinogenic compounds,” Prof Dr Kow notes. This lingering menace poses risks, especially to infants who crawl on carpets or individuals who spend extended periods in contaminated environments that contain more than 200 chemicals [vii]. “Cleaning or airing out rooms isn’t sufficient,” he warns. “Comprehensive measures are required to eradicate these toxic remnants.”
As parents and individuals, awareness is the first step towards change. Prof Dr. Kow advocates for comprehensive education campaigns targeting the youth and the general public across all ages. “We need to debunk myths and present hard facts, especially as parents, when educating children and adolescents about the dangers and contents of these devices,” he says. “Everyone should play a role and must come together to communicate the seriousness of the situation.”
Moreover, he stresses the importance of creating smoke-free and vape-free environments to help prevent the risks of second-hand and thirdhand smoke exposure. “Homes, cars, and public spaces should be sanctuaries. We have seen other countries implementing smoke-free policies with success that has shown very positive results that are encouraging [viii]. At the end of the day, protecting our loved ones from these unseen threats is a collective responsibility.” Prof Dr. Kow emphasises.
Smoking and Vaping Cessation is Possible
There are several effective treatment options for smoking cessation, including nicotine replacement therapies (such as patches, gums, and lozenges), prescription medications, and behavioural counselling which may increase the chances of successfully quitting smoking and help young adults [ix].
Prof Dr. Kow shares, “Quitting smoking can be challenging, but with the right support and treatment plan, it’s achievable. I encourage anyone looking to quit to consult with their doctor, who can help tailor a cessation plan that best suit their needs and improves their chances of long-term success.”
Prof Dr Kow’s words resonate deeply: “Every puff sends ripples far and wide, impacting lives we may never realise. Let’s embrace our role as protectors of our well-being and those of our loved ones.”
The Heart, Lung & Vascular Division at Sunway Medical Centre in Sunway City offers specialised care with advanced tools for lung, heart and vascular diseases. Established in 1999, it is Malaysia’s largest private quaternary hospital. Celebrating its 25th anniversary, it is the first private hospital in Malaysia to earn three major accreditations, including the Joint Commission International’s Gold Seal of Approval®.
The hospital has also received Fost & Sullivan Malaysian Hospital Market Leadership Award 2024, Healthcare Asia Awards, Reader’s Digest Trusted Brand 2024, and is listed among Newsweek’s World’s Best Hospitals 2024.
