Vaping and lung health: what is the long-term impact?

In 2018, nicotine-containing e-cigarettes were legalised in New Zealand. Since then, vaping uptake has steadily increased, particularly among young people.

“New Zealand has some of the highest vaping rates in the world,” says Associate Professor Kelly Burrowes of the Auckland Bioengineering Institute. “When it first came in, there were no rules. People were allowed to market and advertise it. That’s how it became so quickly established.”

While vaping is believed to be less harmful than smoking due to a lack of tobacco and associated toxins, there is no information indicating it is safe.

“Vaping has less dangerous chemicals than smoking, but it does still have known dangerous chemicals,” Kelly explains. “It also has different chemicals to smoking, like flavouring chemicals. These are the same as the flavouring chemicals used in food typically, but it is not known how safe it is to breathe these in.”

Kelly has an extensive background in smoking-related lung disease research and is now leading a new project supported by The Dines Family Charitable Trust investigating the potential long-term effects of vaping on lung function.

Early studies indicate there are short-term health implications from vaping, including an increase in chronic inflammation, which is a key risk factor for lung disease, and in the risk of chronic obstructive pulmonary disease (COPD), a progressive lung condition linked to smoking. Little is known about the possible effects in ten or twenty years, however – something Kelly hopes to change.

“We wanted to focus on that theory of inflammation and use computer modelling to predict what the long-term health effects of vaping might be before they happen. How will vaping affect how the lungs work?”

Two PhD students begin work on the project this month under Kelly’s supervision. They are collaborating with a group in the UK that has a cell-based model they can use to input rules about how vaping will affect the cells and the immune system. The model then predicts what the airways will look like in the future. They are also using AI machine-based learning to run thousands of simulations and use the data gathered to create AI models of how the lungs might change based on different scenarios. 

Funding from The Dines Family Charitable Trust is pivotal to the research, says Kelly.

“Often the big grants in New Zealand are so competitive. This funding was really important and will make a huge impact to the research that we're doing, enabling two PhD students to do a lot of the new development and research work.”

Through the team’s findings, they aim to highlight the potential harm vaping can cause to lung health and, ultimately, guide people away from the activity. 

“We don’t know how bad it is for people yet. Someone might start smoking in their teens, but they won't actually get lung disease until their fifties. Until there are clear links to disease, it's easy for people to ignore,” says Kelly. “We want to find this out before it happens in the population and try and change the rules.”

To do this, government regulation is needed. Australia’s prescription-only e-cigarette model would be a step in the right direction, says Kelly.

“I know there is a big black market for vaping in Australia, but at least they're sending the right message: that vaping should be for smoking cessation and not for recreational use. Countries like the UK and New Zealand are pretty supportive of vaping in terms of smoking cessation, but they haven't protected those people who didn't already smoke. Now they've created a new generation of people that are addicted to nicotine.”

Kelly is hopeful that the results of the new project will encourage this vaping generation to ditch the e-cigarette for good, before irreversible damage occurs.