E-cigarettes more harmful than thought: study

While it will still take decades to come to a definitive answer regarding how harmful e-cigarettes are, "it is now clear that the product is more harmful than initially assumed", according to a study by the Trimbos Institute. E-cigarettes lack many of the toxic combustion products present in tobacco, but harmful substances are still released in the vapor, the Institute concluded.

The Trimbos Institute studied national and international scientific literature and policy documents on the e-cigarette on behalf of the Ministry of Public Health. The researchers concluded that while vaping is not as harmful as smoking, it is still harmful. Harmful substances like nicotine and propylene glycol are released in the vapor, as well as traces of toxic and carcinogenic substances - "which can have adverse health effects". 

According to Trimbos, the most recent figures for the Netherlands show that 3.1 percent of adults used an e-cigarette in 2018, ranging from sometimes to daily. They mainly vaped as a support to stop smoking, although almost three quarters still smoked tobacco cigarettes too.

In 2017 over a quarter of teens between the ages of 12 and 16 had vaped at least once. "For this group, there is increasing evidence that the e-cigarette is a stepping stone to tobacco cigarettes," the Trimbos Institute found. Teens especially like the many flavors e-liquids come in, according to the Institute. Vaping products are also easily available and relatively cheap. 

"Because lung diseases, cardiovascular disease and cancer often take decades to develop, it is only possible to determine the actual long-term effects of the e-cigarette on health over a long period," the Trimbos Institute said. But to err on the side of caution, the Trimbos Institute advised the government to discourage the use of e-cigarettes and to restrict their use to smokers who really need help to quit, provided that proven effective tools like coaching do not work for them. 

In a letter to parliament, State Secretary Paul Blokhuis of Public Health said that he has already taken measures to combat the use of e-cigarettes, but is looking into what more needs to be done, Leeuwarder Courant reports. "The latest insights from Trimbos - concerning, among other things, harmfulness, attractiveness for young people, and the precautionary principle - raise the question whether additional (legal) measures should be considered," he said.