E-cigarettes may change DNA, but the risk of smoking is much greater

According to a paper recently published in the journal Nature, e-cigarette users experience DNA changes that are similar to changes in smokers—though not so obvious.

But crucially, this evidence is based on a small number of people checking their DNA changes at the time, similar to creating a snapshot, without considering any potential changes in e-cigarettes or smoking behavior in the future. The study did not provide real-world evidence of diseases related to e-cigarettes.

It is commendable that the study attempts to distinguish the effects of e-cigarettes from the damage caused by smoking. This is difficult because most e-cigarette users may be former smokers.

An important result of this analysis, which is somewhat hidden in the paper, is that smokers’ damaged genes are about 7.4 times higher than e-cigarettes. Therefore, what this study found is what we already know: e-cigarettes are not completely risk-free, but they are much less risky than smoking.

Transcriptomics (the study of “gene reads” in cells) used in this study is a promising field for exploring the molecular mechanisms and potential processes that lead to cancer. However, it cannot currently be used to accurately predict future cancer risks.

The study recruited relatively few people, but it did not represent the population. And it does not consider other lifestyle habits that may affect the measurement, such as drinking.

Studies have shown that switching from smoking to e-cigarettes can bring benefits, such as improving respiratory symptoms and lung function in asthma patients, or improving predictive indicators such as vascular function in cardiovascular disease.

Other studies have shown that compared with current smokers, e-cigarette users who have ever smoked are exposed to much less toxins. It is important to review all the evidence supporting the harm reduction effects of e-cigarettes as a smoking alternative.

Studies that do not examine the direct clinical effects can easily be interpreted and reported as evidence of health damage. A headline in the “Daily Mail” stated: “Research claims that e-cigarettes can damage DNA like cigarettes and increase the risk of cancer.” Although the second part of the title provides a balance-“but it’s not as bad as traditional smoking”, the damage to public perception may have been done.

No one claims that e-cigarettes are risk-free. Inhaling anything can cause DNA changes, which increases the risk of disease

No one claims that e-cigarettes are completely risk-free. Inhaling anything can cause DNA changes, which increases the risk of disease. For example, inhaling the fumes of diesel cars has been shown to cause DNA changes. In the public interest, the focus should be on reducing harm, because it is impossible to prevent all harm.

Many people rely on nicotine physically. People may first use nicotine through smoking, or in less common cases, may start using nicotine through e-cigarettes. Once dependent, it is difficult to quit. If you try, you will suffer unpleasant withdrawal symptoms and experience cravings.

But some people, especially with support, can overcome nicotine dependence. Others find it more difficult or don’t want to stop. For these people, public health doctors must encourage smokers to use nicotine in a way that reduces harm through e-cigarettes or nicotine replacement products.

The damage to people’s health caused by smoking nicotine is huge. The World Health Organization estimates that tobacco causes more than 8 million deaths each year.

Reporting sensational headlines based on complex research is irresponsible. These studies actually do not show any real-world harm, especially when compared to the huge harm of smoking.