For years, Andy Yang was one of the 300 million-odd Chinese who smoke cigarettes. “I used to cough badly at night, and I couldn’t run more than 50 meters,” the 33-year-old Shanghai resident told Sixth Tone.
More than 1 million Chinese die prematurely due to smoking each year, and Yang knows of some of the health risks associated with the habit. But quitting, he said, is no easy feat. The only way he was able to toss out his cigarettes was by replacing them with a vaporizer, a battery-operated device that falls under the same category as e-cigarettes because of the way it emits vaporized nicotine that is inhaled by users.
Scientific research has also shown that “vaping,” as it is called, can help people quit smoking. In a study by the Onassis Cardiac Surgery Center in Greece, 23 healthy smokers were asked to use e-cigarettes instead. Twenty who made the switch were able to substitute vaping for smoking conventional cigarettes.
Cotton wool is used as a wick inside a vaporizer at Shanghai Vape, October 2016. Grainne Quinlan for Sixth Tone
As health awareness increases in China, the number of vapers like Yang is also said to be rising, as many people believe e-cigarettes and vaporizers are healthier alternatives to conventional nicotine consumption.
But while the devices can help people quit smoking cigarettes, they might just substitute one evil with another, the World Health Organization warned earlier this week. At a meeting of the 180 countries that have signed the Framework Convention on Tobacco Control, which come to a close today, the WHO warned that the health risks of vaping are still unknown.
Electronic smoking devices are “unlikely to be harmless, and long-term use is expected to increase the risk of chronic obstructive pulmonary disease, lung cancer, and possibly cardiovascular diseases, as well as some other diseases also associated with smoking,” the WHO said in an August report presented at the meeting.
The WHO added that it is simply not clear what chemicals e-cigarettes release — only that they administer nicotine to the user in a generally slower manner and at a lower dosage. Although the health effects are likely lower than those associated with normal nicotine consumption, there is no reliable research to support claims that vaping is “safer.”
A Hong Kong Baptist University study recently detected several carcinogenic hydrocarbons that are released from smoking e-cigarettes, which led the municipal Council on Smoking and Health, which commissioned the study, to call for a city-wide ban on e-cigarettes.
Countries that signed the tobacco control framework, including China, should regulate e-cigarettes and vaporizers, “taking into account the need to protect human health,” the WHO’s Beijing office told Sixth Tone in an email.
Currently, however, the market remains unregulated. Ahead of Singles’ Day on Nov. 11, China’s top holiday for online shopping, internet vendors are promoting deals for e-cigarettes and vaping equipment, with ads saying, “Big smoke,” “No oil leak,” and “Long duration.”
Last year, domestic e-cigarette brands enjoyed fast growth, according to market research firm Euromonitor’s 2016 findings.
The global market is already worth $10 billion, and China currently only accounts for a small proportion of that figure. The Asia-Pacific region as a whole is expected to hit its highest annual growth rate between now and 2021.
“Everyone in China knows that smoking is unhealthy,” Adhi Nugroho said as he inhaled from a vaporizer at a Shanghai bar that resembles a café but is actually a meeting point for vaping enthusiasts.
While about 80 percent of Chinese were aware of the increased risk of lung cancer among smokers, only around 30 percent knew that smoking is also linked to strokes, according to China’s 2015 Adult Tobacco Survey. Over the years, awareness of the dangers of smoking has slowly increased, partly thanks to public education campaigns, social media advocacy, and a general realization of the importance of health for one’s general well-being.
But the same awareness does not exist for vaping. In fact, secondhand aerosols from vaping might actually be worse than secondhand smoke from conventional cigarettes, as levels of toxic metals nickel and chromium were found to be higher, the WHO said. But those risks, too, are still largely unknown to China’s vapers like Li Jia, who smokes cigarettes in private but prefers to vape in social settings. “I switched to vaping so I wouldn’t harm my friends and their children with secondhand smoke,” she said.
With contributions from Li You.
(Header image: Niko, an employee at Shanghai Vape in Xintiandi, exhales smoke from a vaporizer, October 2016. Grainne Quinlan for Sixth Tone)