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Is Low Nicotine A Risk?

A recent newspaper article has suggested that vaping e-liquids with higher levels of nicotine is less harmful than using low-nicotine vapes. This is certainly attention grabbing as it’s the opposite of what you might expect. However, like most sensational headlines about vaping, the reality is much less dramatic.
To understand the newspaper article, we need to look at the research it was based on. How was this research carried out, how accurate is it likely to be and what were the conclusions?

The research involved a small group of just twenty vapers. Over a four week period these participants alternated between vaping high and low nicotine e-liquids each week. The researchers found that participants using e-liquids with low nicotine levels were more likely to vape more often and more intensely, increasing their exposure to e-cigarette vapour. While participants using higher levels of nicotine didn’t use their devices as frequently, meaning they had less exposure.
This suggests that e-liquids with low nicotine levels are used more frequently by vapers craving nicotine. Nicotine is highly addictive and giving it up is difficult and one of the main reasons why smokers turn to vaping in the first place. However, the research didn’t show that vapers who use e-liquids more frequently had higher levels of dangerous chemicals in their systems.
So, e-liquids with low-nicotine levels aren’t more harmful than high-level juices, as the newspaper headlines suggested. Instead they simply fail to satisfy the nicotine craving that many ex-smokers have to deal with, encouraging some people to vape more frequently.
One of the main problems with this study is the small sample size. There were only twenty participants, studied over a four week period, this means that the results are unlikely to be true of all vapers.

Research

The headlines come from a small study into the effects of nicotine strength on vaping behaviour and exposure to harmful chemicals. The research was funded by Cancer Research UK, published in the journal Addiction and carried out by London South Bank University, Queen Mary University of London, and other institutions.
Most people take up vaping when trying to quit smoking, which means that a lot of vapers start with nicotine e-liquids to help deal with withdrawal. Over time many vapers lower the level of nicotine in their e-liquids. But reducing the level too quickly can make it harder to give up cigarettes or encourage vapers to vape more intensely to supply the amount of nicotine their body craves.
The researchers were trying to find out if lower levels of nicotine resulted in more intense vaping. And if this increased vaping changed the way solvents in e-liquids break down, potentially releasing more dangerous chemicals.

How the research was carried out

The study used a group of twenty vapers who had given up smoking and were used to high levels of nicotine. These twenty participants were studied over four weeks as they vaped low and high nicotine e-liquids, alternating between high and low each week.
The duration of use and number of times participants drew on the atomiser was recorded and questionnaires were used to track withdrawal symptoms and the desire to vape. Participants also had their urine analysed for signs of the potentially carcinogenic chemicals formaldehyde and acrolein.

Results

The researchers found that participants using e-liquids with low nicotine levels were more likely to vape more often and more intensely, increasing their exposure to e-cigarette vapour. While participants using higher levels of nicotine didn’t use their devices as frequently.
Participants also reported more withdrawal symptoms and that their desire to vape was stronger while using low-nicotine e-liquids. Urine analysis showed no difference in the levels of acrolein and, while the amount of formaldehyde was higher when using low-nicotine e-liquids, the difference wasn’t statistically significant.

Limitations

This study was small scale, with only twenty participants who were all used to high levels of nicotine which means the results may not be an accurate representation of vapers in general. The participants struggled with low-nicotine e-liquids, having more withdrawal symptoms and using more frequently to try and satisfy their cravings. But this could be because they are used to higher levels of nicotine, not all vapers will have the same reaction.
The study was also short, lasting only four weeks. Participants alternated between high and low nicotine strengths for one week periods, which may not have been enough time to accurately judge how their bodies adapted. Participants were also aware of the nicotine strength of the e-liquids they were vaping, which may have affected their behaviour.

What this means

Participants of the study vaped more frequently when using low-nicotine e-liquids, but the levels of formaldehyde and acrolein found in their urine was not significantly higher. More research is needed to verify the findings of this small, short term study.
Vapers who still crave high levels of nicotine will struggle using low-nicotine vapes and they can end up vaping more or going back to cigarettes. And vapers without the same cravings won’t have the same problems with low-nicotine e-liquids.
If you’re using vaping to help quit smoking, finding the right nicotine level is important. Starting with a nicotine level that’s too low or reducing the nicotine level too quickly will make it harder to satisfy the cravings that come with quitting tobacco products. And starting with nicotine levels that are too high creates problems too as it can worsen the addiction or cause increased withdrawal symptoms.

Research has shown that vaping is significantly safer than smoking and medical organisations like Public Health England agree with the findings that vaping is 95% less harmful than cigarettes. This doesn’t mean that vaping is completely risk free, but it’s important to remember that vaping with nicotine, like other nicotine replacement therapies, has been shown to help smokers quit the much more harmful smoking for good.

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