The health implications of smoking cigarettes have long been studied and the results of the research have caused many to take action toward quitting the habit and have likely stopped many from starting it. But for some and more recently, the compromise they’ve made is to smoke electronic cigarettes, or e-cigarettes, instead.
While the liquid used in these devices still contains nicotine to help ease the desire for an actual cigarette, “e-cigs,” such as the popular brand JUUL, use electricity to vaporize the liquid and create a smoking effect that is supposed to be less harmful to the body than the smoke inhaled while smoking traditional cigarettes.
But is it actually less harmful? That’s what recent Salus Physician Assistant (PA) Studies alumni Eric Nguyen, MMS ‘21, set out to find in the research for his capstone project this past fall titled, “Does the use of electronic cigarettes pose the same cardiopulmonary risks compared to traditional cigarette smoking?”
“That's the new wave, that's what everyone’s doing,” Nguyen said of e-cigarette vaping. “But then the question just kind of goes back to, is it actually as good or is it as bad as cigarettes? Everyone seems to be blowing it off saying, ‘It's not the same as cigarettes, it's not as bad.’ So that's why everyone's doing it - I just kind of wanted to get to the bottom of it.”
Nguyen, an Oregon native who made the trip across the country to attend the University’s College of Health Sciences, Education and Rehabilitation, said he wanted to do a capstone project at the end of his academic program that was more on the trendy side rather than something very technical. Having both friends and family who either vape or smoke cigarettes also brought the topic close to home for him and increased his interest.
 Eric Nguyen, MMS ‘21
But it was an experience in one of his first classes as a PA student at Salus that solidified what he wanted to research for his capstone.
“I was actually in my first semester when I was in Physical Diagnosis (class) and we were just doing some practice histories, and one thing that stuck with me, even throughout graduating, was when we were collecting the social history,” he said. “One thing that I had asked was just, ‘Oh, do you drink alcohol? And, do you smoke?’” He went on to explain that's where the questions begin and end. It was at then that the professor overseeing the course pointed out one important thing: in her experience, one thing you should clarify is to mention electronic cigarettes because some people omit that information just because they don't equate it to cigarettes. “So then, although they may tell you, ‘Oh no, I don't smoke.’ But in actuality they're vaping, but then they don't say that. So I was like, ‘Oh, that's kind of a good point,’” he said.
Clarifying whether a patient smokes cigarettes or vapes is something Nguyen said stuck with him throughout his clinical rotations and is something he plans to always do as part of his patient care intake. He sees this type of preliminary screening becoming more commonplace in the medical field moving forward, but believes there is still a hesitancy from some practitioners to do so because of the lack of information available about the effects of vaping.
It’s Nguyen’s hope that as more information becomes available such as the data he presented in his capstone project more medical professionals will feel comfortable inquiring about their patients’ vaping history.
“I stated at the beginning of my presentation that this kind of education is really good for providers and patients just to be more informed about the topics,” he said. “You can make decisions for yourself or for your patients, you can help them, and guide them through their options. And, I had an article in my paper about how certain medical professionals will kind of avoid the topic (of vaping) just due to lack of information. So they don't feel as comfortable talking about that kind of thing. But with this kind of information, we can feel more comfortable to kind of help patients out.”
The reason Nguyen believes it’s important to collect a more comprehensive patient history about smoking and vaping is because it’s widely believed in the medical field that while vaping may be less harmful than smoking, it’s still not safer than abstaining from both practices.
 person holding vape and cigarettes
According to Johns Hopkins Medicine, Vaping is less harmful than smoking, but still not safe. E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create an aerosol that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic.
The findings of Nguyen’s research aligned with this information. But when drawing conclusions on the comparison between vaping and smoking, Nguyen wanted to make it clear that long-term effects of e-cigarettes are still, for the most part, unknown.
While there are certainly still questions in that regard, Nguyen’s research and similar studies show the ingredients of “vape juice” should be less harmful to the body than that of traditional, tobacco-filled cigarettes.
“Cigarettes contain an enormous amount of nicotine as opposed to the JUUL pods and things like that,” he said. “I think I've read somewhere that claims one pod is the equivalent of one pack of cigarettes, which actually is not correct.”
After conducting this research, his solidified conclusion was electronic cigarettes definitely are not as bad as cigarettes. They don't have the tar and the carcinogens that cigarettes have and they are a good alternative for people that already smoke cigarettes. “But I guess, at the end of the day as well, when compared to not smoking at all, it's definitely not good for you,” he said. “But if you had to pick the lesser of the two evils, electronic cigarettes would definitely be the better one.”