The vaping research conundrum

When lung researcher Morgan Seal was a Masters student and tutoring maths in her spare time, she noticed her young students would sometimes mysteriously go missing.

The girls were sneaking out of class so they could go vape. It shocked and worried her – that teenage girls who had no history of smoking were taking up vaping. She wondered what it was doing to those young lungs – and what it might do in the future.

But there’s a problem. Because vaping is relatively new – the first e-cigarettes containing nicotine arrived in New Zealand in 2018, but they didn’t really get popular until seven or eight years ago – we can’t yet look at the long-term impact of vaping on actual lungs, Seal told Jonny Vahry in an interview for bFM’s Ready Steady Learn show.

Now Seal is helping find out what the impact of vaping could be in the future, using mathematical modelling methods. Her work is contributing to developing digital twins of the lungs. Working under Associate Professor Kelly Burrowes in the Lungs and Respiratory Group at the Auckland Bioengineering Institute (ABI), Seal is looking at vaping and the damaging inflammation in the lungs and airways, including how chemicals travelling in the lungs during vaping might exacerbate conditions like asthma.

“There’s no data about what the effects of vaping are going to be in 10, 20 years time, she says. “But at ABI we can put together mathematical models where you take the physiology of the lungs [how the lungs work] and put it into a computer, then you can investigate the physiology that way.”

Digital twins also make it possible to check out the many variables that make research into vaping so complicated, she says.

For a start there are all the different flavours, each with their different chemical profile and potential for damage. Then there’s the temperature variation – different e-cigarette models vaporise at different temperatures and that affects what sort of chemical reactions are occurring in someone’s body.

"And there’s also something called ‘puff topography’, which is how long and how deep you breathe in when you’re vaping – that is, how much of those chemicals are getting into your lungs, and how far into the lungs they are going.”

Each different individual variable has the potential to alter the impact of vaping on someone’s lungs, Seal says. And that’s another reason why it’s difficult to do comparative research on real people who vape. 

“It’s why mathematical modelling is so useful because we are able to study vaping in a standardised way.”

Associate Professor Kelly Burrowes leads the vaping research team at the Auckland Bioengineering Institute. She says research shows vapes contain toxic chemicals, although there are fewer of them than in cigarettes and they are present at lower concentrations.

But that doesn’t mean there are no harmful health impacts.

“Our research is testing several hypotheses to determine whether vaping leads to the same/similar health impacts as smoking,” she wrote in a Newsroom article in May entitled “Vaping and how to stop another chemical generation."

“This includes studying inflammation (the body’s normal defence mechanism), lung lymphatics (which coordinate the immune system response of the lungs) and cardiovascular impacts… Our current research is aiming to predict the long-term health effects of vaping before they become widespread in the rapidly growing vaping population.”

World leading, but not in a good way

Already the numbers are worrying. Latest figures show New Zealand has one of the highest youth vaping rates in the world, with 18 percent of 14 to 15-year-olds reported to be regular vapers. This compares with overseas studies which found, for example, 7.6 percent of UK 11 to 17-year-olds and 5 percent of New South Wales 14 to 17-year-olds reported vaping.

“Though e-cigarettes have been welcomed into New Zealand as a smoking cessation aid, there has been an unexpected uptake of vaping by never-smokers,” Burrowes says. Among daily vapers aged 18-24, 37 percent are never-smokers and in those aged 15-17, the proportion of never-smokers is even higher at 76 percent. 

“Māori are also over-represented in vaping prevalence rates, with one survey showing that a quarter of 14 to 15-year-old Māori females are vaping daily.”

Morgan Seal thinks back to her maths tutoring days and worries about those ‘missing’ girls and the impact of vaping on their health, and also on Aotearoa’s healthcare system in the future.

“Since the biggest uptake is in teenagers and young adults this is something we are going to see reflected in our healthcare 10 or 20 years down the line, if there are more and more illnesses associated with it.

“We know if you vape you are more likely to have asthma, and we also know vaping makes these conditions worse. We know, for example, you are more likely to die as a result of vaping if you have asthma. “But we don’t know whether vaping causes lung disease, because we don’t have enough data.

“We need more information.”