Dear Dr. G,

I understand you are featuring ways to kick bad habits as a New Year’s Resolution for the benefit of better sexual health in men.

I hope to put Dr G on the spot for help to kick my bad habit of cigarette smoking.

I started smoking when I was 16 years old.

Although I have been cutting down on the number of cigarettes I smoke every year, it has still been ten years since I started.

I am sure all that cigarette is not doing my overall and sexual health any good.

I am convinced cigarette smoking can result in ED (Erectile Dysfunction), cancers and heart diseases in the long run.

Although I don’t have problems with erection (yet), I am determined to kick the habit this year and switch to vape as a better alternative.

I have read somewhere that although the e-cigarette itself is not exactly healthy, it is comparatively the lesser of the two evils.

My only concern is e-cigarettes can cause harm to my health, too.

Therefore, I am keen to put Dr G on the spot for some clarification.

Can you tell me what exactly e-cigarette is and what’s the difference with vaping?

Is it true that e-cigarettes contain less toxin and cause less harm?

Do you think it is sensible to use e-cigarettes to stop smoking?

Is there scientific evidence linking e-cigarettes with sexual dysfunction in men?

I have a feeling you are going to tell me my e-cigarette theory is all smoke and mirrors. However, I still look forward to your opinions.

Yours truly,

Vaping Vincent

Electronic nicotine delivery systems (ENDS), also known as e-cigarettes, are battery-powered devices that heat a liquid, creating vapours for inhalation. When e-cigarettes first became available in many countries, the liquids contained nicotine and a range of chemicals to add flavour. Some countries, like Singapore, have entirely banned vaping, while others, such as Australia, require that all nicotine vaping products be purchased only with a doctor’s prescription. For the rest of the world, ENDS are legally accessible.

Vaping is often marketed as a better alternative to smoking cigarettes. When e-cigarettes are used by smokers instead of traditional cigarettes, there is evidence of a slight improvement in an individual’s short-term health. Evidence suggests individuals who use e-cigarettes are likely to be smoking cigarettes, too. Therefore, diseases caused by smoking are unlikely to be reduced by e-cigarettes if cigarette smoking continues. In addition, many diseases take a long time to develop. Therefore, just because there is currently no proof that vaping causes disease, this is not proof that it is safe. Laboratory studies indicate that regular vaping is likely to have detrimental effects on your health, primarily affecting lung function.

Strong public health campaigns and strict regulation in many countries worldwide have seen rates of tobacco smoking almost halve over the last three decades. However, the number of people vaping or using e-cigarettes every day has grown from 6% in 2016 to 9% in 2019, especially among the youth. This trend is sounding alarm bells for many health experts globally. Quitting smoking can be difficult, so the best option is not to vape or smoke at all. Many people use e-cigarettes to try and stop smoking, to reduce the number of cigarettes smoked or to avoid restarting a smoking habit as a gentle cessation strategy. Although evidence suggests ex-smokers who use nicotine e-cigarettes are more likely to not smoke than those who use other nicotine replacement options such as patches, gum, lozenges, mouth sprays, inhalators and intranasal sprays. However, most studies showing this effect have a moderate or high level of bias.

E-cigarettes are also well-known to be addictive. This may impact the relationship and intimacy with partners who do not smoke or vape. There is also plenty of evidence to suggest nicotine impairs normal erectile function and negatively affects male sexual performance. Erectile Dysfunction is twice as common among men who vape every day compared to those who have never vaped. This is likely due to nicotine acting as a vasoconstrictor, resulting in poor circulation to the penis. In addition to impairment of sexual health, e-cigarettes are also noted to have an adverse impact on the reproductive health of men. One Italian study revealed that men who vape for more than two years are shown to have smaller testicles compared to men who do not use e-cigarettes. Other studies also demonstrated that ENDS can also result in male infertility, as sperm quality is noted to deteriorate as vaping continues.

The use of ENDS (Electronic nicotine delivery systems) seems to be associated with erectile dysfunction independent of age, cardiovascular disease and other risk factors. The causative adversity on reproductive health in men is also apparent. While ENDS remain under evaluation for harm reduction and smoking cessation potential, ENDS users should be informed about the possible association between ENDS use and erectile dysfunction and male infertility. Men contemplating New Year’s resolution of smoking cessation by vaping and considering this to be the lesser of the two evils often put Dr G on the spot for his opinion.

His opinion is: “The smoke and mirrors of ENDS is evident. Complete cessation should be the be-all and ENDS-all approach!”