Vaping harms overstated in viral video

A video on TikTok with 2.3 million views overstates the harms of vaping, making several exaggerated or false claims around nicotine content, brain chemistry and heart attack risk. The video states “Stay away from Geek Bars [...] Send this to someone who needs to see this and potentially save a life”. It also appears on Instagram.

Vapes, or e-cigarettes, were used occasionally or daily by 7.7% of over-16s in Great Britain in 2021, an increase on previous years. Current smokers and ex-smokers are more likely to use the products, with just 1.5% of people who have never smoked doing so. 

Vapes heat up ‘e-liquid’ (generally containing nicotine, the addictive drug in tobacco) to a vapour people can inhale, producing less damaging substances than are generated by the burning of tobacco in a cigarette.

We approached the ‘Fatlossfoodie’ account which first posted the video on Tiktok for comment, as well as the ‘loudeanie’ account which posted the video on Instagram, but did not receive a response ahead of publication.

Just one of these bars is equivalent to 125 cigarettes

The video shows a picture of a standard Geek Bar and claims it is equivalent to 125 cigarettes.

But this figure appears to stem from news reporting about Geek Bar Pro devices, not standard Geek Bar devices.

Pro devices are no longer listed on the company's website, but it would appear that in February 2021 the company made this claim itself, based on the number of puffs (1,500) you could take from a Pro device. 

By contrast, Geek Bar claims you can take 575 puffs from a standard device, which it says is equivalent to 48 cigarettes. 

The number of puffs doesn’t tell you much about how much nicotine is absorbed though, as this depends on the strength of the e-liquid being vaped. 

Geek Bar’s standard device comes in a variety of nicotine strengths (though the strongest version is illegal in the UK, and Geek Bar’s website states “sale only allowed in law permitted area”).

Its UK-compliant versions appear to contain up to 20mg of nicotine per ml (the maximum under UK law), and with a capacity of 2ml would appear to contain up to 40mg in total. 

Manufactured cigarettes contain around 10–15 mg of nicotine per cigarette with roughly 1 to 2mg of nicotine per cigarette systemically absorbed. 

The UK Vaping Industry Association (of which Geek Bar is a member) told Full Fact that comparisons of vapes to cigarette equivalents are difficult and not standardised. It told us that nicotine content in cigarettes varies widely, as does nicotine absorption from the two methods. Measurement of puffs is also not standardised, and many people use vapes differently leading to problems comparing them on this basis.

We contacted Geek Bar itself for comment, but did not receive a response.

The picture on the right is of a normal brain and the picture on the left is of someone who vapes

The video presents what are claimed to be images of the brain of a “vaper” and a “normal brain”.

Full Fact was unable to find the specific brain imaging from the video, and no source is provided. In isolation, these brain scan images don’t tell us anything as we do not know what the colours represent.

‘Vaping even once destroys a hormone in the brain called dopamine’

Dopamine is a neurotransmitter—a chemical released by neurons (brain or nerve cells) to send signals to other cells. It is involved in multiple brain pathways including those related to behavioural reinforcement and reward, and it is these that are thought to play a role in substance use and misuse. Dopamine is thought to drive addictive behaviours for many, but not all, drugs.

Nicotine and dopamine have a complex relationship. When nicotine is used it causes the release, not destruction, of dopamine in the user’s brain, along with other neurotransmitters. 

Dopamine is not only involved in behaviour but in movement. Death of dopamine-related brain cells (dopaminergic neurons) causes Parkinson’s Disease (mentioned in the video), and substances such as MPTP which are known to destroy dopaminergic neurons cause similar symptoms. 

Smoking on the other hand has consistently been found to be associated with lower Parkinson’s risk, the opposite of what we would expect if nicotine “destroys” dopamine as claimed. Importantly the increased risk of other heart, lung and other diseases from smoking significantly outweighs this potential benefit.

Mice studies on the effect on dopamine levels in the longer term have shown varied results, with mice exposed to nicotine for long periods of time having decreased levels of dopamine in certain parts of the brain but not others. 

In any case, Full Fact could find no evidence of dopamine being ‘destroyed’ by nicotine. A very small study using functional brain scanning on 45 men found a slight decrease in dopamine synthesis (but not in other aspects of dopamine function) in a certain part of the brain in ongoing smokers compared to non-smokers or smokers in withdrawal—this difference normalised with abstinence.

The nicotine in these vapes also increases your blood flow which can cause a heart attack

The video claims that vapes increase blood flow which can cause a heart attack. 

‘Heart attack’ is a colloquial term for a myocardial infarction which is when an area of heart muscle is damaged by reduced blood supply. This is most often due to a clot caused by coronary heart disease, when cholesterol plaques on the lining of the arteries burst. 

There is evidence that nicotine can both increase and decrease coronary blood flow by increasing the heart rate and narrowing the blood vessels. 

However, the British Heart Foundation states that nicotine “is not a significant health hazard for people without heart conditions [and] does not cause acute cardiac events or coronary heart disease”. 

Public Health England has published a report stating that nicotine has never been shown to cause significant health issues but said more research was needed into adolescent nicotine use.

The UK Health Security Agency (UKHSA) suggests that the effect of vaping on heart health is a topic of ongoing debate but that “evidence shows nicotine actually carries minimal risk of harm to health”. 

A review commissioned by the Department of Health and Social Care found the risk of vapes to be significantly smaller than that posed by smoking tobacco over the short and medium term, but flagged the need for more long-term research. That said, it appears very unlikely that vapes will improve health, and there may be medium and long term damage to the heart or other body functions that we don’t yet know about. Vapes contain a number of chemicals beyond the active nicotine. 

NHS advice is clear that non-smokers should not take up vaping, and that the healthiest option is not to use the products.

It also says that vaping seems to be much less harmful to the heart than smoking tobacco, and that they can help smokers quit cigarettes for good.

Image courtesy of Romain Blu