0:00:04 > 0:00:08I think they have a great potential to save millions of lives
0:00:08 > 0:00:11over the next 20, 30 years.
0:00:11 > 0:00:14There are so many unknowns here and frankly, I think, right now,
0:00:14 > 0:00:18we have... It's a human experiment that's going on right now.
0:00:18 > 0:00:22They could turn out to be one of the greatest, perhaps the greatest even,
0:00:22 > 0:00:25public health innovations of our generation.
0:00:26 > 0:00:30We really don't know what the long-term effects will be.
0:00:32 > 0:00:34I think they are a game changer
0:00:34 > 0:00:37and I'm very excited by that possibility.
0:00:38 > 0:00:40Electronic cigarettes.
0:00:45 > 0:00:49This bit of technology has absolutely exploded into our lives.
0:00:49 > 0:00:53Ten years ago, they barely existed. Now, they're everywhere.
0:00:53 > 0:00:57Science is scrabbling to keep up and the experts are bitterly divided.
0:00:59 > 0:01:03So we're going to carry out our own unique experiment to test
0:01:03 > 0:01:05the effects of e-cigarettes.
0:01:05 > 0:01:09I think I'll be able to do it with e-cigarettes.
0:01:09 > 0:01:12I've got access to one of the more controversial companies which
0:01:12 > 0:01:14produce them.
0:01:14 > 0:01:16So how do I know you haven't got some other lovely
0:01:16 > 0:01:18piece of research which actually shows that it is harmful
0:01:18 > 0:01:20and you're just not showing it?
0:01:23 > 0:01:26And I'll seek out cutting-edge research to discover exactly
0:01:26 > 0:01:29what they do to people who use them...
0:01:29 > 0:01:31Oh, wow! This is really surprising.
0:01:31 > 0:01:37- We killed 95% of the cells. - ..and to people who don't.
0:01:39 > 0:01:42This, I think, is about as high as we've seen it.
0:01:42 > 0:01:44Through the roof, really.
0:01:44 > 0:01:46Are we on the brink of a health revolution or
0:01:46 > 0:01:49gambling our way into a catastrophe?
0:02:09 > 0:02:12Now, I'm about to do something that, many years ago,
0:02:12 > 0:02:14I swore I would never do.
0:02:14 > 0:02:19It's dangerous, it's addictive, it's disgusting and there's a good chance
0:02:19 > 0:02:23that I'm going to be sick, which is why I've got a bucket down there.
0:02:25 > 0:02:26For me, this will be a first,
0:02:26 > 0:02:30but it's something more than a billion people do every day.
0:02:32 > 0:02:35I'm being wired up to monitor what happens.
0:02:40 > 0:02:44HE COUGHS LOUDLY
0:02:47 > 0:02:50Aargh! God! And people do this for pleasure?
0:02:52 > 0:02:56That was... That was really horrible. That was really rank.
0:02:58 > 0:03:01It's, um, really sort of burning.
0:03:01 > 0:03:03It's way down my throat at the moment.
0:03:04 > 0:03:07You might find it hard to believe but I have never,
0:03:07 > 0:03:10ever smoked before, not even a drag.
0:03:11 > 0:03:13HE COUGHS LOUDLY
0:03:13 > 0:03:16This is not, I think, what happens in the movies.
0:03:17 > 0:03:21As soon as you draw that smoke into your lungs, your heart rate and
0:03:21 > 0:03:25blood pressure goes soaring up and toxic chemicals enter your blood.
0:03:27 > 0:03:29I'd like to say it's really vile but it isn't.
0:03:29 > 0:03:32I mean, the coughing is vile, the smell is vile,
0:03:32 > 0:03:34but the effects are actually quite pleasant.
0:03:38 > 0:03:42I don't feel remotely nauseous. I just feel quite buzzy at the moment.
0:03:43 > 0:03:46So I get it. I think I finally get why people smoke.
0:03:50 > 0:03:54What I've just experienced is an extremely efficient drug
0:03:54 > 0:03:58delivery system, sending nicotine to my brain in just ten seconds.
0:03:59 > 0:04:02# I put a spell on you... #
0:04:02 > 0:04:05In the 1950s, it was advertised by sports stars,
0:04:05 > 0:04:09glamorised by Hollywood and even endorsed by doctors.
0:04:13 > 0:04:14These days, we're
0:04:14 > 0:04:19fully aware of the dangers yet there are still ten million smokers in
0:04:19 > 0:04:23the UK and about half of them will die from smoking-related diseases.
0:04:25 > 0:04:27But in the last few years,
0:04:27 > 0:04:33a new device has appeared that could finally blow away this deadly habit.
0:04:33 > 0:04:35# You're mine, you're mine. #
0:04:39 > 0:04:41Now we've got the electronic or e-cigarette.
0:04:41 > 0:04:44It's been marketed as a much less harmful
0:04:44 > 0:04:47way of getting your nicotine hit
0:04:47 > 0:04:50but is it the greatest public health measure ever invented,
0:04:50 > 0:04:54as some people claim, or simply another way of keeping us
0:04:54 > 0:04:58addicted to nicotine with dangerous unforeseen consequences?
0:05:01 > 0:05:05For these people, using e-cigarettes or vaping, as it's known,
0:05:05 > 0:05:07is part of their daily lives.
0:05:07 > 0:05:10So, how long have you been vaping for?
0:05:10 > 0:05:14- Just over two years.- I'll be on my vape-versary for three years.
0:05:14 > 0:05:15Three years?
0:05:15 > 0:05:19- When you took up vaping, did you intend to give up smoking?- Yes.- OK.
0:05:19 > 0:05:21- That was my goal. - I never tried to give up smoking.
0:05:21 > 0:05:25It's just the curiosity of the products and then, just slowly,
0:05:25 > 0:05:28over time, used them more and more.
0:05:28 > 0:05:31E-cigarettes are fast becoming a socially acceptable way to
0:05:31 > 0:05:35consume nicotine but are we gambling with technology
0:05:35 > 0:05:40we don't yet understand, simply replacing one danger with another?
0:05:40 > 0:05:44These new devices are the subject of scientific studies all over
0:05:44 > 0:05:48the world but there are still significant gaps in our knowledge.
0:05:50 > 0:05:54So we decided to carry out our own test.
0:05:55 > 0:05:58To help us, we've recruited 26 smokers,
0:05:58 > 0:05:59all with one thing in common.
0:06:01 > 0:06:03I think it's time to quit.
0:06:04 > 0:06:06First of all, health reasons.
0:06:06 > 0:06:09Secondly, it's not a good example for my kids.
0:06:09 > 0:06:11And also, financial reasons.
0:06:11 > 0:06:15My mum died of lung cancer about four years ago
0:06:15 > 0:06:19so I saw what that had done to her, and if it
0:06:19 > 0:06:23cuts my chances of getting that, then that's good enough for me.
0:06:23 > 0:06:25I was diagnosed with throat cancer -
0:06:25 > 0:06:29that's why my voice is a bit croaky - last July and, even though
0:06:29 > 0:06:32I've been advised by all of my consultants
0:06:32 > 0:06:36and health care professionals, I'm still smoking.
0:06:37 > 0:06:41These smokers are about to embark on what should be a fascinating
0:06:41 > 0:06:44experiment - to uncover what e-cigarettes really do to us.
0:06:52 > 0:06:54It's being run by behavioural scientist
0:06:54 > 0:06:57Paul Aveyard from Oxford University
0:06:57 > 0:07:02and Peter Hajek from Queen Mary University of London.
0:07:02 > 0:07:05We're going to test the effects of e-cigarettes against smoking
0:07:05 > 0:07:11tobacco and compare them with other, more traditional ways to quit.
0:07:13 > 0:07:16To do this, we're dividing our volunteers into four groups.
0:07:18 > 0:07:22One group is going to stick to regular cigarettes.
0:07:22 > 0:07:25And that means you've got four more weeks of smoking.
0:07:25 > 0:07:29My wife's not going to believe I've got this group but thanks anyway!
0:07:29 > 0:07:33Another will try to quit smoking the hard way.
0:07:33 > 0:07:35You're going to be quitting cold turkey.
0:07:36 > 0:07:41- It's not what you wanted?- No!- Have you tried cold turkey before?- Yes.
0:07:41 > 0:07:43- Yeah. Didn't work.- No.
0:07:45 > 0:07:48This group will try quitting with the help of nicotine patches.
0:07:49 > 0:07:53You're going to be quitting with nicotine replacement therapy.
0:07:53 > 0:07:56- All right.- That's good. - Is that all right?- Yeah.- Yeah.
0:07:58 > 0:08:02And this is the group who we're really interested in.
0:08:02 > 0:08:07- You're going to be quitting with e-cigarettes.- Yay!- Why yay?
0:08:07 > 0:08:09I think I'll be able to do it with e-cigarettes.
0:08:09 > 0:08:13I've never tried it but I think it's possibly the easiest way.
0:08:15 > 0:08:20Everybody here currently smokes at least 20 cigarettes a day,
0:08:20 > 0:08:23and it's a notoriously hard habit to break.
0:08:23 > 0:08:26Research shows that when people try without help,
0:08:26 > 0:08:28the success rate is just 4%.
0:08:30 > 0:08:32So this is a pretty hard-core group of people, smokers.
0:08:32 > 0:08:35They've really tried and tried again, is that right?
0:08:35 > 0:08:36They certainly are.
0:08:36 > 0:08:38I mean, we selected them for being hard-core and, of course,
0:08:38 > 0:08:42you don't volunteer for this kind of study unless, really,
0:08:42 > 0:08:44you've struggled to just quit smoking on your own.
0:08:48 > 0:08:51Our volunteers are all undergoing a range of health tests.
0:08:51 > 0:08:54We're measuring the levels of some toxic substances
0:08:54 > 0:08:57in their bodies, like carbon monoxide in their lungs.
0:08:59 > 0:09:01Most of the people, possibly all the people,
0:09:01 > 0:09:03here on the programme are heavy smokers.
0:09:03 > 0:09:06You will see the flashing red lights showing you that
0:09:06 > 0:09:10that level of carbon monoxide they have is rather alarming.
0:09:11 > 0:09:14And we're using cutting-edge technology to probe
0:09:14 > 0:09:18- deep inside their airways. - We're measuring airways resistance.
0:09:18 > 0:09:21It's a measure of how well the lungs are functioning.
0:09:21 > 0:09:24This will give us baseline measurements before our
0:09:24 > 0:09:28experiment starts, while our volunteers are still heavy smokers.
0:09:29 > 0:09:33The major cause of health problems for people who smoke is,
0:09:33 > 0:09:35of course, heart attack and stroke.
0:09:35 > 0:09:37So we've got a couple of tests here
0:09:37 > 0:09:40- that are looking at the heart function itself.- Mm-hm.
0:09:40 > 0:09:44And over here, we're looking at the way that the arteries respond
0:09:44 > 0:09:49when they're called on to do so by a physiological stress.
0:09:49 > 0:09:53In four weeks' time, the volunteers will undergo exactly the same
0:09:53 > 0:09:56tests to find out if anything's changed.
0:09:57 > 0:10:01Remember that today, for most of you, is the last day
0:10:01 > 0:10:06of your smoking and tomorrow is the first day of your non-smoking lives.
0:10:06 > 0:10:09And I can see it's going to be really tough
0:10:09 > 0:10:12but I'm really crossing my fingers for you
0:10:12 > 0:10:16because you know it's important and I know it's important and I really
0:10:16 > 0:10:18look forward to seeing you again in four weeks' time
0:10:18 > 0:10:20and we shall see what we shall see.
0:10:20 > 0:10:23We're feeling good, though, aren't we? Yeah!
0:10:23 > 0:10:24APPLAUSE
0:10:26 > 0:10:29I'm hoping that, in a month's time, our results will begin to
0:10:29 > 0:10:32answer some of the fundamental questions about vaping.
0:10:37 > 0:10:39There are still so many unknowns
0:10:39 > 0:10:43because the habit has become popular so suddenly.
0:10:43 > 0:10:47E-cigarettes are one of those bits of technology, like mobile phones,
0:10:47 > 0:10:50that have absolutely exploded into our culture.
0:10:50 > 0:10:54From nowhere, they have become a multibillion pound industry.
0:10:54 > 0:10:57In the UK alone, there are over 2.5 million users.
0:11:00 > 0:11:04Their extraordinary rise has polarised opinion around the world.
0:11:06 > 0:11:09So when electronic cigarettes came on the market,
0:11:09 > 0:11:13many countries prohibited their use.
0:11:15 > 0:11:20They include countries like Canada, Brazil, Uruguay, Australia.
0:11:20 > 0:11:22When you look at some of those governments that are doing
0:11:22 > 0:11:25practically nothing about tobacco control
0:11:25 > 0:11:28and yet they're banning e-cigarettes, you think, why?
0:11:29 > 0:11:31The UK took a different approach.
0:11:34 > 0:11:37So in 2010, we took the view, in the Behavioural Insights Team,
0:11:37 > 0:11:40that we should make these widely available
0:11:40 > 0:11:43because of their potential to be a very effective route
0:11:43 > 0:11:47out of smoking, and so we argued for a deliberately light touch
0:11:47 > 0:11:50regulation in order to make them widely available.
0:11:51 > 0:11:55On this advice, the UK government took a relatively liberal
0:11:55 > 0:12:00stance and allowed the sale and advertising of e-cigarettes.
0:12:00 > 0:12:03You know that feeling you get when something's great?
0:12:05 > 0:12:08But not everybody agreed with this decision.
0:12:08 > 0:12:11There was widespread concern that e-cigarettes would have
0:12:11 > 0:12:16a broader appeal than just as a tool to help smokers quit.
0:12:16 > 0:12:19Well, now you can taste it.
0:12:28 > 0:12:31Now, some people are worried that e-cigarettes will encourage
0:12:31 > 0:12:34non-smokers to take up vaping.
0:12:34 > 0:12:37Even if that's true, would it be such a bad thing?
0:12:37 > 0:12:40Well, surprisingly enough, no-one has really studied
0:12:40 > 0:12:44the effects of vaping on healthy volunteers.
0:12:44 > 0:12:47So I thought I'd give it a go.
0:12:47 > 0:12:50Current research tends to look at the effects of e-cigarettes
0:12:50 > 0:12:52only on smokers.
0:12:52 > 0:12:55To discover what they do to a healthy non-smoker, I'm going
0:12:55 > 0:12:57to test them on myself.
0:13:01 > 0:13:03I guess this is how addiction begins -
0:13:03 > 0:13:06you start with a single cigarette, and the next thing you know,
0:13:06 > 0:13:09you've committed yourself to a month full of vaping.
0:13:09 > 0:13:12I must admit, I'm feeling a little apprehensive.
0:13:16 > 0:13:20So, for some advice on how to get started, I've come to one
0:13:20 > 0:13:25of the many e-cigarette shops that have sprung up all over the country.
0:13:25 > 0:13:28- Ah! Hi there.- Afternoon. How are you?
0:13:28 > 0:13:30I'm expecting something a little bit smoky,
0:13:30 > 0:13:33but actually, it's quite sort of pleasantly fruity, isn't it?
0:13:35 > 0:13:38I'm expecting also sort of fungus yellow wallpaper with stuff
0:13:38 > 0:13:39dripping down it.
0:13:41 > 0:13:45- So assume I'm a vaping virgin, which I am.- Yep.
0:13:45 > 0:13:47- Er... What have you got?- Lovely.
0:13:47 > 0:13:50So what I've got - some of our bestselling starter kits
0:13:50 > 0:13:53for someone who's never used an electronic cigarette before.
0:13:53 > 0:13:56- Do you think that's a bit girlie for me?- Not necessarily.
0:13:56 > 0:13:58- I would say this one here is one of our most basic.- OK.
0:13:58 > 0:14:00And what about this? This is kind of cooler and more geeky?
0:14:00 > 0:14:02Yeah, definitely.
0:14:03 > 0:14:05E-cigarettes come in many shapes and sizes
0:14:05 > 0:14:07but they all work on the same principle.
0:14:09 > 0:14:13There is a battery, which powers a heating element known as a coil.
0:14:15 > 0:14:18A fluid called an e-liquid is put in here.
0:14:20 > 0:14:24The heat from the coil turns it into a vapour which the user inhales
0:14:24 > 0:14:26through the mouthpiece.
0:14:27 > 0:14:31The e-liquid usually contains nicotine and flavourings,
0:14:31 > 0:14:34and there are hundreds of flavours to choose from.
0:14:34 > 0:14:35Blimey!
0:14:35 > 0:14:39So you've got fruity flavours, sweet and dessert flavours,
0:14:39 > 0:14:41tobacco-based flavours to replicate a real cigarette, which is
0:14:41 > 0:14:44really good for someone who's about to quit, in my opinion,
0:14:44 > 0:14:46then we've got another category called Fresh, which is
0:14:46 > 0:14:49menthol-based flavours or neutral flavours, so not too much taste.
0:14:49 > 0:14:52I suspect I'm not going to go for the tobacco. Fruity sounds...
0:14:52 > 0:14:55- Fruity sounds lovely. - Fruity sounds kind of healthy and Fresh sounds healthy.
0:14:55 > 0:14:58- I'm going to go for Fresh, and I like mint.- Spot on.
0:14:58 > 0:14:59So give me a mint.
0:14:59 > 0:15:03So all I want you to do is to hold this button down for 2-3 seconds,
0:15:03 > 0:15:07take an inhale of the device as you would a normal cigarette.
0:15:08 > 0:15:11HE COUGHS AND SPLUTTERS
0:15:11 > 0:15:15- OK. It's not as aggressive as a cigarette, is it?- No, not at all.
0:15:15 > 0:15:17And I got a nice sort of minty flavour to it rather than
0:15:17 > 0:15:22tobacco flavour. And how often would you kind of do a little puff?
0:15:22 > 0:15:24I use the device when I'm kind of getting the shakes
0:15:24 > 0:15:25or when I feel I want a drag.
0:15:25 > 0:15:29So, for me, it might be a puff or two puffs every 15-20 minutes,
0:15:29 > 0:15:31but there's no right or wrong way to use these devices.
0:15:31 > 0:15:33It's however you feel like you'd want to take a drag
0:15:33 > 0:15:35- and when you feel you need one. - Right.
0:15:37 > 0:15:41But as a non-smoker, I don't yet have nicotine needs.
0:15:43 > 0:15:46So I've asked psychologist and addiction expert
0:15:46 > 0:15:50Dr Lynne Dawkins to create a vaping schedule for me to follow.
0:15:52 > 0:15:55If you want to reflect what a regular vaper would do,
0:15:55 > 0:15:59you're looking at fairly continuous puffing throughout the day.
0:15:59 > 0:16:01- So you don't want to have a big three-hour gap.- Yeah.
0:16:01 > 0:16:06You want to maybe have a few short bouts of 5-10 puffs every
0:16:06 > 0:16:08half an hour to an hour.
0:16:08 > 0:16:09And then it gradually increases,
0:16:09 > 0:16:13the nicotine strength increases, and, as you say,
0:16:13 > 0:16:16either I will tolerate it or there will come a point where it just
0:16:16 > 0:16:17makes me feel
0:16:17 > 0:16:20so awful that I have to stop.
0:16:20 > 0:16:21What are the possible side
0:16:21 > 0:16:22effects from that experience?
0:16:22 > 0:16:26You might experience nausea, headache,
0:16:26 > 0:16:31you might feel a little bit sick or feel a little bit dizzy,
0:16:31 > 0:16:34but if you feel that you can't withstand those effects,
0:16:34 > 0:16:37then please, please do stop. Throughout the day...
0:16:37 > 0:16:40Don't know what my wife is going to make of this! I warned her...
0:16:40 > 0:16:42My wife is a GP and, I have to say,
0:16:42 > 0:16:44she's not ecstatically happy about this.
0:16:44 > 0:16:45I'm not surprised. As we say,
0:16:45 > 0:16:48- it's not recommended for non-smokers.- No.
0:16:50 > 0:16:54Of course, it's not advisable for anyone who doesn't smoke to
0:16:54 > 0:16:55start using e-cigarettes.
0:16:57 > 0:17:01I'm a bit worried I might end up getting hooked on nicotine.
0:17:01 > 0:17:03# Alabama, Arkansas
0:17:03 > 0:17:06# I do love my ma and pa... #
0:17:06 > 0:17:08Just four days into my experiment
0:17:08 > 0:17:13and I'm already finding it difficult to stick to my vaping schedule.
0:17:13 > 0:17:14I'm behind in my exercise.
0:17:14 > 0:17:16I'm supposed to have puffed, I think,
0:17:16 > 0:17:1860 today and I've only done about ten, maybe.
0:17:18 > 0:17:20I'm still not kind of feeling it.
0:17:23 > 0:17:28When Mike first said to me that he was going to start vaping, I was
0:17:28 > 0:17:33horrified and said, absolutely, you know, don't go there. Um...
0:17:33 > 0:17:39Not terribly well-informed but that was my initial instinct, partly
0:17:39 > 0:17:43because, you know, I don't want him to become a poster boy for vaping.
0:17:43 > 0:17:45He doesn't look like he's going to be doing that
0:17:45 > 0:17:47because he's kind of coughing and spluttering at the moment.
0:17:49 > 0:17:52Now I've started on e-cigarettes,
0:17:52 > 0:17:56I want to dig deeper into exactly what these things are doing to us.
0:17:59 > 0:18:02But first, I'm going right back to the beginning of the story.
0:18:05 > 0:18:11Remarkably, it all begins with one man - Chinese pharmacist Hon Lik.
0:18:14 > 0:18:17- TRANSLATION:- I started smoking when I was 18
0:18:17 > 0:18:21and I smoked between one to two packs each day.
0:18:21 > 0:18:24Am I right in thinking your father used to be a heavy smoker?
0:18:26 > 0:18:29- TRANSLATION:- My father smoked for a long time and, in his old age,
0:18:29 > 0:18:31he got lung cancer.
0:18:32 > 0:18:36Hon Lik had tried to quit smoking six times.
0:18:36 > 0:18:38It occurred to him he might find it easier
0:18:38 > 0:18:41if he used a device that resembled a cigarette.
0:18:43 > 0:18:45So he decided to invent one.
0:18:47 > 0:18:50- TRANSLATION:- This is the first generation product.
0:18:50 > 0:18:52It is very similar to this prototype.
0:18:52 > 0:18:55So this is the prototype and this is your first model, and you had
0:18:55 > 0:18:58to kind of cram all of that into that?
0:18:58 > 0:19:03In 2004, Hon Lik launched his new product - the e-cigarette.
0:19:03 > 0:19:06He had no idea that, within a decade, it would be
0:19:06 > 0:19:09a global success.
0:19:09 > 0:19:12So how do you feel when you come to somewhere like the UK
0:19:12 > 0:19:17and you see people on the street using your product?
0:19:17 > 0:19:21- TRANSLATION:- I think that British consumers are very health-conscious
0:19:21 > 0:19:25and I'm so pleased that my invention has been recognised.
0:19:34 > 0:19:37From these modest beginnings in China, e-cigarettes were
0:19:37 > 0:19:42first imported into the West by small independent companies.
0:19:43 > 0:19:47But as their popularity soared, large corporations
0:19:47 > 0:19:50jumped on the bandwagon, and that was controversial.
0:19:56 > 0:19:58When e-cigarettes became popular,
0:19:58 > 0:19:59what we saw was the tobacco industry,
0:19:59 > 0:20:02what we call the big companies, transnational tobacco companies,
0:20:02 > 0:20:05coming in and buying up these manufacturers.
0:20:05 > 0:20:07I've worked in the field for 30 years.
0:20:07 > 0:20:09The tobacco industry, during that time,
0:20:09 > 0:20:15has misled populations about the impacts of cigarette smoking
0:20:15 > 0:20:19on people's health, what's in cigarettes.
0:20:21 > 0:20:25There's a long history of, you know,
0:20:25 > 0:20:28pretty bad behaviour by some tobacco companies.
0:20:28 > 0:20:30It must be correct to look at it with
0:20:30 > 0:20:33a degree of wariness that those companies are getting involved.
0:20:35 > 0:20:38The big tobacco companies are now major players
0:20:38 > 0:20:40in the business of making e-cigarettes.
0:20:43 > 0:20:46David O'Reilly is the director of research
0:20:46 > 0:20:48and development at one of the largest.
0:20:51 > 0:20:55And I've come here for a rare opportunity - to quiz
0:20:55 > 0:20:59a scientist who's been working in the tobacco industry for many years.
0:21:01 > 0:21:04I've never seen a tobacco plant before. I must admit, it's rather beautiful.
0:21:04 > 0:21:07And it's hard to imagine the scale of sort of death
0:21:07 > 0:21:10and destruction that this plant has wrought, if you like.
0:21:10 > 0:21:15So what is it in the plant that is so destructive to human beings?
0:21:15 > 0:21:17When you take tobacco, that's in any plant.
0:21:17 > 0:21:19So if you took lettuce and you dried it
0:21:19 > 0:21:22and you rolled it up into a rod like this, you set fire to it
0:21:22 > 0:21:24and you inhaled it, you would inhale very similar
0:21:24 > 0:21:27toxicants that you would get from tobacco.
0:21:27 > 0:21:29So there's nothing particularly damaging about this plant per se.
0:21:29 > 0:21:34- It's actually mainly the process of combustion. Is that right?- Correct. So if you set fire to something,
0:21:34 > 0:21:36you're going to create round about 100 toxicants or so
0:21:36 > 0:21:39that are known to be harmful, potentially harmful, to humans.
0:21:39 > 0:21:43So really, the idea is to get rid of combustion altogether,
0:21:43 > 0:21:45to give consumers the nicotine which they're seeking along with
0:21:45 > 0:21:49the flavours that they want in a way that they would find acceptable.
0:21:49 > 0:21:51And that's what takes you to e-cigarettes, presumably
0:21:51 > 0:21:54because you don't get combustion - you simply get heating?
0:21:54 > 0:21:59In 2013, British American Tobacco started selling e-cigarettes.
0:21:59 > 0:22:02Now they make a range of products, including e-liquids.
0:22:04 > 0:22:07What's actually in this e-liquid that I'm eagerly puffing?
0:22:07 > 0:22:10E-liquids are fairly simple.
0:22:10 > 0:22:13You have nicotine, you'd have water and flavourings,
0:22:13 > 0:22:17and also two simple compounds called propylene glycol and glycerol
0:22:17 > 0:22:19which bulk out the vapour
0:22:19 > 0:22:21and give that cloud that you see
0:22:21 > 0:22:23when people use e-cigarettes.
0:22:23 > 0:22:26What's the difference between what you inhale if you smoke
0:22:26 > 0:22:30a real cigarette and what you inhale if you smoke an e-cigarette?
0:22:30 > 0:22:34This is a scan of toxicants produced by the combustible cigarette.
0:22:34 > 0:22:38There are around about 6,000 chemicals on this chart.
0:22:38 > 0:22:41Each of these peaks represents a different chemical?
0:22:41 > 0:22:43Each of these peaks represent a different chemical
0:22:43 > 0:22:45and around about 100 of those are known to be harmful,
0:22:45 > 0:22:47or potentially harmful to humans.
0:22:47 > 0:22:51When you look at an e-cigarette, you can see in the same scan,
0:22:51 > 0:22:54there are fewer peaks, much fewer peaks.
0:22:54 > 0:22:57And most of the toxicants that you see in cigarettes,
0:22:57 > 0:22:59combustible cigarettes, are absent.
0:22:59 > 0:23:02Those that are there tend to be at levels
0:23:02 > 0:23:05way below the levels that we would be concerned on.
0:23:05 > 0:23:08Nobody says that e-cigarettes are totally safe.
0:23:08 > 0:23:12The evidence to date suggests they are about 95% safer
0:23:12 > 0:23:15than cigarette smoking and this is part of the supporting
0:23:15 > 0:23:18evidence, that the chemistry of the vapour of the e-cigarettes
0:23:18 > 0:23:22is completely different from combustible cigarettes.
0:23:23 > 0:23:27Lab analysis shows the chemistry of the vapour is vastly
0:23:27 > 0:23:29different from cigarette smoke.
0:23:29 > 0:23:34But what really matters is what it does to us, and that's something
0:23:34 > 0:23:37that David's team are investigating in their biology lab.
0:23:38 > 0:23:42- This is what would happen in a normal, healthy individual.- Yeah.
0:23:42 > 0:23:46Seen through a microscope, these are cells that line our blood vessel.
0:23:46 > 0:23:49The gap in the middle is a tiny tear.
0:23:49 > 0:23:51The kind of minor damage that is happening
0:23:51 > 0:23:54all the time as we go about our daily lives.
0:23:55 > 0:23:59In a healthy person, these minute wounds heal very easily,
0:23:59 > 0:24:01as we see in this time-lapse film.
0:24:01 > 0:24:05The cells move back together to close the gap.
0:24:05 > 0:24:06And that's healthy.
0:24:06 > 0:24:10So that's healthy, that's the normal system.
0:24:10 > 0:24:11To test the effects of smoking,
0:24:11 > 0:24:15David's team have carried out what is called a scratch test.
0:24:15 > 0:24:19They make a tiny scratch in healthy blood vessel cells to mimic
0:24:19 > 0:24:22the natural tears that happen every day.
0:24:22 > 0:24:27Then they pass tobacco smoke in a liquid solution over the cells
0:24:27 > 0:24:29and see what happens.
0:24:29 > 0:24:32- You can see the wound in the middle. - It looks completely different. Yeah.
0:24:32 > 0:24:34It's looking very cruddy, isn't it?
0:24:34 > 0:24:36You've got a lot of sort of black bits.
0:24:36 > 0:24:39The black bits you can see are dead and dying cells.
0:24:39 > 0:24:42- They're just not closing. - They're not closing.
0:24:42 > 0:24:44The cells are moving around, they don't which direction to go
0:24:44 > 0:24:47and the tear is not being repaired, even after 21 hours.
0:24:47 > 0:24:49Right, it's very striking, isn't it?
0:24:49 > 0:24:53The tobacco smoke disrupts the way the cells behave.
0:24:53 > 0:24:56We can see the wound just isn't healing.
0:24:56 > 0:24:59I do find something ironic about the fact that here I am
0:24:59 > 0:25:01in a cigarette company looking at footage
0:25:01 > 0:25:03and being told just how bad cigarettes are for me.
0:25:03 > 0:25:05Not something I ever imagined would happen.
0:25:05 > 0:25:07We've been doing this research for years
0:25:07 > 0:25:10and of course it's well known that cigarette smoking causes
0:25:10 > 0:25:12diseases, including heart disease
0:25:12 > 0:25:14and this is a model of heart disease.
0:25:14 > 0:25:18Now, the big question is, what will happen with vaping?
0:25:20 > 0:25:23The team here have repeated the scratch test
0:25:23 > 0:25:24with e-cigarette vapour.
0:25:26 > 0:25:29You can see now it's repairing normally, even though
0:25:29 > 0:25:32it has been exposed to e-cigarette vapour and again,
0:25:32 > 0:25:37after 12, 13 hours, it is closing the gap and by 21 hours,
0:25:37 > 0:25:40it should have closed the gap completely.
0:25:40 > 0:25:43That is good evidence that e-cigarettes,
0:25:43 > 0:25:45the vapour of e-cigarettes,
0:25:45 > 0:25:48doesn't impair the ability of blood vessels to repair themselves
0:25:48 > 0:25:52when they are naturally injured, as they are on a day-to-day basis.
0:25:52 > 0:25:53It's certainly compelling, yes.
0:25:55 > 0:25:58The blood vessel cells on top
0:25:58 > 0:25:59were exposed to nothing more
0:25:59 > 0:26:00than fresh air.
0:26:00 > 0:26:02The middle ones,
0:26:02 > 0:26:03e-cigarette vapour
0:26:03 > 0:26:05and the bottom ones,
0:26:05 > 0:26:06cigarette smoke.
0:26:06 > 0:26:08The difference is clear.
0:26:10 > 0:26:11So what that shows us
0:26:11 > 0:26:14is that the ability of the cells to repair themselves
0:26:14 > 0:26:16with fresh air
0:26:16 > 0:26:17or with e-cigarette vapour
0:26:17 > 0:26:18are very similar,
0:26:18 > 0:26:20virtually indistinguishable,
0:26:20 > 0:26:21but with cigarette smoke,
0:26:21 > 0:26:22it impedes the ability of the
0:26:22 > 0:26:24blood vessel to repair itself.
0:26:24 > 0:26:27This single test doesn't mean the vapour from e-cigarettes
0:26:27 > 0:26:28is harmless.
0:26:28 > 0:26:31But it does suggest that vaping doesn't impair our body's
0:26:31 > 0:26:35ability to heal in the same way that tobacco smoke does.
0:26:37 > 0:26:40So, how do I know you haven't got some other lovely
0:26:40 > 0:26:42piece of research which actually shows that it is harmful
0:26:42 > 0:26:44and you're just not showing me that?
0:26:44 > 0:26:47All of the research that we do in British American Tobacco we publish
0:26:47 > 0:26:50in international peer review journals.
0:26:50 > 0:26:52- That's a policy, regardless of the result.- OK.
0:26:52 > 0:26:54And we do operate to good research practice
0:26:54 > 0:26:57in all of our R&D facilities around the group.
0:26:57 > 0:27:01It does feel odd, having someone from a tobacco company
0:27:01 > 0:27:05telling me how much healthier vaping is than smoking.
0:27:05 > 0:27:07But the real point is to quit.
0:27:07 > 0:27:10So how effective are e-cigarettes at helping people do that?
0:27:13 > 0:27:16In our big experiment, it's been a week
0:27:16 > 0:27:19since our volunteers tried to stop smoking.
0:27:19 > 0:27:22So, how are they getting on?
0:27:23 > 0:27:26It's just been really hard to not think about smoking,
0:27:26 > 0:27:28to be honest.
0:27:28 > 0:27:30I was so chuffed with the amount of money I'd saved,
0:27:30 > 0:27:32I decided to go out and treat myself
0:27:32 > 0:27:35because I had been such a good girl and bought myself a new duvet.
0:27:35 > 0:27:39I haven't killed the missus yet or kicked the dogs out,
0:27:39 > 0:27:40or vice versa!
0:27:42 > 0:27:44The cold turkey group are struggling.
0:27:44 > 0:27:46Several of them have gone back to smoking.
0:27:47 > 0:27:52But the e-cigarette and nicotine patch groups are doing much better.
0:27:52 > 0:27:55Probably because they both have a replacement source of nicotine
0:27:55 > 0:27:57to help them get through the cravings.
0:27:59 > 0:28:03By midday I was really, really, really, wanting to smoke
0:28:03 > 0:28:07a cigarette so I put on my patch, I didn't smoke a single cigarette.
0:28:07 > 0:28:08I've still got my e-cigarette so
0:28:08 > 0:28:10that's helping with the cravings a bit.
0:28:10 > 0:28:12The only thing is,
0:28:12 > 0:28:13I am finding that I am smoking this
0:28:13 > 0:28:15a lot more that I would a normal cigarette.
0:28:15 > 0:28:18I found the e-cigarette to be most helpful.
0:28:18 > 0:28:21It really does help with satisfying the urges
0:28:21 > 0:28:22and cravings to smoke.
0:28:26 > 0:28:29I'm having a very different experience.
0:28:30 > 0:28:33As a non-smoker who has taken up vaping for a month to see how
0:28:33 > 0:28:38it affects me, I'm struggling to stick to my schedule.
0:28:38 > 0:28:43I'm not experiencing cravings but I am experiencing inconvenience.
0:28:43 > 0:28:46Vaping several times an hour is tricky
0:28:46 > 0:28:50when you work on the seventh floor of a building that doesn't allow it.
0:28:50 > 0:28:55My colleagues are amused and slightly alarmed by my new habit.
0:28:55 > 0:28:59- It kind of reminds me of the naughty boys at school.- OK.
0:28:59 > 0:29:02I've always wanted to be... Never having been one.
0:29:02 > 0:29:04SHE LAUGHS
0:29:04 > 0:29:07- You weren't in that crowd? - I wasn't, I was a science nerd.
0:29:07 > 0:29:10- Is it making me look cool? - No.
0:29:10 > 0:29:11- Sophisticated?- No.
0:29:11 > 0:29:13- A man of the world? - A bit dirty maybe.
0:29:13 > 0:29:15THEY LAUGH
0:29:15 > 0:29:18- So, you don't approve?- No. You do what you like, Mike.
0:29:18 > 0:29:20- I wouldn't do it.- OK.- Crazy.
0:29:24 > 0:29:25COUGHING
0:29:28 > 0:29:31It's not surprising my colleagues feel uneasy
0:29:31 > 0:29:33about seeing me using e-cigarettes.
0:29:33 > 0:29:37Every few days, there are new headlines warning of their dangers.
0:29:44 > 0:29:47There have been recent reports claiming that some of the
0:29:47 > 0:29:50chemicals used to give e-liquids their flavours
0:29:50 > 0:29:52are potentially toxic.
0:29:54 > 0:29:57I've got a rhubarb and custard.
0:29:57 > 0:29:58This is pear drops.
0:29:58 > 0:30:00Peach yoghurt in there.
0:30:00 > 0:30:03- Cheesecake.- Black honey tobacco and cream.
0:30:03 > 0:30:07Ginger, vanilla, wild hops and mild tobacco.
0:30:07 > 0:30:11They all sound rather benign, but very few have been properly tested.
0:30:11 > 0:30:13So, should vapers be worried?
0:30:21 > 0:30:25It's a question that concerns this toxicologist.
0:30:28 > 0:30:31After many years researching tobacco, he has begun to
0:30:31 > 0:30:36investigate how the flavours used in e-liquids affect our bodies.
0:30:39 > 0:30:42Many flavourings are in the cosmetics and in the food
0:30:42 > 0:30:43and they were tested.
0:30:43 > 0:30:46We know that they are safe when we eat them,
0:30:46 > 0:30:48when we apply them on the skin.
0:30:48 > 0:30:51However, now we need to make sure that they are also safe
0:30:51 > 0:30:53when we inhale them.
0:30:54 > 0:30:58To find out if flavourings which are safe to eat
0:30:58 > 0:31:00are also safe when inhaled,
0:31:00 > 0:31:03he has devised an experiment using living cells
0:31:03 > 0:31:05grown from a human airway.
0:31:09 > 0:31:13First, he puts a sample of healthy cells into a Petri dish.
0:31:16 > 0:31:18This is connected to a tube.
0:31:20 > 0:31:23At the end, he attaches an e-cigarette which contains
0:31:23 > 0:31:26menthol flavoured e-liquid.
0:31:28 > 0:31:31The e-cigarette is connected to a machine that mimics someone
0:31:31 > 0:31:33puffing and creates vapour.
0:31:35 > 0:31:38That vapour travels down the tube and over the living cells.
0:31:40 > 0:31:42After 55 puffs,
0:31:42 > 0:31:46he puts the cells into a machine to count how many are still alive.
0:31:48 > 0:31:51He then repeats the experiment with fresh cells,
0:31:51 > 0:31:54but this time, there will be one crucial difference.
0:31:56 > 0:31:57We will use the same device,
0:31:57 > 0:31:59the same type of electronic cigarette,
0:31:59 > 0:32:01we will use the e-liquid
0:32:01 > 0:32:04with exactly the same nicotine concentration
0:32:04 > 0:32:07and the same composition of the solvent for nicotine.
0:32:07 > 0:32:11The only difference will be the flavouring in the product.
0:32:12 > 0:32:15This time, the e-cigarette is filled
0:32:15 > 0:32:18with pina colada flavoured e-liquid.
0:32:20 > 0:32:24He then compares the number of cells that survive being exposed
0:32:24 > 0:32:26to the two different flavours,
0:32:26 > 0:32:29menthol and pina colada.
0:32:30 > 0:32:34After exposure to pina colada flavour,
0:32:34 > 0:32:3753% of cells survived.
0:32:37 > 0:32:43Comparing to menthol, there was 25% that survived.
0:32:43 > 0:32:47So it's twice as many cells survived after being exposed
0:32:47 > 0:32:49to pina colada electronic cigarette
0:32:49 > 0:32:53compared to menthol electronic cigarette.
0:32:53 > 0:32:55Surprisingly enough, in this experiment,
0:32:55 > 0:32:58the fresh menthol flavouring killed many more cells
0:32:58 > 0:33:01than the sweet pina colada.
0:33:01 > 0:33:03I think that people will be surprised about the effect
0:33:03 > 0:33:05of the menthol.
0:33:05 > 0:33:10We have menthol in many products like toothpaste and cosmetics
0:33:10 > 0:33:16and chewing gums, but this is very important that we are looking
0:33:16 > 0:33:19at the toxicity of menthol when it is inhaled
0:33:19 > 0:33:21with electronic cigarettes.
0:33:23 > 0:33:25His research certainly suggests that flavourings
0:33:25 > 0:33:29which are safe to eat can be harmful to inhale.
0:33:31 > 0:33:34He is working through different flavours one by one.
0:33:36 > 0:33:41We need to get this data as soon as possible to inform users
0:33:41 > 0:33:44and regulators about different flavourings
0:33:44 > 0:33:47and the effect on our lungs.
0:33:49 > 0:33:52It's worrying that after being exposed to menthol,
0:33:52 > 0:33:54only a quarter of the cells survived.
0:33:56 > 0:33:59But how does that compare to tobacco smoke?
0:34:01 > 0:34:04He repeats the experiment with fresh cells
0:34:04 > 0:34:07but this time he connects the machines to a normal cigarette.
0:34:09 > 0:34:12Oh, this is really, really toxic.
0:34:12 > 0:34:17Only 6% of the cells survived exposure to tobacco smoke.
0:34:17 > 0:34:24Remember the pina colada, we had 53% cells survived
0:34:24 > 0:34:26and here, only 5%.
0:34:26 > 0:34:30There is a huge difference between electronic cigarettes
0:34:30 > 0:34:31and tobacco cigarettes.
0:34:33 > 0:34:36So, not as bad as cigarette smoke
0:34:36 > 0:34:39but hardly a clean bill of health for e-liquids.
0:34:43 > 0:34:45Now, I chose mint because I like the flavour
0:34:45 > 0:34:47and because it's widely used in foods
0:34:47 > 0:34:50but the toxicologist's research has shown that just because something
0:34:50 > 0:34:54is safe to eat doesn't necessarily mean it is safe to inhale.
0:34:54 > 0:34:56He and his team are currently working their way through
0:34:56 > 0:34:59different flavours but in the meantime, if you are a vaper,
0:34:59 > 0:35:02the best advice seems to be to try a range of flavours
0:35:02 > 0:35:05so you don't get too much of any one.
0:35:10 > 0:35:12HE COUGHS
0:35:12 > 0:35:16E-cigarettes can harm the airways of people who use them,
0:35:16 > 0:35:19but what about passive vaping?
0:35:19 > 0:35:22You're not going to vape in front of the stall, are you?
0:35:22 > 0:35:27- This is an electronic one. - It's as bad.- Almost as bad.
0:35:29 > 0:35:32But are these reactions prejudiced, unreasonable
0:35:32 > 0:35:34or could the vapour from my e-cigarette
0:35:34 > 0:35:36really be harming people around me?
0:35:41 > 0:35:44Dr Mark Travers of the Roswell Park Cancer Institute
0:35:44 > 0:35:47believes very strongly that air in public places
0:35:47 > 0:35:50should be clean and uncontaminated.
0:35:51 > 0:35:54His research played a big part in helping get smoking
0:35:54 > 0:35:57banned in restaurants and pubs.
0:35:57 > 0:36:01We've made tremendous progress with smoke-free air policies,
0:36:01 > 0:36:02especially globally.
0:36:02 > 0:36:05We have whole countries,
0:36:05 > 0:36:06dozens of countries around the world,
0:36:06 > 0:36:08that are completely smoke-free.
0:36:08 > 0:36:11And then electronic cigarettes appeared.
0:36:11 > 0:36:14Is this something to be concerned about?
0:36:14 > 0:36:18How is this product going to fit into our existing policies?
0:36:18 > 0:36:19Do clean air laws apply to this product?
0:36:19 > 0:36:21Do we need to worry about it?
0:36:22 > 0:36:26For years, Mark has been studying the effects of passive smoking.
0:36:27 > 0:36:29He has set up a special chamber.
0:36:29 > 0:36:33It is fitted with sensitive air monitoring equipment...
0:36:35 > 0:36:37..to measure exactly what is released into the air
0:36:37 > 0:36:40when volunteers smoke inside the chamber.
0:36:42 > 0:36:44You put a non-smoker in there and it's a very hazardous
0:36:44 > 0:36:46environment for them.
0:36:46 > 0:36:50We know that being exposed to that over time leads to a wide variety
0:36:50 > 0:36:54of health effects, so heart disease, respiratory disease, lung cancer.
0:36:54 > 0:36:55Things that are going to kill you.
0:36:57 > 0:36:59But what about e-cigarettes?
0:36:59 > 0:37:02Is there any such thing as passive vaping?
0:37:03 > 0:37:07Mark is now using his chamber for a new set of experiments.
0:37:08 > 0:37:10You guys are both e-cigarette users, or vapers
0:37:10 > 0:37:15What we're going to ask you to do is come into our chamber
0:37:15 > 0:37:18and essentially you're just going to hang out
0:37:18 > 0:37:20and vape while you're doing that.
0:37:24 > 0:37:27As the vapers vape inside the chamber, Mark measures
0:37:27 > 0:37:31the aerosol, the number of particles suspended in the air.
0:37:34 > 0:37:36Oh, wow. In a matter of seconds,
0:37:36 > 0:37:39we saw a huge increase in the aerosol in the room.
0:37:39 > 0:37:40They started vaping
0:37:40 > 0:37:44and immediately the levels went through the roof really.
0:37:45 > 0:37:47This is unusual.
0:37:47 > 0:37:49We usually don't see levels this high
0:37:49 > 0:37:52and sustained during electronic cigarette experiments.
0:37:54 > 0:37:58Mark is a surprised because in previous experiments, the levels
0:37:58 > 0:38:01of particles released by vapers were far lower.
0:38:03 > 0:38:08What this tells me is that there is huge potential variability
0:38:08 > 0:38:12in exposures when using an electronic smoking device,
0:38:12 > 0:38:18depending on the device itself and how the user chooses to use it.
0:38:18 > 0:38:21But the key question is, what are these particles?
0:38:23 > 0:38:25Mark has been looking for carbon monoxide
0:38:25 > 0:38:30and other toxic chemicals that are present in cigarette smoke.
0:38:30 > 0:38:32What we found with electronic cigarettes is no exposure to
0:38:32 > 0:38:36carbon monoxide, so compared to traditional cigarettes,
0:38:36 > 0:38:42electronic cigarettes have at least 99% less toxins in them.
0:38:42 > 0:38:46So, dramatically different in terms of exposure profile.
0:38:47 > 0:38:51E-cigarettes release far fewer toxins than cigarettes
0:38:51 > 0:38:53because there's no combustion.
0:38:54 > 0:38:59But there's one thing they have in common with cigarettes, nicotine.
0:39:00 > 0:39:01We found nicotine in the air
0:39:01 > 0:39:05but at a much lower level than with tobacco smoke.
0:39:05 > 0:39:08The levels were about 20 times higher from tobacco smoke,
0:39:08 > 0:39:10compared to the e-cig vapour.
0:39:10 > 0:39:14There's a lot more nicotine in the air from tobacco smoking
0:39:14 > 0:39:17compared to electronic cigarettes, vaping.
0:39:18 > 0:39:22Mark's experiments have shown that e-cigarette vapour contains
0:39:22 > 0:39:26far lower levels of toxins and nicotine than tobacco smoke,
0:39:26 > 0:39:29so what is in the vapour?
0:39:30 > 0:39:32We know most of it is the carrier liquids,
0:39:32 > 0:39:34so propylene glycol or glycerin.
0:39:34 > 0:39:37That is getting vaporised and getting put in the air.
0:39:37 > 0:39:40That is the bulk of what we're seeing.
0:39:40 > 0:39:42But frankly, we don't know
0:39:42 > 0:39:45what the potential health effects are of that.
0:39:45 > 0:39:47Propylene glycol and glycerin
0:39:47 > 0:39:50aren't usually present in the air we breathe.
0:39:50 > 0:39:54They could be harmless, they might not be.
0:39:54 > 0:39:58And it's the fact that we don't know that worries Mark.
0:39:58 > 0:40:01We find that there is a massive amount of aerosol
0:40:01 > 0:40:05emitted from electronic cigarettes into the air.
0:40:05 > 0:40:07What we don't know is what the ultimate health effect
0:40:07 > 0:40:08of that exposure might be.
0:40:12 > 0:40:14So we need more research to look at that
0:40:14 > 0:40:17and see what's going to happen over time.
0:40:17 > 0:40:19We just do not know at this point.
0:40:23 > 0:40:27'The evidence we do have at the moment suggests that passive vaping
0:40:27 > 0:40:31'is nothing like as bad for you as passive smoking.'
0:40:31 > 0:40:34Nonetheless, if you are using an e-cigarette,
0:40:34 > 0:40:37you will be breathing out a small amount of nicotine
0:40:37 > 0:40:38on your nearest and dearest.
0:40:38 > 0:40:40And that is, presumably, a bad thing.
0:40:40 > 0:40:42Or is it?
0:40:42 > 0:40:46'When it comes to nicotine, experts are divided.'
0:40:46 > 0:40:49Nicotine in your system is not necessarily
0:40:49 > 0:40:52particularly harmful to your health.
0:40:52 > 0:40:56It doesn't seem to be carcinogenic, that means it doesn't cause cancer.
0:40:56 > 0:41:00If there is an excess risk of heart disease, it is small.
0:41:00 > 0:41:01Mothers that are exposed to nicotine,
0:41:01 > 0:41:05whether it's through tobacco or just through pharmaceutical nicotine,
0:41:05 > 0:41:08have potential harmful effects on a developing foetus.
0:41:10 > 0:41:13There have been studies done and there seems to be negligible risks
0:41:13 > 0:41:15of nicotine, when used outside of smoking.
0:41:15 > 0:41:20So my own feeling is that it's probably equivalent to caffeine.
0:41:21 > 0:41:24Nicotine has been associated with
0:41:24 > 0:41:26cells behaving in abnormal manners
0:41:26 > 0:41:29and leading to premature cell death.
0:41:37 > 0:41:40When most people think of nicotine, they obviously think of cigarettes.
0:41:40 > 0:41:43And this is certainly nicotine in a purer form.
0:41:43 > 0:41:48I'd never sampled nicotine before I started this little self experiment.
0:41:48 > 0:41:51And yet I've been puffing away conscientiously for four weeks.
0:41:51 > 0:41:54So what has it been doing to me?
0:41:56 > 0:41:59'To find out, I am catching up with Dr Lynne Dawkins.'
0:42:02 > 0:42:04So how have you been getting on, Michael?
0:42:04 > 0:42:06I've actually been OK.
0:42:06 > 0:42:08So, have you managed to stick to the schedule?
0:42:08 > 0:42:12Broadly. I haven't managed to fit in as many vapes as you wanted me to.
0:42:12 > 0:42:15Cos I can only fit in about five vapes in one go, before I start
0:42:15 > 0:42:18feeling a bit light-headed and ever so slightly nauseous.
0:42:19 > 0:42:22'But although I am not enjoying nicotine,
0:42:22 > 0:42:25'it may be giving me an edge.
0:42:25 > 0:42:28'Some studies have shown that nicotine quickens reaction times.
0:42:31 > 0:42:35'But most of the research into nicotine has been done in smokers.
0:42:36 > 0:42:39'Less is known about its effect on non-smokers.
0:42:41 > 0:42:44'And so I am a rare and, I like to think, valuable test subject.'
0:42:47 > 0:42:51In this task, an arrow will appear on the screen
0:42:51 > 0:42:54and the arrow will point either to the left or to the right.
0:42:54 > 0:42:59Before each problem, you will see the instruction, "Which direction"?
0:43:00 > 0:43:04'Lynne is putting me through a variety of cognitive tests.
0:43:04 > 0:43:05BEEPING
0:43:05 > 0:43:09'She tested me before I started vaping.
0:43:09 > 0:43:13'Now, we will see if nicotine has made any difference to my brain.'
0:43:15 > 0:43:19Your reaction time today, after using your e-cigarette,
0:43:19 > 0:43:22was fairly consistently slower
0:43:22 > 0:43:24- than when we tested you at baseline. - OK.
0:43:24 > 0:43:28We did find some improvement. For example, on the fine motor task,
0:43:28 > 0:43:31we found that your accuracy had improved.
0:43:31 > 0:43:33And when might I want to use a skill like that?
0:43:33 > 0:43:36We're talking about sewing or writing or...
0:43:36 > 0:43:38I could be better at sewing.
0:43:38 > 0:43:40'I've improved in a couple of tests,
0:43:40 > 0:43:44but in others I've got worse. BEEPING
0:43:44 > 0:43:48'My results aren't consistent with what Lynne has found in smokers.'
0:43:50 > 0:43:53Well, in smokers, there's very clear evidence that,
0:43:53 > 0:43:56if you test somebody after they've taken nicotine,
0:43:56 > 0:43:59compared to their performance when they haven't had nicotine
0:43:59 > 0:44:02for several hours, there's a clear cognitive enhancing effect.
0:44:02 > 0:44:06So it may be, in smokers, that nicotine is just
0:44:06 > 0:44:10reversing an effect associated with not having nicotine
0:44:10 > 0:44:11for a period of time.
0:44:11 > 0:44:13So it's like, basically, coffee drinking.
0:44:13 > 0:44:16If you are a heavy coffee drinker, you feel terrible.
0:44:16 > 0:44:18And if you have coffee, you then feel better.
0:44:18 > 0:44:20But you don't necessarily feel better than you would have
0:44:20 > 0:44:23- if you'd never drunk coffee. - Yes, of course.
0:44:23 > 0:44:27'A few weeks of inhaling nicotine hasn't made me any smarter...'
0:44:27 > 0:44:28Whoa!
0:44:28 > 0:44:29'..or quicker.
0:44:29 > 0:44:33'But, surprisingly enough, there is research which suggests
0:44:33 > 0:44:35'taking nicotine in a pure form
0:44:35 > 0:44:38'can benefit people with certain brain diseases,
0:44:38 > 0:44:40'whether they have smoked before or not.'
0:44:42 > 0:44:45There is some emerging evidence that, in certain conditions,
0:44:45 > 0:44:48such as Alzheimer's disease, Parkinson's disease,
0:44:48 > 0:44:51the nicotine may have a cognitive enhancing effect.
0:44:56 > 0:44:59'So there are potential health benefits.
0:44:59 > 0:45:02'But what about the obvious downside?'
0:45:03 > 0:45:06Nicotine is an addictive substance.
0:45:07 > 0:45:11Once you're hooked, it is very, very difficult to quit.
0:45:11 > 0:45:13'When I set out to vape for a month,
0:45:13 > 0:45:16'I was worried I'd get hooked on nicotine.
0:45:16 > 0:45:18'But I haven't begun to crave it at all.
0:45:21 > 0:45:24'Research in animals suggests that nicotine is more addictive
0:45:24 > 0:45:26'when it is delivered in combination with other chemicals
0:45:26 > 0:45:28'found in regular cigarettes.
0:45:31 > 0:45:34'So it may be that vaping is simply less addictive than smoking.'
0:45:36 > 0:45:39We are seeing an increase in experimentation
0:45:39 > 0:45:44with electronic cigarettes amongst young people, say 11 to 18.
0:45:44 > 0:45:48What we are not seeing is regular use among young people
0:45:48 > 0:45:49who are never smokers.
0:45:52 > 0:45:54And that might be because, actually,
0:45:54 > 0:45:57when young people use these products, they might be appealing,
0:45:57 > 0:45:59but they are not as addictive as a tobacco cigarette.
0:45:59 > 0:46:01I think they are quite different.
0:46:04 > 0:46:08In Britain, the proportion of young people who don't smoke,
0:46:08 > 0:46:10who are using an e-cigarette,
0:46:10 > 0:46:13it's so small that it's barely measurable.
0:46:13 > 0:46:17It's something in the region of 0.02%.
0:46:22 > 0:46:26So, most regular e-cigarettes users are ex-smokers,
0:46:26 > 0:46:27just like our volunteers.
0:46:31 > 0:46:33It's now four weeks since Quit Day.
0:46:33 > 0:46:37And I'm going to find out how they are getting on.
0:46:37 > 0:46:40I'm still kind of irritable.
0:46:40 > 0:46:43The first week, I nearly broke up with my partner.
0:46:43 > 0:46:47The e-cigarette has been a great help.
0:46:47 > 0:46:52It's really sort of curbed the urges for smoking.
0:46:52 > 0:46:56And I've...been using it like a trooper.
0:46:56 > 0:46:59I have not managed to stop smoking.
0:46:59 > 0:47:01I was on cold turkey.
0:47:01 > 0:47:04It's proving to be very, very difficult.
0:47:04 > 0:47:07I have decreased the amount I smoke phenomenally.
0:47:09 > 0:47:12'I'm keen to discover just how the results
0:47:12 > 0:47:16'from the e-cigarette group compare with others.
0:47:16 > 0:47:19'Which ones were most successful at quitting smoking?
0:47:20 > 0:47:23'First, the group that went cold turkey.'
0:47:23 > 0:47:25Out of the seven of you in this group,
0:47:25 > 0:47:28two of you have managed to make it.
0:47:28 > 0:47:30'Not a brilliant result.
0:47:30 > 0:47:33'Has the nicotine replacement group done any better?'
0:47:33 > 0:47:37We've got seven out of eight of you who succeeded in the NRT group.
0:47:37 > 0:47:39So well done for you.
0:47:39 > 0:47:41APPLAUSE AND CHEERING
0:47:41 > 0:47:44'And what about the e-cigarette group?'
0:47:44 > 0:47:48And you have done exactly the same as the NRT group,
0:47:48 > 0:47:51in that seven out of eight of you have made it through
0:47:51 > 0:47:53being perfectly abstinent.
0:47:53 > 0:47:54- Well done.- Brilliant.
0:47:54 > 0:47:56APPLAUSE
0:47:58 > 0:48:01'So, when it comes to helping smokers quit,
0:48:01 > 0:48:04'e-cigarettes, like nicotine replacement therapy,
0:48:04 > 0:48:07'are far more effective than going cold turkey.
0:48:09 > 0:48:12'But what have been the effects on our volunteers' health?
0:48:14 > 0:48:17'Everyone is repeating the test they did four weeks ago.'
0:48:19 > 0:48:21- BEEPING - Nice, steady blow.
0:48:24 > 0:48:27'First, carbon monoxide.
0:48:27 > 0:48:30'The people who have quit smoking all have far lower levels
0:48:30 > 0:48:34'of this toxic gas in their lungs than four weeks ago,
0:48:34 > 0:48:37'regardless of which method they used.'
0:48:37 > 0:48:39So that's a non-smoker's reading. It's really good.
0:48:39 > 0:48:41Whey, well done.
0:48:41 > 0:48:43Someone who has never smoked would have the same reading.
0:48:43 > 0:48:45- Thank you.- Well done.- Yeah.
0:48:46 > 0:48:48'We've also been testing for acrolein,
0:48:48 > 0:48:51'a toxic chemical known to increase the risk of cancer.
0:48:53 > 0:48:55'Here again, everyone who's quit smoking
0:48:55 > 0:48:58'has dramatically reduced their levels.
0:49:02 > 0:49:03'Next, nicotine.
0:49:03 > 0:49:07'The people in the e-cigarette and the nicotine replacement groups
0:49:07 > 0:49:11'are still taking in nicotine, but the levels in the body
0:49:11 > 0:49:13'are just half of what they were when they were smoking.
0:49:16 > 0:49:19'And the levels of nicotine in the two volunteers who managed to quit
0:49:19 > 0:49:22'cold turkey are less than a quarter of what they were.
0:49:25 > 0:49:27'In some of our volunteers,
0:49:27 > 0:49:31'there has already been measurable improvement in heart function.'
0:49:31 > 0:49:34So what we can see now, from this scan,
0:49:34 > 0:49:35is that your heart's actually
0:49:35 > 0:49:41made a great improvement and is far more elastic than it was before.
0:49:41 > 0:49:44So we can see that you're well within the healthy spectrum now,
0:49:44 > 0:49:46whereas you were on the borderline before.
0:49:46 > 0:49:51I'm surprised, actually, that there is such a change in just a month.
0:49:51 > 0:49:53I feel really pleased, cos it's nice to see it in black and white,
0:49:53 > 0:49:58that, you know, that there are good side effects from not smoking
0:49:58 > 0:50:00and your heart is so important.
0:50:02 > 0:50:05'Most of the tests showed no real difference between the people
0:50:05 > 0:50:07'who used e-cigarettes and the other groups.
0:50:10 > 0:50:14'But one test has revealed something that has not been seen before.
0:50:16 > 0:50:20'They've been testing what's called airway resistance.
0:50:20 > 0:50:23'That's how easily air goes in and out of our volunteers' lungs.'
0:50:25 > 0:50:26How's it been going then?
0:50:26 > 0:50:29Not too bad. We have some interesting results.
0:50:29 > 0:50:31After they stopped smoking,
0:50:31 > 0:50:34they showed an improvement in airway resistance,
0:50:34 > 0:50:37indicating that air goes in and out of the lungs more easily.
0:50:37 > 0:50:40- Even in four weeks, you saw changes? - That's right, yes.
0:50:43 > 0:50:46'What is particularly intriguing our scientists
0:50:46 > 0:50:49'is our nicotine replacement group showed a greater improvement
0:50:49 > 0:50:51'than the people who used e-cigarettes.
0:50:54 > 0:50:56'But our study is quite small,
0:50:56 > 0:50:59'so this result could just be down to chance.
0:50:59 > 0:51:02'But it is possible that e-cigarettes are slowing down
0:51:02 > 0:51:04'the improvement in airway resistance.
0:51:04 > 0:51:07'The scientists are planning more research.
0:51:10 > 0:51:14'Our experiment has produced some really interesting findings.
0:51:14 > 0:51:17'For me, the most impressive has been the clear demonstration
0:51:17 > 0:51:20'that giving up smoking, however you do it,
0:51:20 > 0:51:23'produces such big health benefits in just four weeks.'
0:51:25 > 0:51:28What the experiment tells us about e-cigarettes is that
0:51:28 > 0:51:31they are probably on par with nicotine replacement
0:51:31 > 0:51:33and they may have a slight edge,
0:51:33 > 0:51:36in that they give people a little bit of enjoyment as well.
0:51:36 > 0:51:40So, in other words, it's just like NRT in fancy clothes.
0:51:40 > 0:51:42But the thing is, those are clothes
0:51:42 > 0:51:44that a lot of people who smoke want to wear.
0:51:44 > 0:51:46Most people on the e-cigarettes were not keen
0:51:46 > 0:51:48to keep using them for ever and ever.
0:51:48 > 0:51:50I was going to say, all of them, when I spoke to them,
0:51:50 > 0:51:53- their goal was essentially to give it up entirely.- Yep.
0:51:53 > 0:51:56They didn't see it as a sort of bridge, or an alternative,
0:51:56 > 0:51:58or a way to just keep on inhaling nicotine.
0:51:58 > 0:52:00The plan was eradication.
0:52:07 > 0:52:11Now, it's absolutely fantastic that almost all the heavy smokers
0:52:11 > 0:52:15who took up e-cigarettes have managed to stop smoking.
0:52:15 > 0:52:18I was, however, in a completely different situation,
0:52:18 > 0:52:21because I was a non-smoker to begin with.
0:52:21 > 0:52:23So what, if anything, has vaping done to me?
0:52:29 > 0:52:31I'm going to a specialist airway lab
0:52:31 > 0:52:34at the Royal Brompton Hospital in London.
0:52:34 > 0:52:36I came here before I started vaping
0:52:36 > 0:52:39and now I'm going to repeat the same tests I did then
0:52:39 > 0:52:42to find out if vaping has affected my lungs.
0:52:44 > 0:52:49- OK. So make sure your mouth is well sealed around this.- OK.
0:52:49 > 0:52:51Blow! Keep on going. Keep on going.
0:52:51 > 0:52:53As long as you can. As long as you can. Go on.
0:52:53 > 0:52:56'The nurse tests for the amount of nitric oxide I'm exhaling -
0:52:56 > 0:52:59'an indicator of inflammation of the airways.'
0:52:59 > 0:53:01That's good.
0:53:01 > 0:53:02Take your nose clip off.
0:53:02 > 0:53:06'The scientists also want to analyse samples of my sputum -
0:53:06 > 0:53:08'mucus from deep inside my airways.
0:53:10 > 0:53:12'I will need to cough it up
0:53:12 > 0:53:15'and, to help, she gives me salty air to inhale.'
0:53:15 > 0:53:19- OK. A bit like fresh sea air.- Yep.
0:53:19 > 0:53:21- Down by the seaside. - Yeah. Are you OK?
0:53:21 > 0:53:24You don't feel sick or anything? No.
0:53:24 > 0:53:26'It is incredibly unpleasant.'
0:53:27 > 0:53:30HE RETCHES
0:53:30 > 0:53:32'Will the tests find any damage in my airways?'
0:53:32 > 0:53:37- OK.- That's it. I'm afraid that's your lot.- Yep.
0:53:37 > 0:53:38'The results of these tests will be analysed
0:53:38 > 0:53:41'by respiratory specialist Dr Omar Usmani.
0:53:44 > 0:53:47'First, he measures my airway resistance,
0:53:47 > 0:53:49'one of the tests our volunteers did.
0:53:49 > 0:53:51'In them, there was a suggestion
0:53:51 > 0:53:53'that e-cigarettes increased resistance.'
0:53:55 > 0:53:58We didn't really see much difference over the 28 days,
0:53:58 > 0:54:01with this specialised long blowing test.
0:54:01 > 0:54:04This is unsurprising to me, because you are a healthy person.
0:54:04 > 0:54:06It was a very short period of time.
0:54:06 > 0:54:08And what I'd be interested in seeing
0:54:08 > 0:54:12is the long-term effects of e-cigarettes on these measures.
0:54:12 > 0:54:14So you'd like me to go on vaping for another six months?
0:54:14 > 0:54:17I'd like you to go on vaping for six to nine months to a year
0:54:17 > 0:54:20and then my hunch is we may see something.
0:54:20 > 0:54:22'That's not going to happen.
0:54:22 > 0:54:24'But, even after just four weeks,
0:54:24 > 0:54:27'Omar discovered a difference in other tests.'
0:54:29 > 0:54:31So what did change, interestingly,
0:54:31 > 0:54:35is a marker of airway inflammation, called nitric oxide.
0:54:35 > 0:54:39And what happened to you was that your baseline level,
0:54:39 > 0:54:43before you had your e-cigarettes, was well within the normal range.
0:54:43 > 0:54:45And then, after five minutes of vaping,
0:54:45 > 0:54:47we found that it had slightly increased.
0:54:47 > 0:54:49Does it mean anything?
0:54:49 > 0:54:52Yeah, every time you puff, there is an insult to your airway cells.
0:54:52 > 0:54:54By an insult, you mean a mild injury?
0:54:54 > 0:54:57An injury that increased your airway inflammation
0:54:57 > 0:55:00to nearly four times the level that it should do, into abnormal areas.
0:55:00 > 0:55:02So, if you are taking - and I asked you earlier -
0:55:02 > 0:55:07100 puffs a day, that's happening to you 100 times a day.
0:55:09 > 0:55:10'And there's more.
0:55:11 > 0:55:13'When Omar analysed my sputum sample,
0:55:13 > 0:55:17'he discovered an increase in the number of macrophages in my lungs.'
0:55:22 > 0:55:25Macrophages are defence cells that line the airways of our lungs
0:55:25 > 0:55:28to protect them from foreign bodies.
0:55:28 > 0:55:30Too many can be detrimental.
0:55:30 > 0:55:34They produce enzymes, which can, ultimately, damage the airways.
0:55:36 > 0:55:37'From these test results,
0:55:37 > 0:55:40'it's clear that vaping has done some subtle damage.'
0:55:41 > 0:55:44Do you think that e-cigarettes are safer than cigarettes?
0:55:44 > 0:55:47The concern I have with e-cigarettes
0:55:47 > 0:55:51is they are being used as a substitute for smoking
0:55:51 > 0:55:53in environments where you can't smoke.
0:55:53 > 0:55:55And that's the real concern I have.
0:55:55 > 0:55:57So there really needs to be a concerted approach
0:55:57 > 0:56:01to actually quit to zero cigarettes.
0:56:01 > 0:56:02And, in that scenario,
0:56:02 > 0:56:04if e-cigarettes are able to achieve that aim,
0:56:04 > 0:56:07then they can only be a good thing.
0:56:07 > 0:56:10But there are concerns about their safety and there are concerns
0:56:10 > 0:56:12that, actually, they are used as a substitute.
0:56:12 > 0:56:16And, in those two scenarios, they can be a real detriment, I think.
0:56:18 > 0:56:20'My month-long experiment has shown
0:56:20 > 0:56:22'that vaping can affect healthy lungs.
0:56:22 > 0:56:26'But Omar assures me they should return to normal once I stop.'
0:56:34 > 0:56:37It seems to me that whether e-cigarettes are good news or not
0:56:37 > 0:56:40really depends on how they are used.
0:56:41 > 0:56:45The evidence suggests that vaping is far safer than smoking
0:56:45 > 0:56:47and is also an effective way to help you quit.
0:56:49 > 0:56:52Vaping does seem to cause some harm to our bodies,
0:56:52 > 0:56:55but in the short term the risks appear to be low.
0:56:56 > 0:56:58The one thing that science can't yet answer
0:56:58 > 0:57:01is what are the long-term effects?
0:57:01 > 0:57:03On this, there is no consensus.
0:57:04 > 0:57:07'Medicine has been littered with examples'
0:57:07 > 0:57:10where there's been a revolutionary new drug
0:57:10 > 0:57:13and then it's had to be withdrawn several years later,
0:57:13 > 0:57:16because of side-effects or complications.
0:57:16 > 0:57:18Cigarettes are so uniquely dangerous.
0:57:18 > 0:57:23Every cigarette reduces somebody's life by 11 minutes.
0:57:23 > 0:57:25If everybody in the population took up electronic cigarettes,
0:57:25 > 0:57:27we'd still be better off.
0:57:27 > 0:57:30I do worry that, in 10, 20, 30 years from now,
0:57:30 > 0:57:34we are going to discover health effects from e-cigarette use
0:57:34 > 0:57:36that we don't know about now.
0:57:36 > 0:57:40Books and PhDs and movies will be made about
0:57:40 > 0:57:44how was it possible that people from within public health
0:57:44 > 0:57:46vigorously opposed something
0:57:46 > 0:57:49which provides such a huge public health benefit?
0:57:52 > 0:57:53When I started,
0:57:53 > 0:57:55I was quite sceptical about the benefits of e-cigarettes.
0:57:55 > 0:57:58But I've changed my mind.
0:57:58 > 0:58:00Clearly, if you are not a smoker,
0:58:00 > 0:58:03then taking up vaping is a stupid thing to do.
0:58:03 > 0:58:07'But, if I was a smoker, then, despite the uncertainties
0:58:07 > 0:58:11'and potential downsides, I would certainly give it a go.'
0:58:14 > 0:58:18'Worldwide, there are currently around one billion smokers
0:58:18 > 0:58:22'and about half of them will be killed by their habit.
0:58:23 > 0:58:26'If e-cigarettes can win a significant share
0:58:26 > 0:58:28'of the trillion dollar tobacco market,
0:58:28 > 0:58:31'this could transform the world's health.'