Urgent action is needed to combat the "vaping epidemic" among youth.

Professor Filip Lardon

Interview with professor Filip Lardon

“Vaping has its place. It can help adults quit smoking or at least encourage them to quit. However, I must sound the alarm about children and young people taking up vaping. It's gradually getting them addicted to nicotine.”

Cancer expert Professor Filip Lardon from the University of Antwerp has recently published a book on the harmful effects of smoking and vaping. This, he insists, is essential as smoking continues to claim one to two lives every hour. "As cancer researchers, specialists, general practitioners… we are exhausted by having to deliver harsh diagnoses to our patients every day because of smoking-related diseases such as lung cancer and COPD. Yet 80 to 90% of these diseases are preventable.

Is vaping less harmful than smoking?

Yes, based on current knowledge. Smoking involves burning tobacco, while vaping involves evaporating a liquid - a fundamentally different process. Tobacco contains over 4,000 harmful substances and burning it releases even more. Vaping liquids, while unhealthy, contain a less harmful cocktail of chemicals. And evaporation doesn't generate the same plethora of additional toxins.

In 2003, Chinese pharmacist Hon Lik introduced vaping with the best of intentions. However, the tobacco industry immediately saw an opportunity. With more and more smokers either quitting or dying, vapers became the "replacement generation". To appeal to vapes, attractive packaging was used with "healthy" images, child-friendly fluorescent colours, and a wide range of flavours - over 7,000 worldwide. The industry has been particularly successful in mass-administering the highly addictive drug nicotine to young people and children.

"To appeal to vapes, attractive packaging was used with "healthy" images, child-friendly fluorescent colours, and a wide range of flavours."

Ten years ago, I started a project to warn third- and fourth-year secondary school students about the dangers of smoking. I rarely visited primary schools, but in the past two years I've been doing so. It's shocking to see that up to 15 to 20% of 11–12-year-olds are vaping, with some children being as young as 8 or 9 years old. Children don't understand the health risks. When they taste apple, they associate it with a healthy snack. That's why I'm raising the alarm.

Sixteen-year-olds often hide their smoking but openly admit to vaping. At a recent lecture, nearly half of the students said they used a disposable vape and not a refillable one. Most didn't know whether their device contained nicotine, while it almost always does. This lack of awareness, both among teenagers and parents, makes it harder to address nicotine addiction.

What are the health risks?

Vaping has only been popular for ten years, so the long-term effects are not well known. There are health risks, however. Nicotine, while not carcinogenic, is highly addictive in adults. And for children under the age of 16, whose brains are still developing. Nicotine disrupts the development of the frontal cortex, including the reward center, potentially leading to concentration problems later in life. Increasingly, doctors are reporting ADHD-like symptoms in children who vape. Furthermore, altered reward systems in adolescence may lead to issues in adulthood.  

"Increasingly, doctors are reporting ADHD-like symptoms in children who vape."

But no link between vaping and cancer has been proven?

Emerging studies and 2024 conference reports show mild DNA damage in the lung and airway epithelium of laboratory animals exposed to frequent vaping. This could increase the risk of cancer. While I don’t want to cause panic, there is an urgent need to address the "vaping epidemic" among young people.

What is (legally) possible?

Drastic measures are overdue. Since early 2024, the Netherlands has limited vape flavors to neutral or tobacco options. However, illegal online stores continue to sell disposable vapes with a wide range of flavors, many of which contain alarmingly high nicotine levels—sometimes equivalent to 400 cigarettes. That's terrible.

The Belgian Superior Health Council, of which I am a member, initially recommended against banning flavors. We reasoned that smokers switching to vaping might need flavored options, like strawberry, to successfully quit. But perhaps it’s time to reconsider. Either way, we're lagging behind. Belgium will ban disposable vapes starting January 1, but manufacturers have already shifted to pod-based e-cigarettes with reusable attachments, circumventing the law. These devices remain readily available in convenience stores and night shops.  

One solution could be restricting sales of (disposable) vapes to specialized vape shops, which enforce the age limit of 18, unlike regular stores. Australia has gone further, banning all vaping devices except those sold in pharmacies, and is even considering requiring a doctor’s prescription.  

Federal Health Minister Vandenbroucke wants to ban tobacco in public places?

Yes, that includes vaping. Under Belgium’s Tobacco Plan, set to take effect on January 1, smoking and vaping will be banned in the presence of children and in locations like amusement parks, playgrounds, and zoos. Additionally, there will be a significant price increase, and from April, all smoking and vaping products must be removed from public display. Mr. Vandenbroucke is the first Health Minister to take decisive action and take good measures. However, controlling online sales remains a significant challenge.  

'Twee doden per uur',the new book by Prof. Filip Lardon