When vaping first appeared we were sold the idea that it was a harmless way to transition from combustible cigarettes.

We were advised that its success levels in helping people stop smoking were at least equivalent to those of traditional nicotine replacement therapies (NRT).

Even more daringly, the manufacturers and those in support reassured us that there was no way that non smokers would start using e-cigarettes.

Moreover, there was the implication that children would not be able to purchase such items, and that marketing would not draw them like moths to a flame.

Yet figures from NHS digital show that compared the previous year, in 2022 there have been quadruple the number of vaping related hospital admissions in those aged under18 in England.

The numbers are not massive (32 as opposed to eight) and this will certainly be pointed out by those sitting firmly in the vaping camp.

However, a recent poll of UK teenagers between the ages of 11-17 shows that 17 per cent have tried vaping at least once, with seven per cent identifying themselves as ‘regular vapers’.

Such is the rise in e-cigarette use in the younger age group that one Australian psychologist commented that teenage vapers were like ‘little babies with a dummy, unable to function without their vape in hand’.

Perhaps the final nail in the coffin is that across all age groups, a quarter of those who regularly vape have never smoked.

The stratospheric rise in vaping and its now indelible place in normal society has probably much to do with the completely opposite views of two major health bodies.

Much was made of Public Health England’s stance that ‘Vaping is 95 per cent less harmful than smoking’. Somehow safer became the same as safe. Against this the World Health Organisation (WHO) robustly advised that ‘e-cigarettes are harmful to health’.

While the WHO was criticised for this standpoint to the point of being accused of being outdated, the harsh reality is that often the truth hurts.

Added to this, you are not seen as a social pest if you vape. E-cigarettes are smokeless, don’t leave behind nasty odours and can be consumed without the highly visible ritual of lighting up.

Let us not forget that manufacturers have really gone to town on making these devices appealing. Instead of uncomfortable pictures of blackened, charred lungs, or a person collapsed mid-stroke and the command ‘Smoking kills, stop now’, you are greeted with brightly coloured yet often discrete items, some of which have become genuine fashion items.

But behind all of the marketing hype is the reality that safer is not the same as safe, and never will be.

E-cigarettes contain the active chemical nicotine, shown in studies to be as addictive as heroin or cocaine. You do not need nicotine, but once exposed to it addiction is rapid. It is the one chemical that keeps smokers and indeed vapers hooked.

Studies have demonstrated that nicotine causes surges in heart rate and blood pressure and that these sudden rises in blood pressure are a greater risk for heart attack and stroke than having a raised blood pressure without the surges.

While many of the flavourings in e-cigarettes have been approved for human consumption, it is important to signal that they have been agreed as safe for eating, not inhaling.

The inhalation of heated vapour is how e-cigarettes work. Yet an outbreak of lung injury due to vaping in the US caused over 2,500 hospital admissions and over 60 deaths.

While the wellbeing of organs that cannot be seen may be of less concern, one thing that should be food for thought is the damage e-cigarettes cause to your oral health.

They are as bad as traditional cigarettes such that a dentist can easily recognise the mouth of someone who regularly vapes.

Propylene glycol, one of the main ingredients, degrades into three substances which work together to damage tooth enamel. They also bind with saliva molecules in the mouth, causing the uncomfortable phenomenon of dry mouth.

Not only is this irritating but saliva is one of the main ways of maintaining oral health and washing away bacteria.

Glycerin, also found in e-cigarettes, is a sugar, causing bacteria to stick to teeth fourfold.

Nicotine reduces the blood supply to the teeth, so gums do not bleed. The chemical also causes you to grind your teeth.

While e-cigarettes undoubtedly are here to stay, and can have a place in smoking cessation, they should be a bridge to cessation, not another harmful vice.

Dr Zak Uddin is a GP