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Electronic Cigarette Health Update: The Good, Bad and Ugly

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The electronic cigarette health controversy continues in light of recent data gleaned from studies and surveys.  Some of the data is good; some is bad; and some is ugly.

First of all, whether your take is good, bad, or indifferent, e-cigarettes are now under the regulation of the e-cigarette regulationU.S. Food and Drug Administration (FDA).  Its earlier declaration of e-cigarettes as a tobacco product paved the way for this change.  The agency assumed that authority in August 2016 with enforcement of key provisions of the Family Smoking Prevention and Tobacco Control Act.  Those provisions pertain to the sale, marketing and manufacturing of the devices.

As a result of the new law it is now illegal for a vendor to sell the products to anyone under the age of 18.  Also, if a manufacturer makes a therapeutic claim – such as the product helps quit smoking – it has to submit proof through a series of clinical trials that the product is effective and safe.  

electronic cigarette health

There was some good electronic cigarette health news that appeared in a publication by a team of researchers at Rosewell on August 17, 2016.   It reported on the results of a study that looked at the effect that switching from cigarette smoking to e-cigarette vaping had on exposure to certain toxicants (poisons) and carcinogens in tobacco.  

The study consisted of 20 people who on the average had smoked cigarettes for 12 years. To determine exposure the researchers measured certain biomarkers in the urine of the participants. The first measurement was at the start of the study.  A second measurement was 2 weeks after they had made the switch to e-cigarettes. The measurements showed a marked reduction in the biomarkers after the switch, indicating decreased exposure to the harmful substances in tobacco.  

The conclusion of the Rosewell study was that totally switching from cigarette smoking to vaping might reduce the risk of cancer.  One of the problems with this study though, is the sample size of 20 people, which was rather small.  Another drawback is the 2-week timeframe of the study, which was short.  Also of concern is the 5-year gap between the study per se and the publishing of the results. The lead author for the study attributed the delay to “academics being very busy.”

heavy metals in e-cigarettes

The above image is a modified work of Synthetic Biology under CC license at http://2015.igem.org/Team:Bielefeld-CeBiTec/Project/HeavyMetals

There was also some bad electronic cigarette health news that recently hit the press. It had to do with the discovery of heavy metals in the liquid portion of the five most popular brands of the devices. In its January 2017 issue the journal, Environment Research, reported that researchers at the Johns Hopkins School of Public Health found high levels of toxic and potentially carcinogenic cadmium, chromium, lead, manganese and nickel in the liquid of all five leading brands of so-called first generation e-cigarettes. The researchers believe the source of the metals is the coil which heats the liquid to produce the aerosol, which is often but incorrectly called, the vapor.  

More surprisingly, the concentration of the metals varied considerably between the different brands of e-cigarettes.  One brand had a high concentration of all 5 metals including nickel which was 400 times higher than the brand with the lowest concentration of that metal.  It also had a concentration of manganese which was 240 times higher than the brand with the lowest concentration of it.  

This striking variation in the amounts of the metals in the liquid of the different brands of devices prompted one of the researchers to say that the FDA should consider including the ingredients found in the e-cigarettes’ liquids as part of its quality control regulation of the devices themselves.  

Opinions vary among clinicians and researchers with regard to whether or not heavy metals cause cancer, neurodegenerative disease, autoimmune disease and other diseases.  But except for small amounts of manganese and chromium, those metals found in e-cigarettes by the study serve no useful purpose in the body. When inhaled at some of the concentrations detected it is almost certain that they can all cause harm.  

It would not be surprising if future research shows that in addition to the above mentioned diseases, long-term use of the e-cigarettes leads to an increased incidence of interstitial lung disease, asthma and a host of other lung problems.

The ugly side of the electronic cigarette health debate is the explosion in the use of e-cigarettes by high school electronic cigarette healthyouth. According to one report the percentage increased by 900% between 2011 and 2015 with more teens now using the devices than cigarettes.  

Perhaps more gloomy is the skyrocketing increase in the number of poisonings of children who ingested e-juice – the liquid part of the device. Such exposure involving children rose from 14 in January 2012 to 223 in April 2015.  

The world-wide revenue from e-cigarette sales surpassed $3,000,000,000 in 2016 with estimates that it will be in excess of $10,000,000,000 by the end of 2017; even so, the jury is still out with respect to whether or not they are safe or if they constitute health hazards.   

Suffice it to say though, based on what we know up to this point it appears as if the handwriting is on the wall.  The health of the industry is clearly very good for now.  But the health of its patrons might not be — for long.

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