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E-Cigarettes and Your Health

Are e-cigarettes safer than traditional smokes?
Are e-cigarettes safer than traditional smokes?

Every third Thursday of November, the American Cancer Society holds the "Great American Smokeout." The goal is to encourage, "smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. By quitting — even for one day — smokers will be taking an important step towards a healthier life – one that can lead to reducing cancer risk."

The good news is that a combination of factors has reduced smoking, year after year for decades. In 1965 about 42% of the population smoked. In 2011, that number is down to about 19% or 43.8 million people.

Cigarette companies have responded to their declining United States market share with several tactics. They're expanding into countries with less restrictive laws on advertising, they're buying up and consolidating rivals and they're heavily investing in new technology. In fact, one of the biggest game changers in decades is the arrival of electronic cigarettes or e-cigarettes.

E-cigarettes are essentially nicotine delivery systems. They're battery powered devices that use heat to turn nicotine-laced liquid into a vapor that the user can inhale. Many are designed to look like cigarettes, right down to the glowing tip when you inhale, to make smokers feel more comfortable.

For cigarette companies, they have several advantages.

  1. Unlike traditional cigarettes, e-cigarettes aren't nearly as heavily taxed, so they can be sold cheaper while still providing healthy profit margins.
  2. The vapor that people breathe out doesn't smell as noxious as traditional burning tobacco, so people are using them inside where cigarettes have been banned.
  3. Safety is also heavily promoted with companies claiming e-cigarettes are healthier alternatives to tobacco because you're not ingesting all the smoke and toxic chemicals.

Since safety is one of the primary messages e-cigarette companies use, I thought I'd see if they were truly as harmless as many people believe.

When you smoke tobacco cigarettes, the inflammation and chemicals you're ingesting turn vascular smooth muscle cells into miniature drills that dig through connective tissue. That means your muscle cells are burrowing into blood vessels, where those cells and other debris clump up into artery clogging plaque. Over time it leads to hardening of the arteries, heart attack and stroke.

Nicotine was always thought of as the chemical that got people addicted to smoking, most people didn't think it actually did any damage. A recent study at Brown University in Providence, Rhode Island showed that thinking was wrong. Researchers exposed smooth muscle cells, riled up by inflammation, to nicotine. Those muscle cells formed ringlike structures and started burrowing away. Since e-cigarettes are designed primarily as nicotine delivery systems, they may not be so harmless after all.

That leads me to my second problem, there is no guarantee of how much nicotine each e-cigarette dispenses. When you give someone a pill or a shot, the dosage is very carefully regulated. With e-cigarettes, there is no agency that dictates how much, or how little nicotine is dispensed with each puff. Without standards, the consumer doesn't know what they're really getting.

When the Food and Drug Administration did their initial tests, they detected diethylene glycol, a dangerous chemical found in antifreeze. There were also traces of nitrosamines and other cancer causing agents. On top of that, some vials labeled "nicotine free" actually had low levels of the addictive substance.

A huge advantage for cigarette companies is that e-cigarettes are being promoted to a whole new group of buyers that wouldn't consider traditional tobacco products. It's a way to stop the decades long erosion of market share.

In a study published in JAMA Pediatrics, researchers compared, "Electronic Cigarettes and Conventional Cigarette Use Among US Adolescents." They found several disturbing trends. People who used e-cigarettes had "higher odds of ever or current cigarette smoking" and "lower odds of abstinence from conventional cigarettes." They also concluded that, "Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US adolescents."

That's really my biggest problem with e-cigarettes. I don't want to see people who wouldn't normally smoke, consider taking up the habit.

Advantages

There are a few advantages that cannot be overlooked. There is no doubt that smoking an e-cigarette is significantly less harmful than one made out of tobacco. E-cigarettes are far less likely to cause a fire if left burning in the house. And in The Lancet's trial of e-cigarettes used to quit smoking, they had a slightly higher success rate than nicotine patches. The six-month quit rate for people who used the nicotine patch was 5.8% compared to 7.3% of people who used e-cigarettes.

Ultimately I think the public would be best served by sensible regulations. They're simple really, as long as political leaders have the nerve to put them in place.

  1. Prevent e-cigarettes sale and promotion to underage children.
  2. Regulate the amount of nicotine and other chemicals they deliver.
  3. Restrict their use just like traditional cigarettes, until the risk of secondhand vapors is known.

UPDATE: Since we wrote the original article, several new facts have emerged. This is from Science News, June 18, 2014.

"...data from 18 studies on e-cigarette vapors found that most contain at least traces of the solvents in which nicotine and flavorings had been dissolved. Those solvents, known as lung irritants, can transform into something even more worrisome: carbonyls. Carbonyls include cancer-causing chemicals, such as formaldehyde, and suspected carcinogens, such as acetaldehyde."

Users inhale or "vape" large amounts of these very small particles and 40% will lodge in the lungs tiniest airways. The amount of particles a "vaper" will inhale is 100 times as high as the Environmental Protection Agency's 24-hour exposure limit for fine air particles.

On top of the cancer risk is the germ factor. Scientists now believe the vapors may make germs like MRSA (methicillin-resistant Staphylococcus aureus) even harder to kill.

E-cigarettes do seem safer than traditional tobacco, but they're NOT a safe passtime. You should definitely make all attempts to quit.


UPDATE: E-Cigarettes Gateway for Adolescent Smokers

In July of 2014, JAMA Pediatrics published a study from the University of California San Francisco. Researchers looked at the habits of 40,000 middle and high school students. Here's what they found:

"Use of e-cigarettes was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes. Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US adolescents."

You read that right. E-cigarettes may encourage conventional cigarette use among US adolescents. Even more of a reason to make sure their sale is highly regulated.


UPDATE: E-Cigarettes CONFIRMED as Gateway to Traditional Tobacco Products

In a study published in the August 18th, 2015 issue of JAMA (Journal of the American Medical Association) researchers made a clear link between e-cigarette or "vaping" use and experimentation or use of traditional tobacco products.

In other words, vaping or e-cigarettes ARE a gateway drug. Kids who vaped or used e-cigarettes were about three times more likely to start smoking tobacco products within the year than children who didn't vape.

Ad campaigns promoting vaping or e-cigarettes should be restricted the same way ads for traditional tobacco products are regulated, to prevent millions more people from getting addicted. The sale of vaping products should also be limited to adults.

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11/16/2014
Updated 9/23/2015
Updated 10/17/2018