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Tuesday, June 28, 2016

How Safe are E-cigarettes?

E-cigarettes are a fairly new phenomenon born from research into new ways to cut down on the population’s cigarette use. There are 500 brands of e-cigarettes on the worldwide market and their popularity is growing. With approximately 2.8 million e-cigarette smokers in Great Britain alone (47% being ex-smokers), the rise of e-cigarette use continues to grow. But are they safe?

Table (click to enlarge): ash.org.uk

What Is an E-cigarette?

An e-cigarette, also known as an e-cig, is an electronic means of inhaling nicotine.

They are formed as cigarettes so users can hold and inhale the ‘smoke’ as if they were smoking a traditional cigarette. A rechargeable heating battery warms a cartridge of chemicals and nicotine transforming it into breathable aerosol. The act of breathing in the aerosol is often called ‘vaping’. Nicotine or ‘e-liquid’ cartridges are sold in pharmacies and supermarkets.

What’s in them and how are they different?

E-cigarettes fundamentally differ from traditional tobacco cigarettes because they contain no tar or ‘smoke’ substances. Because tar and the chemicals associated with it are the main cause of lung cancer, e-cigarettes are viewed as healthier alternative.

There are no governing bodies for standards in the e-cigarette market and brands contain different ingredients that are not monitored by health agencies.

Diagram (click to enlarge): buisnessinsider.com

Here are the main ingredients usually included:

•  Nicotine. Nicotine is the substance smokers are addicted to. It stimulates the nervous system, raises the heart rate and blood pressure.

•  Propylene glycol. This is the liquid used to make artificial fog at concerts. It’s approved by the Food and Drug Administration (FDA).

•  Glycerin. Also viewed as safe by the FDA, it’s used in many food and drug products.

•  Flavourings. There are over 7,000 flavourings available worldwide including sweet flavours such as cherry, cinnamon and even tobacco flavour. These chemicals are used in food but there’s no research into their effects on the lungs.

When these substances heat up they form other chemicals including formaldehyde, acetaldehyde and acrolein, which are probable carcinogens, that is, cancer causing substances.

The Health Aspects

Researchers simply don’t know about the long term effects of e-cigarettes because they haven’t been used for long enough to show any benefits or otherwise. Trials into their ingredients have taken place, which show they are not completely safe. However, in comparison to traditional smoking they are a safer and a healthier option.

The pros of E- cigarettes include:

•  They help people quit smoking - a huge plus for the population’s health and the burden on health systems.

•  Traditional smoking is well known for its cancer causing habits. The American Lung Association reports a traditional cigarette releases 7000 chemicals when burnt and that 69 of those cause cancers. Cigarette smoking can cause a number of health problems. Along with lung cancer, live cancer, mouth and bladder cancer, cervical cancer, cigarette smoking can also lead to kidney disease, heart disease, stroke, high blood pressure and male impotence. There are no pros to traditional cigarette smoking.

•  E-cigarettes contain nicotine but no tar, which is the cause of cancer. The National Health Service will soon be clear to prescribe them to those seeking to quit tobacco cigarettes.

•  E-cigarettes don’t cause passive smoking. Nearly all the aerosol is inhaled by the user, whereas cigarettes pollute the air and other people’s lungs. Neal Benowitz, MD former member of the FDA’s Tobacco Products Scientific Advisory Committee said “Seventy-five percent of the smoke generated by cigarettes is side-stream smoke, and that goes into the environment.

The cons of e-cigarettes include:

Researchers don’t know much about the downside of e-cigarettes, but this doesn’t mean they are risk free.

•  Researchers from the Harvard TH Chan School of Public Health investigated 52 types of flavoured e-cigarettes for the chemical diacetyl which is used as a flavouring but causes ‘popcorn lung’ when inhaled. 92% of the e-cigarettes tested flagged it up. Popcorn lung describes tiny tears in air sacs which lead to lung scarring and shortness of breath.

•  Another study from the University of California re-created e-cigarette vapours and tested it on human cells. Cells exposed to the vapour developed DNA damage and died more quickly than untreated cells. Nicotine free e-cigarettes caused 50% more DNA strand breaks than untreated cells.  The researchers suggest that the study shows e-cigarettes are not as safe at the marketing makes out.

•  A reliance on e-cigarettes is still an addiction. Addictions have physical and psychological side effects and disruption everyday life. A nicotine addiction cannot be described as healthy.

•  Some experts are concerned that the nicotine cartridge can be easily replaced with other substances making them a new way to deliver health damaging drugs.

Use In Teenagers

Experts have debated over the use of e-cigarettes in teens. In 2015 UK law changed to make e-cigarettes available to over 18s only, but not all US states have the same law. E-cigarettes are easily ordered online making them available to anyone with an internet connection.

Teens have been subjected to anti-smoking campaigns all their lives. At no point for them has it been ‘safe’ to smoke real cigarettes, but teenagers who take up e-cigarettes as a way of safely smoking may cause themselves harm.

E-cigarettes are products for adults trying to quit smoking, not for recreational enjoyment but the sweet flavouring used to mask the taste of nicotine is appealing to teens who are increasingly taking up the habit. Evidence shows this leads to an uptake of traditional smoking.

Safer Than Traditional Smoking

Although e-cigarettes are healthier than traditional tobacco, and a helpful way for smokers to gradually decrease their smoking habit, e-cigarettes are not without their own risks.

Perhaps the biggest risk is that researchers simply don’t know what the longer term effects are yet. In the past tobacco was prescribed as a cure for asthma so e-cigarettes may well hold undiscovered side effects in store and this in itself is a risk.

Current research shows that inhaling the cocktail of chemicals created by e-cigarettes is potentially harmful. Public bodies and legislators worldwide are evaluating new evidence before implementing regulatory controls.

When taken in relation to traditional tobacco, e-cigarettes are currently a safer alternative, but they should be used as a short-term tool for smokers trying to quit, not as a healthy risk-free habit for non smokers.

This is a guest blog entry.

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