Tony Casey of the Johnson City Press released an article on Dec. 14, 2014 titled Traditional vs. electronic: FDA considers regulation for e-cigarettes. The article is based upon research by Hadii Mamudu, Ph.D. of Eastern Tennessee State University’s Department of Public Health.
The manufacturers of e-cigs claim that e-cigs are healthier than traditional cigarettes. This is very likely to be true, but it does not make e-cigs a healthy product.
Mamudu compares the relative dangers of e-cigarettes versus traditional cigarettes as being similar to falling off a 10 story building versus a 100 story building. Either product is a health danger that will reduce the life span of users. Mamudu has recommended increased regulation of e-cigs by the FDA.
E-cigs are a highly effective way to deliver nicotine into the users’ bodies. The E-cigs also deliver atomized particles of propylene glycol or glycerin propellants, and low concentrations of carbonyl compounds as propellant byproducts. The formaldehyde and acetaldahyde are known carcinogens that are produced in small quantities by the e-cigs. These compounds along with the nicotine from e-cigs may be factors in kidney, lung and liver cancers and leukemia.
There is no long-term data to establish whether the combustion products are cancerous or otherwise a serious health threat to users of e-cigs over an extended period of time. The e-cig manufacturers continue to claim that there are limited data about the physiological effects of nicotine adsorption into the body from e-cigs. There is an alternative nicotine delivery system that does have extensive data to document the physiological effects of nicotine without smoking. It is from the use of oral snuff, nicotine gum and chewing tobacco.
There was a comparison study carried out by the General Clinical Research Center (R-0083) at San Francisco General Hospital in 1987 that was funded by the NIH. The title of the study was Nicotine adsorption and cardiovascular effects with smokeless tobacco use: Comparison with cigarettes and nicotine gum. The smokeless nicotine delivery systems were oral snuff and chewing tobacco. It was published in the journal of Clinical Pharmacology & Therapeutics in 1988.
The report was written by Neal L Benowitz MD, Herve Porchet MD*, Lewis Sheiner MD and Peyton Jacob III PhD San Francisco, Calif.
Because of recent resurgence in its consumption, the effects and health consequences of smokeless tobacco are of considerable public health interest. We studied the extent and time course of absorption of nicotine and cardiovascular effects of smokeless tobacco (oral snuff and chewing tobacco) and compared it with smoking cigarettes and chewing nicotine gum in 10 healthy volunteers. Maximum levels of nicotine were similar but, because of prolonged absorption, overall nicotine exposure was twice as large after single exposures to smokeless tobacco compared with cigarette smoking. All tobacco use increased heart rate and blood pressure, with a tendency toward a greater overall cardiovascular effect despite evidence of development of some tolerance to effects of nicotine with use of smokeless tobacco. Relatively low levels of nicotine and lesser cardiovascular responses were observed with use of nicotine gum. Adverse health consequences of smoking that are nicotine related would be expected to present a similar hazard with the use of smokeless tobacco. (Clinical Pharmacology & Therapeutics 1988; 44:23-8.)
Nicotine is highly addicting, with proven data as to how it decreases the life span of users. Nicotine constricts blood vessels, which leads to high blood pressure, heart disease, heart attacks, strokes and blood clots. Nicotine causes cancer in the liver, bladder and kidneys.
The greatest area of growth of e-cig use in the US is documented as being in the age group from middle school to high school. There are no regulations to prevent the sale of e-cigs to minors. There are no regulations to prevent the advertising of e-cigs to minors, or prohibitions of e-cig formulations that directly appeal to minors, e.g. cotton candy, blueberry and strawberry e-cig liquid flavorings. Many of these children are smoking e-cigs without ever having tried cigarettes.
As e-cigs have evolved, the voltages of the e-cigs and the quantity of nicotine in the liquid have been increased. Higher voltages produce higher temperatures, which causes higher concentrations of nicotine and other known toxic chemicals into the e-cig user’s body. At their worst, the combination of higher temperature when used with propylene glycol propellant produces formaldehyde and acetaldehyde that are known carcinogens. As longer term data is gathered among e-cig users, the cancer risks from the nicotine and propellants will be determined.
A study was done to determine the effects of the higher temperatures in producing carbonyl compounds that are considered to be dangerous by-products from the e-cig liquids. The corresponding author of the study was Maciej L. Goniewicz, PharmD, PhD, Department of Health Behavior, Division of Cancer Prevention and Population Science, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
The major conclusions of this study are available.
Glycerin (VG) and propylene glycol (PG) are the most common nicotine solvents used in e-cigarettes (ECs). It has been shown that at high temperatures both VG and PG undergo decomposition to low molecular carbonyl compounds, including the carcinogens formaldehyde and acetaldehyde.
According to a disputed Japanese study, the levels of formaldehyde in vapors from high-voltage device were in the range of levels reported in tobacco smoke. There is no disputing that nicotine is addictive and lowers life expectancy.
It can be concluded that e-cigs present a lesser health risk to users than smokers of traditional cigarettes. That is the good news. E-cigs deliver nicotine to the users, as well as atomized particles of propellants that have been heated by the e-cig devices. Nicotine is highly addictive, and has serious health effects on multiple organs that include the heart, arteries and veins, the lungs, kidneys, liver and bladder. There is an increased risk of heart attacks, strokes, and cancer.
The FDA needs to regulate the advertising and sale of e-cigs, with an emphasis on preventing advertising and distribution to minors. E-cigs and e-cig liquids need to carry health warning labels. The regulation of e-cigs as a nicotine delivery system needs to be done sooner than later by the FDA.