Electronic cigarettes have steadily gained in popularity over the last several years, sometimes as a “safer” alternative to smoking. However, serious doubt still exists over the safety of these products. A recent letter in The New England Journal of Medicine, reported that some e-cigarettes release formaldehyde, a probable carcinogen (can cause cancer). This has refueled the debate regarding the health concerns with e-cigarettes.
E-cigarettes are battery operated inhalers that look like real cigarettes. The Tobacco Vapor Electronic Cigarette Association (yes, there is such an association) estimates about 4 million Americans now use e-cigs. They project sales to cross the 1 billion mark by the end of this year. Currently there are more than 250 different brands of e-cigarettes available in different flavors and colors!
The e-cigarettes are not regulated. Lack of oversight from a federal agency means that nobody knows for sure what is in an e-cigarette. Even the labels may inaccurately describe ingredients. All e-cigarettes contain a solution that’s heated up and converted to an aerosol, which users inhale. E-cigarettes do not contain tobacco, but have many potentially dangerous ingredients:
- Nicotine: This is what causes addiction (e-cigarettes and regular cigarettes). However, nicotine does not cause cancer; it is the other ingredients that are carcinogens.
- Flavorings: Numerous flavors exist. These are the same flavors that are also used to flavor food. Although safe when eaten, they may be toxic when inhaled.
- Propylene glycol: FDA views this as safe in food, drugs, and cosmetics. But it may be harmful for people with chronic lung diseases like asthma and emphysema.
- Toxic chemicals are formed as the e-liquid heats up: Among these are two probable carcinogens – formaldehyde and acetaldehyde. These chemicals are released in increasing amounts as the temperature of the e-liquid rises.
- Particulates: The tiny particles in the aerosol also may be harmful. E-cigarette aerosol has similar levels of particulates as regular cigarettes.
- Toxic metals: Many have been detected in e-cigarette aerosol. A 2013 study notes that some metals, such as nickel, occur in concentrations 2 to 100 times that of cigarettes.
According to the American Lung Association, regular cigarettes give off about 7,000 chemicals when burned, many of them poisonous, and at least 69 of those chemicals cause cancer. On first glance, compared to cigarettes, e-cigarettes appear to be less hazardous. E-cigarettes also are less dangerous to people around smokers (second hand smoke). Still, much more research needs to be done to fully figure out the health risks that e-cigarettes pose for both users and bystanders.
Who might benefit from e-cigarettes?
E-cigarettes may prove helpful to smokers who are trying to quit. But the jury is out on that. In fact, The WHO has asked marketers not to make that claim. In a recent study published in the medical journal Lancet, researchers compared e-cigarettes to nicotine patches and other smoking cessation methods and found them statistically comparable in helping smokers quit. So, experts consider e-cigarettes promising but not fool proof.
What’s the harm?
Nicotine addiction of any kind is bad, and people with the habit need help quitting, not help continuing their habit in more socially acceptable ways (which e-cigarettes may provide). Long term effects of e-cigarettes are unknown. Studies have shown that e-cigs contain many hazardous compounds and possible carcinogens.
Adverse Effect on Youth!
E-cigarettes are being advertised in a rather glamorous portrayal of smoking or “vaping”. Many feel that this is designed to entice youngsters. There are no federal age restrictions to prevent kids from obtaining e-cigarettes. Most e-cigarette companies voluntarily do not sell to minors, yet “vaping” among young people is on the rise. A Center for Disease Control and Prevention study found nearly 1.8 million young people had tried e-cigarettes and the number of middle and high school student e-smokers doubled over the last year.
This information is strictly an opinion of Dr Prakash, and is not intended to replace the advice of your doctor. Dr Chris Prakash is a contributing columnist, and author of eParisExtra’s “The Doctor is In” column. He is a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris, TX with his wife and two children, and can be reached at 9037850031, or Sucharu.prakash@usoncology.com.