On March 30, 2015, the Center for Disease Control (CDC) added electronic cigarettes to its long-standing anti-smoking campaign, called “Tips from Former Smokers.” The e-cigarette smoker in one ad is named Kristy. Her picture appears with a caption that reads: “I started using e-cigarettes, but kept smoking. Right up until my lung collapsed.”
The California Department of Health rolled out its media campaign against e-cigarettes the week before. According to the Wall Street Journal, the California campaign comes two months after state health officials declared e-cigarettes a health risk. The ads correctly point out that e-cigarettes are “brought to you by the people who brought you lung cancer.”
Although many e-cigarettes are manufactured overseas, almost all of the major cigarette companies have businesses devoted to selling these nicotine delivery devices (It is reported to now be an approximately $3 billion industry).
What exactly are e-cigarettes?
Electronic cigarettes are devices that deliver vaporized nicotine liquid into your lungs. They consist of three parts:
- A cartridge that holds a liquid nicotine solution that contains propylene glycol, glycerol or both. The solution may also have different flavoring additives, such as coffee, mint, candy, and fruit
- A heating device that vaporizes the liquid
- A battery or other power source
When the user puffs on the e-cigarette, it activates the heating element which vaporizes the liquid in the cartridge. The resulting vapor is then inhaled, giving the act of smoking an e-cigarette its nickname, vaping. Users can purchase bottles of nicotine liquid, with such enticing names as Cinnabomb, Frosted Clove, Fruit Juice, and Citrus Blast, to refill certain devices.
Health effects of e-cigarettes
Although the CDC and the California DHS have come down on the anti-e-cigarette side, it shouldn’t be much of a surprise to learn that there is a lot of obfuscation going on when it comes to describing the health effects of e-cigarettes.
To paraphrase the state of California, these lucrative little nicotine delivery devices are being brought to you by the same companies whose leaders testified before Congress that nicotine was not addictive.
While it is true that e-cigarettes have fewer toxins than traditional cigarettes, they are not toxin-free. When tested, the vapor of some e-cigarette products has been found to contain carcinogens and other toxic chemicals, such as formaldehyde and acetaldehyde.
A recent letter published in the New England Journal of Medicine (1/22/15) titled, “Hidden Formaldehyde in E-cigarette Aerosols,” estimated that an e-cigarette user smoking (vaping) at a rate of 3 ml/day would inhale 14.4 mg of formaldehyde per day as formaldehyde-releasing agents. The average delivery of formaldehyde from conventional cigarettes is approximately 3 mg per pack.
Although we don’t yet know if this exposure will cause cancer, we do know that formaldehyde is a carcinogen. It’s is interesting to note that people freaked out when they learned that Lumber Liquidators’ Chinese-made laminate flooring seemed to be emitting formaldehyde, but so far, there has been no such outrage that cigarette companies are able to legally sell devices that we can use to inhale this toxin directly into our lungs.
Nicotine, itself, is also poisonous when ingested or absorbed through the skin. It is very worrisome that the number of calls to poison control centers related to exposure to or ingestion of the nicotine liquid has increased markedly correlating with the rise in popularity of this product.
Most of the exposures have been in children under 5 years old. Many of the poisonings were mild, however, some kids required emergency department care and some were even hospitalized. Although no deaths have been reported yet, beware, as little as a teaspoon of the liquid nicotine preparations used to refill e-cigarette cartridges can be lethal in a child.
A report from the Surgeon General found that exposure to nicotine during adolescence may adversely affect brain development and nicotine exposure during pregnancy can lead to preterm delivery and fetal demise. The Surgeon General’s report concludes:
“The evidence is already sufficient to provide appropriately cautious messages to pregnant women and women of reproductive age as well as adolescents about the use of nicotine-containing products such as smokeless tobacco and electronic cigarettes, and newer forms of nicotine-containing tobacco products, as alternatives to smoking.”
E-cigs as an anti-smoking strategy
E-cigarettes have been suggested as an anti-smoking strategy, substituting the relatively toxin-free liquid nicotine vapor for the carcinogen-laden smoke of cigarettes. However, nicotine is highly addictive and some experts worry that e-cigarettes may be a gateway to the use of conventional cigarettes.
In August 2004, in fact, the CDC released a study showing that adolescents who vape are more likely to try traditional cigarettes. Further, there is no evidence to support the use of e-cigarettes as a way to stop smoking. A recent meta-analysis of 11 published studies shows that smokers who use e-cigarettes are 30% less likely to quit than smokers who don’t use them.
E-cigarette advocacy organizations, such as the American Vaping Organization (AVA) and the Consumer Advocates for Smoke-free Alternative Association (CASAA) publish testimonials about benefits of e-cigarettes as stop-smoking aids—here’s a sampling:
- Brilliant alternative to cigarette smoking. When you consider that almost 450,000 people die every year from cigarette smoking diseases, and so far no national health service has noted any significant cases of people hospitalized from Vaping, that should tell you something. I have heart disease, type 2 diabetes, and edema, and have noticed no ill effects. My doctors have uttered nary a word of objection, at this point.
- Amazing. That’s all I can say. I’m 35 and I’ve been smoking for nearly 20 years. I just smoked two cigarettes this morning and have no desire to smoke cigarettes anymore. After 10 years, your lung cancer risk is the same as a non-smoker. So, by the time I am 45, I will be healthy. Vaping probably is going to save my life. And it tastes better than cigarettes. Too bad there’s all this bad vaping science out there but I can’t see how the benefits (to a smoker) couldn’t outweigh the measly risks of vaping.
- Dakota. Me and my mom started vaping together because her lung doctor told her if she didn’t quit smoking, she wouldn’t live much longer so we started vaping and she’s doing way better and improving every day. I feel like it’s a better lifestyle and we’re both breathing better and healthier.
Both organizations proclaim that they are not trade associations, but here is the list of Platinum Sponsors of AVA:
- Smokeless Image
- Vapor Kings
The bottom line is the bottom line
The one thing you can count on is that when there’s big bucks to be made, industries will go all out to prove their product is safe and sound. But let’s just inject some common sense here. This product is designed to deliver an addicting substance into your body. Once you are hooked, tobacco companies won’t necessarily care whether e-cigarettes are the delivery mechanism or not.
If we regulate e-cigarettes out of existence, the addicted user may turn to conventional cigarettes. It is what is known as a win-win—unless of course you want to include the hapless consumer in the equation…then it is a win-win for industry and a big loss for the consumer!