The Truth on E Cigarettes
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let them fight their war, i'll just keep vaping and watch it like a movie. the selfishness of humans has allowed earth to rot. when it's totally rotten we'll be dead, and it should be the year 2150. who can live till then? turn into vampires?
I never tried it but my brother did with no problems. I mentioned it at an appointment and my doctor strongly discouraged it because of side effects. I researched online after that, of course, and the discouragement seems to be a growing trend nowadays.
To quote the late George Carlin, "The planet is fine. The people are fxxxed."
Some updates
Secondhand Smoke vs. E-Cig Vapor
Our latest article in Modern Vapor’s e-cigarette knowledge center provides an in-depth explanation of secondhand smoke and e-cig vapor.
Over the years, ads have blanketed the airwaves warning of the dangers of secondhand smoke. In 2012, it’s common knowledge that anyone exposed to smoke is at risk – be it first-hand through smoking or second hand by being in the vicinity.
Many detractors of electronic cigarettes claim the vapor given off when using the device is just as dangerous since it isn’t really known what’s in the vapor. This of course is a flat-out distortion since e-cig vapor really only contains 3 or so ingredients – all of which are much less harmful than cigarette smoke.
When most people think about cigarette smoke, nicotine and carbon monoxide comes to mind.
In reality though, cigarette smoke contains over 4000 distinct substances…at least 30 of which are known to be cancer-causing substances or carcinogens.
Some of these chemicals include formaldehyde, ammonia and even hydrogen cyanide.
Numerous tests and research studies over the years have explored the effects of ingesting these substances, which include increased risk of cancer and heart disease. Smokers with allergies and coronary conditions exacerbate these issues when smoking.
E-cig vapor on the other hand has a different, much simpler chemical composition.
Independent lab tests have confirmed that most brands of nicotine infused liquid out there only contain three substances – nicotine, glycerin and propylene glycol.
Nicotine of course is a no-brainer. It’s the substance your body craves, which is why you smoke, vape or may be considering a switch to e-cigarettes.
Glycerin is an everyday substance found extensively in a wide array of foods, often serving as a sweetener or thickening agent. Sometimes referred to as glycerol, the substance is also found in certain medications, toothpaste and mouthwash.
Propylene glycol is a common substance with properties similar to glycerin and is found in many everyday items like asthma inhalers and fog machines. Propylene glycol is sometimes confused with ethylene glycol, a substance that used to be found in antifreeze. Ethylene glycol though gave antifreeze a sweet smell to pets and small kids.
If it was ingested, it generally proved fatal.
In light of this, makers of antifreeze switched to the non-toxic propylene glycol, which achieved the same results as propylene glycol without the risk to unsuspecting pets and young children.
As you can see, the vapor emitted when using an e-cigarette can be considered much safer than secondhand smoke from traditional cigarettes. And since vapor dissipates much quicker, the chance of a bystander inhaling any is much less as well.
To learn more, check out our latest e-cigarette knowledge center article – Secondhand Smoke vs. Vapor – today.
Secondhand Smoke vs. E-Cig Vapor
Our latest article in Modern Vapor’s e-cigarette knowledge center provides an in-depth explanation of secondhand smoke and e-cig vapor.
Over the years, ads have blanketed the airwaves warning of the dangers of secondhand smoke. In 2012, it’s common knowledge that anyone exposed to smoke is at risk – be it first-hand through smoking or second hand by being in the vicinity.
Many detractors of electronic cigarettes claim the vapor given off when using the device is just as dangerous since it isn’t really known what’s in the vapor. This of course is a flat-out distortion since e-cig vapor really only contains 3 or so ingredients – all of which are much less harmful than cigarette smoke.
When most people think about cigarette smoke, nicotine and carbon monoxide comes to mind.
In reality though, cigarette smoke contains over 4000 distinct substances…at least 30 of which are known to be cancer-causing substances or carcinogens.
Some of these chemicals include formaldehyde, ammonia and even hydrogen cyanide.
Numerous tests and research studies over the years have explored the effects of ingesting these substances, which include increased risk of cancer and heart disease. Smokers with allergies and coronary conditions exacerbate these issues when smoking.
E-cig vapor on the other hand has a different, much simpler chemical composition.
Independent lab tests have confirmed that most brands of nicotine infused liquid out there only contain three substances – nicotine, glycerin and propylene glycol.
Nicotine of course is a no-brainer. It’s the substance your body craves, which is why you smoke, vape or may be considering a switch to e-cigarettes.
Glycerin is an everyday substance found extensively in a wide array of foods, often serving as a sweetener or thickening agent. Sometimes referred to as glycerol, the substance is also found in certain medications, toothpaste and mouthwash.
Propylene glycol is a common substance with properties similar to glycerin and is found in many everyday items like asthma inhalers and fog machines. Propylene glycol is sometimes confused with ethylene glycol, a substance that used to be found in antifreeze. Ethylene glycol though gave antifreeze a sweet smell to pets and small kids.
If it was ingested, it generally proved fatal.
In light of this, makers of antifreeze switched to the non-toxic propylene glycol, which achieved the same results as propylene glycol without the risk to unsuspecting pets and young children.
As you can see, the vapor emitted when using an e-cigarette can be considered much safer than secondhand smoke from traditional cigarettes. And since vapor dissipates much quicker, the chance of a bystander inhaling any is much less as well.
To learn more, check out our latest e-cigarette knowledge center article – Secondhand Smoke vs. Vapor – today.
Research Suggests Switching to E-Cigarettes May Help Boost Memory
A recent study of 85 regular smokers (…both female and male) at the University of East London sought to determine the effects e-cigarettes have on memory and cravings.
Dr. Lynne Dawkins, head researcher in the study, recently presented her findings at the annual conference of the British Psychological Society.
Participants in the study were given, at random, an e-cigarette that contained either nicotine or a placebo. Some were told to just hold the e-cigarette while others were instructed to use the device as if it was a regular cigarette. After using the device for about 5 minutes, participants were asked to complete a questionnaire on their mood and cravings.
The questionnaire was administered again after another 20 minutes. Roughly ¾ of the participants were also asked to complete a “…working memory task” about 10-15 minutes after using the e-cigarette.
Results from the study showed that the nicotine helped men more so than women in reducing cravings and improving their mood. For women, the placebo e-cigarette was just as effective as the nicotine. Results from those tested for memory showed that the e-cigarettes containing nicotine helped boost memory in both men and women.
“We were interested in exploring the effectiveness of e-cigarettes as relatively little research has been done. In terms of reducing cravings it is interesting to note the difference in effectiveness for men and women,” comments Dr. Dawkins.
Dr. Dawkins went on to explain that people who choose to stop smoking without some sort of nicotine substitute may experience a dip in their working memory as their body adjusts to no nicotine. E-cigarettes “…seem to be effective at reducing this problem for men and women.”
While the study didn’t examine self-consciousness of using an e-cigarette in public, it did provide some interesting insight into some of the benefits e-cigarettes can provide for those smokers looking to give up their old habits.
E-cigarettes used in the study were provided by the Electronic Cigarette Company. No other financial assistance was provided outside of a small grant for the researchers to travel to the recent conference to present their findings.
A recent study of 85 regular smokers (…both female and male) at the University of East London sought to determine the effects e-cigarettes have on memory and cravings.
Dr. Lynne Dawkins, head researcher in the study, recently presented her findings at the annual conference of the British Psychological Society.
Participants in the study were given, at random, an e-cigarette that contained either nicotine or a placebo. Some were told to just hold the e-cigarette while others were instructed to use the device as if it was a regular cigarette. After using the device for about 5 minutes, participants were asked to complete a questionnaire on their mood and cravings.
The questionnaire was administered again after another 20 minutes. Roughly ¾ of the participants were also asked to complete a “…working memory task” about 10-15 minutes after using the e-cigarette.
Results from the study showed that the nicotine helped men more so than women in reducing cravings and improving their mood. For women, the placebo e-cigarette was just as effective as the nicotine. Results from those tested for memory showed that the e-cigarettes containing nicotine helped boost memory in both men and women.
“We were interested in exploring the effectiveness of e-cigarettes as relatively little research has been done. In terms of reducing cravings it is interesting to note the difference in effectiveness for men and women,” comments Dr. Dawkins.
Dr. Dawkins went on to explain that people who choose to stop smoking without some sort of nicotine substitute may experience a dip in their working memory as their body adjusts to no nicotine. E-cigarettes “…seem to be effective at reducing this problem for men and women.”
While the study didn’t examine self-consciousness of using an e-cigarette in public, it did provide some interesting insight into some of the benefits e-cigarettes can provide for those smokers looking to give up their old habits.
E-cigarettes used in the study were provided by the Electronic Cigarette Company. No other financial assistance was provided outside of a small grant for the researchers to travel to the recent conference to present their findings.
Some Updates, source from Electronic cigarette - Wikipedia, the free encyclopedia
Bases
Flavors and nicotine are dissolved in hygroscopic components, which turn the water in the solution into a smoke-like vapor when heated. Commonly used hygroscopic components include propylene glycol, vegetable glycerin, and polyethylene glycol 400 (often sold under the abbreviations PG, VG, and PEG 400, respectively).
Safety of liquid bases
All three liquid bases are common food additives used in a variety of pharmaceutical formulations. Propylene glycol, the current dominating liquid base, has been utilized in asthma inhalers and nebulizers since the 1950s, and because of its water-retaining properties, is the compound of choice for delivering atomized medication. (Notes: Quote on the government website: ..."propylene glycol (a known irritant when inhaled or ingested).. so they gonna ban asthma inhalers also...?"The U.S. Food and Drug Administration (FDA) includes propylene glycol on its list of substances Generally Recognized as Safe (GRAS), and it meets the requirements of acceptable compounds within Title 21 of the Code of Federal Regulations. In comparison, traditional tobacco cigarettes contain at least 80 cancer causing chemicals, including tar.
Health concerns
The health effects of using electronic cigarettes are currently unknown. Several studies regarding the long-term health effects of nicotine vapor, both inhaled directly and second hand, are currently in progress. The effects of passive nicotine and smoke inhalation must be separate in such studies because there is no smoke involved in the process. There is no sidestream smoke directly from burned cigarettes to the environment.
World Health Organization
The World Health Organization stated in September 2008 that to its knowledge, "no rigorous, peer-reviewed studies have been conducted showing that the electronic cigarette is a safe and effective nicotine replacement therapy. WHO does not discount the possibility that the electronic cigarette could be useful as a smoking cessation aid." WHO Tobacco Free Initiative director ad interim Douglas Bettcher stated that claims that electronic cigarettes can help smokers quit need to be backed up by clinical studies and toxicity analyses and operate within the proper regulatory framework. He added: "Until they do that, WHO cannot consider the electronic cigarette to be an appropriate nicotine replacement therapy, and it certainly cannot accept false suggestions that it has approved and endorsed the product."
In 2010, the Tobacco Regulation meeting held in Uruguay came out with warnings about electronic cigarettes. Signatories of the meeting's treaty included representatives of countries and regions such as Brazil, Thailand, Hong Kong, and Saudi Arabia, where electronic cigarettes had been banned.
The secretariat of the meeting refused and stated that electronic cigarettes do not violate articles 9 and 10 of the framework convention for tobacco control regarding composition (toxins, carcinogens, harm to self) or emissions (second hand smoke or harm to others). The secretariat stated that the problems regarding electronic cigarettes relate to regulatory issues and not to the work that the convention is tasked with. In the memo, they also mentioned that electronic cigarettes can be considered a medical product only IF the marketer wanted to make medical claims, otherwise they are a tobacco product.
United States of America
Food and Drug Administration
In May 2009 the US Food and Drug Administration (USFDA) Division of Pharmaceutical Analysis tested the contents of 19 varieties of electronic cigarette cartridges produced by two vendors (NJoy and Smoking Everywhere). Diethylene glycol, which is poisonous, was detected in one of the cartridges manufactured by Smoking Everywhere . In addition, tobacco-specific nitrosamines (TSNAs), known cancer-causing agents, were detected in all of the cartridges from one brand and two of the cartridges from the other brand. The study found that the actual nicotine levels did not always correspond to the amount of nicotine the cartridges purported to contain.[12] The analysis found traces of nicotine in some cartridges that claimed to be nicotine-free. Further concerns were raised over inconsistent amounts of nicotine delivered when drawing on the device. In July 2009, the FDA issued a press release discouraging the use of electronic cigarettes and repeating previously stated concerns that electronic cigarettes may be marketed to young people and lack appropriate health warnings.
In addition, chemical analysis was performed on sample cartridge. The cartridges were found to contain "tobacco-specific impurities suspected of being harmful to humansanabasine, myosmine, and β-nicotyrinewere detected in a majority of the samples tested."
The Electronic Cigarette Association said that the FDA testing was too "narrow to reach any valid and reliable conclusions. Exponent, Inc., commissioned by NJOY to review the FDA's study in July 2009, objected to the FDA analysis of electronic cigarettes lacking comparisons to other FDA-approved nicotine replacement therapy products where similar levels of TSNA were detected. Exponent concluded that the FDA's study did not support the claims of potential adverse health effects from the use of electronic cigarettes. Furthermore, FDA methods "have been lambasted in journals" by some medical and health research experts who noted the potentially harmful chemicals were measured at "about one million times lower concentrations than are conceivably related to human health.
American Association of Public Health Physicians
As of April 2010, The American Association of Public Health Physicians (AAPHP) supports electronic cigarettes sales to adults, "because the possibility exists to save the lives of four million of the eight million current adult American smokers who will otherwise die of a tobacco-related illness over the next twenty years." However, the AAPHP is against sales to minors. The AAPHP recommends that the FDA reclassify the electronic cigarette as a tobacco product (as opposed to a drug/device combination).
Boston University School of Public Health study
A study by researchers at the Boston University School of Public Health in 2010 concluded that electronic cigarettes were safer than real cigarettes and may aid in breaking the habit of smoking. Researchers said that while further studies on electronic cigarettes were needed, "few, if any, chemicals at levels detected in electronic cigarettes raise serious health concerns." Electronic cigarettes were found to be "much safer" than traditional tobacco ones, and had a level of toxicity similar to existing nicotine replacements.
In the report, the level of carcinogens in electronic cigarettes was found to be up to 1,000 times lower than regular cigarettes. It also said early evidence shows that electronic cigarettes may help people to stop smoking by simulating a tobacco cigarette.
Health Canada
On 27 March 2009, Health Canada issued an advisory against electronic cigarettes. The advisory stated "Although these electronic smoking products may be marketed as a safer alternative to conventional tobacco products and, in some cases, as an aid to quitting smoking, electronic smoking products may pose risks such as nicotine poisoning and addiction."
Health New Zealand Ltd. study
In 2008, Dr. Murray Laugesen, of Health New Zealand, published a report on the safety of Ruyan electronic cigarette cartridges funded by e-cigarette manufacturer, Ruyan; Laugesen and the WHO claim that the research is independent. The presence of trace amounts of TSNAs in the cartridge solution was documented in the analysis. The results also indicated that the level of nicotine in the electronic cigarette cartridges was not different from the concentration of nicotine found in nicotine patches. John Britton, a lung specialist at the University of Nottingham, UK and chair of the Royal College of Physicians Tobacco Advisory Group said if the levels are as low as in nicotine replacement therapy, I dont think there will be much of a problem. The study's detailed quantitative analysis concluded that carcinogens and toxicants are present only below harmful levels. It concluded: "Based on the manufacturers information, the composition of the cartridge liquid is not hazardous to health, if used as intended."
Other reports
According to Cancer Research UK, "For a smoker, the health hazards of continuing to smoke greatly outweigh any potential risks of using nicotine replacement therapy".
A report from a UK Government advisory unit favoured to adopt "smokeless nicotine cigarettes" instead of the traditional "quit or die" approach believing this would save more lives.
While electronic cigarettes are purported to deliver nicotine to the user in a manner similar to that of a nicotine inhaler, no electronic cigarette has yet been approved as a medicinal nicotine replacement therapy (NRT) product or provided the necessary clinical testing for such approval. Doubts have also been raised as to whether electronic cigarettes actually deliver any substantial amount of nicotine at all.
Research carried out at the University of East London on the effects of the use of an electronic cigarette to reduce cravings in regular tobacco smokers showed that there was no significant reported difference between smokers who inhaled vapour containing nicotine, and those who inhaled vapour containing no nicotine. The report concluded that although electronic cigarettes can be effective in reducing nicotine-related withdrawal symptoms, the nicotine content does not appear to be of central importance, and that other smoking related cues (such as taste, vapour resembling smoke) may account for the reduction in discomfort associated with tobacco abstinence in the short term.
Though manufacturers have marketed electronic cigarettes as a way to curtail an addiction to nicotine, the World Health Organization has stated they know of no evidence confirming these claims.
In an online survey from November 2009 among 303 smokers, it was found that e-cigarette substitution for tobacco cigarettes resulted in reduced perceived health problems, when compared to smoking conventional cigarettes (less cough, improved ability to exercise, improved sense of taste and smell).
Bases
Flavors and nicotine are dissolved in hygroscopic components, which turn the water in the solution into a smoke-like vapor when heated. Commonly used hygroscopic components include propylene glycol, vegetable glycerin, and polyethylene glycol 400 (often sold under the abbreviations PG, VG, and PEG 400, respectively).
Safety of liquid bases
All three liquid bases are common food additives used in a variety of pharmaceutical formulations. Propylene glycol, the current dominating liquid base, has been utilized in asthma inhalers and nebulizers since the 1950s, and because of its water-retaining properties, is the compound of choice for delivering atomized medication. (Notes: Quote on the government website: ..."propylene glycol (a known irritant when inhaled or ingested).. so they gonna ban asthma inhalers also...?"The U.S. Food and Drug Administration (FDA) includes propylene glycol on its list of substances Generally Recognized as Safe (GRAS), and it meets the requirements of acceptable compounds within Title 21 of the Code of Federal Regulations. In comparison, traditional tobacco cigarettes contain at least 80 cancer causing chemicals, including tar.
Health concerns
The health effects of using electronic cigarettes are currently unknown. Several studies regarding the long-term health effects of nicotine vapor, both inhaled directly and second hand, are currently in progress. The effects of passive nicotine and smoke inhalation must be separate in such studies because there is no smoke involved in the process. There is no sidestream smoke directly from burned cigarettes to the environment.
World Health Organization
The World Health Organization stated in September 2008 that to its knowledge, "no rigorous, peer-reviewed studies have been conducted showing that the electronic cigarette is a safe and effective nicotine replacement therapy. WHO does not discount the possibility that the electronic cigarette could be useful as a smoking cessation aid." WHO Tobacco Free Initiative director ad interim Douglas Bettcher stated that claims that electronic cigarettes can help smokers quit need to be backed up by clinical studies and toxicity analyses and operate within the proper regulatory framework. He added: "Until they do that, WHO cannot consider the electronic cigarette to be an appropriate nicotine replacement therapy, and it certainly cannot accept false suggestions that it has approved and endorsed the product."
In 2010, the Tobacco Regulation meeting held in Uruguay came out with warnings about electronic cigarettes. Signatories of the meeting's treaty included representatives of countries and regions such as Brazil, Thailand, Hong Kong, and Saudi Arabia, where electronic cigarettes had been banned.
The secretariat of the meeting refused and stated that electronic cigarettes do not violate articles 9 and 10 of the framework convention for tobacco control regarding composition (toxins, carcinogens, harm to self) or emissions (second hand smoke or harm to others). The secretariat stated that the problems regarding electronic cigarettes relate to regulatory issues and not to the work that the convention is tasked with. In the memo, they also mentioned that electronic cigarettes can be considered a medical product only IF the marketer wanted to make medical claims, otherwise they are a tobacco product.
United States of America
Food and Drug Administration
In May 2009 the US Food and Drug Administration (USFDA) Division of Pharmaceutical Analysis tested the contents of 19 varieties of electronic cigarette cartridges produced by two vendors (NJoy and Smoking Everywhere). Diethylene glycol, which is poisonous, was detected in one of the cartridges manufactured by Smoking Everywhere . In addition, tobacco-specific nitrosamines (TSNAs), known cancer-causing agents, were detected in all of the cartridges from one brand and two of the cartridges from the other brand. The study found that the actual nicotine levels did not always correspond to the amount of nicotine the cartridges purported to contain.[12] The analysis found traces of nicotine in some cartridges that claimed to be nicotine-free. Further concerns were raised over inconsistent amounts of nicotine delivered when drawing on the device. In July 2009, the FDA issued a press release discouraging the use of electronic cigarettes and repeating previously stated concerns that electronic cigarettes may be marketed to young people and lack appropriate health warnings.
In addition, chemical analysis was performed on sample cartridge. The cartridges were found to contain "tobacco-specific impurities suspected of being harmful to humansanabasine, myosmine, and β-nicotyrinewere detected in a majority of the samples tested."
The Electronic Cigarette Association said that the FDA testing was too "narrow to reach any valid and reliable conclusions. Exponent, Inc., commissioned by NJOY to review the FDA's study in July 2009, objected to the FDA analysis of electronic cigarettes lacking comparisons to other FDA-approved nicotine replacement therapy products where similar levels of TSNA were detected. Exponent concluded that the FDA's study did not support the claims of potential adverse health effects from the use of electronic cigarettes. Furthermore, FDA methods "have been lambasted in journals" by some medical and health research experts who noted the potentially harmful chemicals were measured at "about one million times lower concentrations than are conceivably related to human health.
American Association of Public Health Physicians
As of April 2010, The American Association of Public Health Physicians (AAPHP) supports electronic cigarettes sales to adults, "because the possibility exists to save the lives of four million of the eight million current adult American smokers who will otherwise die of a tobacco-related illness over the next twenty years." However, the AAPHP is against sales to minors. The AAPHP recommends that the FDA reclassify the electronic cigarette as a tobacco product (as opposed to a drug/device combination).
Boston University School of Public Health study
A study by researchers at the Boston University School of Public Health in 2010 concluded that electronic cigarettes were safer than real cigarettes and may aid in breaking the habit of smoking. Researchers said that while further studies on electronic cigarettes were needed, "few, if any, chemicals at levels detected in electronic cigarettes raise serious health concerns." Electronic cigarettes were found to be "much safer" than traditional tobacco ones, and had a level of toxicity similar to existing nicotine replacements.
In the report, the level of carcinogens in electronic cigarettes was found to be up to 1,000 times lower than regular cigarettes. It also said early evidence shows that electronic cigarettes may help people to stop smoking by simulating a tobacco cigarette.
Health Canada
On 27 March 2009, Health Canada issued an advisory against electronic cigarettes. The advisory stated "Although these electronic smoking products may be marketed as a safer alternative to conventional tobacco products and, in some cases, as an aid to quitting smoking, electronic smoking products may pose risks such as nicotine poisoning and addiction."
Health New Zealand Ltd. study
In 2008, Dr. Murray Laugesen, of Health New Zealand, published a report on the safety of Ruyan electronic cigarette cartridges funded by e-cigarette manufacturer, Ruyan; Laugesen and the WHO claim that the research is independent. The presence of trace amounts of TSNAs in the cartridge solution was documented in the analysis. The results also indicated that the level of nicotine in the electronic cigarette cartridges was not different from the concentration of nicotine found in nicotine patches. John Britton, a lung specialist at the University of Nottingham, UK and chair of the Royal College of Physicians Tobacco Advisory Group said if the levels are as low as in nicotine replacement therapy, I dont think there will be much of a problem. The study's detailed quantitative analysis concluded that carcinogens and toxicants are present only below harmful levels. It concluded: "Based on the manufacturers information, the composition of the cartridge liquid is not hazardous to health, if used as intended."
Other reports
According to Cancer Research UK, "For a smoker, the health hazards of continuing to smoke greatly outweigh any potential risks of using nicotine replacement therapy".
A report from a UK Government advisory unit favoured to adopt "smokeless nicotine cigarettes" instead of the traditional "quit or die" approach believing this would save more lives.
While electronic cigarettes are purported to deliver nicotine to the user in a manner similar to that of a nicotine inhaler, no electronic cigarette has yet been approved as a medicinal nicotine replacement therapy (NRT) product or provided the necessary clinical testing for such approval. Doubts have also been raised as to whether electronic cigarettes actually deliver any substantial amount of nicotine at all.
Research carried out at the University of East London on the effects of the use of an electronic cigarette to reduce cravings in regular tobacco smokers showed that there was no significant reported difference between smokers who inhaled vapour containing nicotine, and those who inhaled vapour containing no nicotine. The report concluded that although electronic cigarettes can be effective in reducing nicotine-related withdrawal symptoms, the nicotine content does not appear to be of central importance, and that other smoking related cues (such as taste, vapour resembling smoke) may account for the reduction in discomfort associated with tobacco abstinence in the short term.
Though manufacturers have marketed electronic cigarettes as a way to curtail an addiction to nicotine, the World Health Organization has stated they know of no evidence confirming these claims.
In an online survey from November 2009 among 303 smokers, it was found that e-cigarette substitution for tobacco cigarettes resulted in reduced perceived health problems, when compared to smoking conventional cigarettes (less cough, improved ability to exercise, improved sense of taste and smell).
Source: The Rest of the Story: Tobacco News Analysis and Commentary: New Study Shows that in Contrast to Tobacco Cigarettes, Electronic Cigarettes Do Not Impair Acute Lung Function
New Study Shows that in Contrast to Tobacco Cigarettes, Electronic Cigarettes Do Not Impair Acute Lung Function
A new study published online ahead of print in the journal Chest demonstrated that in contrast to both tobacco cigarette smoking and secondhand smoke exposure, which have been shown to cause acute impairment of lung function, electronic cigarettes have no acute effect on pulmonary function as measured by spirometry testing.
See: Constantine I. Vardavas, Nektarios Anagnostopoulos, Marios Kougias, Vassiliki Evangelopoulou, Gregory N. Connolly, Panagiotis K. Behrakis. Acute pulmonary effects of using an e-cigarette: impact on respiratory flow resistance, impedance and exhaled nitric oxide. Chest 2011. Published online before print December 22, 2011, doi: 10.1378/chest.11-2443.
Active smoking is known to impair lung function, as measured by pulmonary function testing of lung air flow rates (also called spirometry). For example, short-term active smoke exposure has been shown to reduce forced expiratory flow rates.
Secondhand smoke exposure has also been shown to impair lung function, as evidenced by decreased FEV1 and FEV1/FVC ratios in tobacco smoke-exposed nonsmokers.
In this study, 30 smokers used an electronic cigarette for for 5 minutes, with lung function tested before and after use. A control group of smokers used an electronic cigarette with the cartridge removed.
The study found "no differences between basic pulmonary measurements" between the two groups, demonstrating that acute exposure to electronic cigarette vapor did not affect FEV1, FVC, PEF or MEF50 and MEF75.
However, the study did find that acute electronic cigarette vapor exposure decreased exhaled nitric oxide and increased peripheral airway resistance.
The study concludes: "E-cigarettes assessed in the context of this study were found to have immediate adverse physiologic effects after short term use that are similar to some of the effects seen with tobacco smoking, however the long term health effects of e-cigarette use are unknown but potentially adverse and worthy of further investigation."
The Rest of the Story
It is first interesting to note that although the study's declared purpose was to "assess whether using an e-cigarette for five minutes has an impact on pulmonary function tests and exhaled nitric oxide," the study's abstract only reported the observed reduction in exhaled nitric oxide, not the lack of any effect on pulmonary function tests.
Moreover, the study failed to compare the acute respiratory effects of electronic cigarette exposure with those of active smoking, which is the most important comparison that needs to be made.
In contrast to what some are reporting, the study found no effect of e-cigarettes on lung function, as measured by spirometry. This is in contrast to tobacco smoking, which does have effects on lung function that can be measured using spirometric testing.
While previous research indicates that active smoking and even secondhand smoke exposure can affect acute lung function as measured by spirometry, the study demonstrated that electronic cigarette use led to no impairment of lung function detectable via spirometric testing.
What the study did show was subclinical evidence of impaired lung function, meaning that the observed (measurable) lung function was unchanged, but that there was evidence of physiologic effects consistent with some bronchial inflammation. What is not known is whether this acute bronchial inflammation has any significance in the long-term. The presence of bronchial inflammation may be a result of propylene glycol having a respiratory irritant effect. But this does not necessarily mean that long-term exposure would lead to any adverse effect on lung function. More research is necessary to clarify that point.
The authors acknowledge this: "We must state though that while the differences within our study are of statistical significance, the clinical changes may be too small to be of major clinical importance."
While this is only conjecture, I suspect that the study is detecting a respiratory irritant effect of propylene glycol. It will be interesting to see if the same effect is present or not with glycerin-based products.
The study does not change my overall assessment, which is that e-cigarettes are much safer than smoking. But it does suggest that e-cigarettes are not “safe” in any absolute sense (which we knew already because they contain nicotine). The real question is whether there are effects of long-term exposure to propylene glycol. Whether there are or not, I don’t think it will change the conclusion that e-cigarettes are much safer than smoking. However, it may have implications for the composition of e-cigarette liquid, as it may be that glycerin-based juice is safer than propylene glycol-based juice. It may be, for example, that a glycerin-based liquid fails to produce the airways inflammation that is being observed with a propylene-glycol based electronic cigarette.
In news coverage of the study, one of the authors was quoted as recommending: "If you're trying to quit, stick to the methods that are known to work." (i.e., nicotine replacement therapy and pharmacotherapy like Chantix and Buproprion).
I find this to be irresponsible advice, because these methods that are "known to work" actually are quite ineffective, with dismal results in terms of long-term cessation. Advising smokers to stick with the FDA-approved medications is tantamount to advising the overwhelming majority of smokers to continue smoking.
More importantly, since thousands of ex-smokers are remaining smoke-free with the help of electronic cigarettes, the study author's advice is essentially telling these ex-smokers that they are better off returning to active smoking than continuing to vape. Clearly, if these vapers switch to NRT or Chantix, they are very unlikely to be successful and will most likely return to cigarette smoking.
The American Council on Science and Health made the same point in its Facts and Fears column yesterday, writing: "The study’s lead researcher recommends that, instead of trying e-cigarettes as a reduced-risk method to quit smoking, smokers should “stick to the methods that are known to work.” But Dr. Ross criticizes this recommendation. 'He would have more accurately said, ‘stick to the methods that are known to not work,’ since those currently approved have a ‘success’ rate of only 5 to 10 percent. It’s the old ‘quit or die,’ abstinence-only agenda.'".
The rest of the story is that a propylene-based electronic cigarette system has been shown to produce airways inflammation in users, resulting in subclinical evidence of increased airway resistance. Whether long-term use of electronic cigarettes would lead to clinical manifestations due to actual airway obstruction is unclear, and more research is necessary to make such a determination. What we do know, however, is that long-term continuation of cigarette smoking will almost certainly lead to clinically significant airway obstruction.
The bottom line: if a smoker is choosing between active smoking and electronic cigarette use, the use of the electronic cigarette is clearly the wiser choice. And in fact, this is the choice that most electronic users are facing. The idea that any substantial proportion of electronic cigarette users will quit smoking if they take the article's advice and stick to approved NRT or pharmacotherapy products is unsupported by the scientific evidence.
New Study Shows that in Contrast to Tobacco Cigarettes, Electronic Cigarettes Do Not Impair Acute Lung Function
A new study published online ahead of print in the journal Chest demonstrated that in contrast to both tobacco cigarette smoking and secondhand smoke exposure, which have been shown to cause acute impairment of lung function, electronic cigarettes have no acute effect on pulmonary function as measured by spirometry testing.
See: Constantine I. Vardavas, Nektarios Anagnostopoulos, Marios Kougias, Vassiliki Evangelopoulou, Gregory N. Connolly, Panagiotis K. Behrakis. Acute pulmonary effects of using an e-cigarette: impact on respiratory flow resistance, impedance and exhaled nitric oxide. Chest 2011. Published online before print December 22, 2011, doi: 10.1378/chest.11-2443.
Active smoking is known to impair lung function, as measured by pulmonary function testing of lung air flow rates (also called spirometry). For example, short-term active smoke exposure has been shown to reduce forced expiratory flow rates.
Secondhand smoke exposure has also been shown to impair lung function, as evidenced by decreased FEV1 and FEV1/FVC ratios in tobacco smoke-exposed nonsmokers.
In this study, 30 smokers used an electronic cigarette for for 5 minutes, with lung function tested before and after use. A control group of smokers used an electronic cigarette with the cartridge removed.
The study found "no differences between basic pulmonary measurements" between the two groups, demonstrating that acute exposure to electronic cigarette vapor did not affect FEV1, FVC, PEF or MEF50 and MEF75.
However, the study did find that acute electronic cigarette vapor exposure decreased exhaled nitric oxide and increased peripheral airway resistance.
The study concludes: "E-cigarettes assessed in the context of this study were found to have immediate adverse physiologic effects after short term use that are similar to some of the effects seen with tobacco smoking, however the long term health effects of e-cigarette use are unknown but potentially adverse and worthy of further investigation."
The Rest of the Story
It is first interesting to note that although the study's declared purpose was to "assess whether using an e-cigarette for five minutes has an impact on pulmonary function tests and exhaled nitric oxide," the study's abstract only reported the observed reduction in exhaled nitric oxide, not the lack of any effect on pulmonary function tests.
Moreover, the study failed to compare the acute respiratory effects of electronic cigarette exposure with those of active smoking, which is the most important comparison that needs to be made.
In contrast to what some are reporting, the study found no effect of e-cigarettes on lung function, as measured by spirometry. This is in contrast to tobacco smoking, which does have effects on lung function that can be measured using spirometric testing.
While previous research indicates that active smoking and even secondhand smoke exposure can affect acute lung function as measured by spirometry, the study demonstrated that electronic cigarette use led to no impairment of lung function detectable via spirometric testing.
What the study did show was subclinical evidence of impaired lung function, meaning that the observed (measurable) lung function was unchanged, but that there was evidence of physiologic effects consistent with some bronchial inflammation. What is not known is whether this acute bronchial inflammation has any significance in the long-term. The presence of bronchial inflammation may be a result of propylene glycol having a respiratory irritant effect. But this does not necessarily mean that long-term exposure would lead to any adverse effect on lung function. More research is necessary to clarify that point.
The authors acknowledge this: "We must state though that while the differences within our study are of statistical significance, the clinical changes may be too small to be of major clinical importance."
While this is only conjecture, I suspect that the study is detecting a respiratory irritant effect of propylene glycol. It will be interesting to see if the same effect is present or not with glycerin-based products.
The study does not change my overall assessment, which is that e-cigarettes are much safer than smoking. But it does suggest that e-cigarettes are not “safe” in any absolute sense (which we knew already because they contain nicotine). The real question is whether there are effects of long-term exposure to propylene glycol. Whether there are or not, I don’t think it will change the conclusion that e-cigarettes are much safer than smoking. However, it may have implications for the composition of e-cigarette liquid, as it may be that glycerin-based juice is safer than propylene glycol-based juice. It may be, for example, that a glycerin-based liquid fails to produce the airways inflammation that is being observed with a propylene-glycol based electronic cigarette.
In news coverage of the study, one of the authors was quoted as recommending: "If you're trying to quit, stick to the methods that are known to work." (i.e., nicotine replacement therapy and pharmacotherapy like Chantix and Buproprion).
I find this to be irresponsible advice, because these methods that are "known to work" actually are quite ineffective, with dismal results in terms of long-term cessation. Advising smokers to stick with the FDA-approved medications is tantamount to advising the overwhelming majority of smokers to continue smoking.
More importantly, since thousands of ex-smokers are remaining smoke-free with the help of electronic cigarettes, the study author's advice is essentially telling these ex-smokers that they are better off returning to active smoking than continuing to vape. Clearly, if these vapers switch to NRT or Chantix, they are very unlikely to be successful and will most likely return to cigarette smoking.
The American Council on Science and Health made the same point in its Facts and Fears column yesterday, writing: "The study’s lead researcher recommends that, instead of trying e-cigarettes as a reduced-risk method to quit smoking, smokers should “stick to the methods that are known to work.” But Dr. Ross criticizes this recommendation. 'He would have more accurately said, ‘stick to the methods that are known to not work,’ since those currently approved have a ‘success’ rate of only 5 to 10 percent. It’s the old ‘quit or die,’ abstinence-only agenda.'".
The rest of the story is that a propylene-based electronic cigarette system has been shown to produce airways inflammation in users, resulting in subclinical evidence of increased airway resistance. Whether long-term use of electronic cigarettes would lead to clinical manifestations due to actual airway obstruction is unclear, and more research is necessary to make such a determination. What we do know, however, is that long-term continuation of cigarette smoking will almost certainly lead to clinically significant airway obstruction.
The bottom line: if a smoker is choosing between active smoking and electronic cigarette use, the use of the electronic cigarette is clearly the wiser choice. And in fact, this is the choice that most electronic users are facing. The idea that any substantial proportion of electronic cigarette users will quit smoking if they take the article's advice and stick to approved NRT or pharmacotherapy products is unsupported by the scientific evidence.
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