What We Don’t Know About E-Cigarettes – – Let’s Flip the Script

We are talk about e-cigarettes again—this is going to be an ongoing topic in health, regulatory, and marketing news until we’re able to fully understand the long-range implications of vaping, which involves the inhaling of liquid nicotine. The latest story to catch my attention states that e-cigarettes are 95% less harmful than the traditional cigarette. That may be true if you break it down statistically. But that kind of approach changes the conversation and leads to the perception that e-cigarettes are relatively risk free.

So what if the overall health risk of e-cigarettes is less than traditional cigarettes. Let’s talk about the people who weren’t smoking cigarettes in the first place. Let’s talk about our kids using these e-cigarettes to inhale fumes containing nicotine and other chemicals.

To fully understand the risks of e-cigarettes we need to evaluate them as a stand-alone product, not as a less toxic version of the traditional cigarette.  That becomes a different conversation. So while I think it is important to do the comparisons and point out that for people who already use nicotine this may be a safer product, they are not the people we should be as concerned about.

To look at e-cigarettes as a stand-alone product we have to look at the specifics, the possibilities for abuse, and the addictive qualities of the nicotine absorbed through smoking, or vaping, an e-cigarette. And maybe we need to talk about the e-cigarette as a vehicle for delivery of illicit drugs.

Consider these:

• Nicotine is addictive—in any amount. Nicotine acts as a stimulant. It increases the heart rate and blood pressure, a potentially dangerous thing for some individuals. It can be passed through the placenta, causing harm to unborn babies. Nicotine has been linked to increased risk of stroke and cardiovascular disease.
• E-cigarettes contain nanoparticles that can be become embedded in the lungs and lead to inflammation. The impact of such inflammation has yet to be fully tested or understood.
• The FDA does not currently regulate electronic cigarettes. There are no standards for manufacturing or marketing. The current design of many e-cigarette devices allows users to vary the amounts of nicotine inhaled.

The common denominator in all these possible side effects is the lack of sufficient research to evaluate or document the long-term harm of e-cigarettes. And most of the marketing is pushing e-cigarettes as a safer alternative to traditional cigarettes—which serves to deflect the safety risks.

E-cigarettes vary from model to model; with hundreds of types of devices out there it is nearly impossible to evaluate the way nicotine is delivered. No one is checking to see that devices labeled ‘nicotine-free’ are indeed free of nicotine.

Research results are beginning to come in but good research takes time and this is a relatively new product. One of the current areas of research is looking at the absorption of nicotine in the airways and lining in the mouth.  What does that mean for users? Will this result in an increase in mouth and throat cancers? Lung cancer? Increased rates of inflammation that could leave the body vulnerable to infections? We simply do not yet know.

It is what we do not know that should be worrying us as the rates of e-cigarette use climbs among teens and middle-school children.  Then consider  a recent study by researchers at the Yale University School of Medicine that found a significant number of Connecticut teens are using e-cigarettes to inhale marijuana. Hash oil, the resin from marijuana plants, can be used in these vaping devices just as liquid nicotine. In the Yale study one-third of the, roughly, 4,000 teens surveyed had tried e-cigarettes. Of that number,18% had tried the e-cig with hash oil.

We have a young, curious, ‘experiment-prone’ target market with access to a cool new product that has a wider potential for abuse than we understand, with no definitive documentation outlining the risks. There are no federal regulations and most of the public commentary is focused on e-cigs as a healthier alternative to traditional cigarettes and their value as a smoking cessation tool. The script needs to be flipped.   We have to take a hard look at the dangers of e-cigarettes to our youth. We need to be worried less about cigarette smokers trying to break their addiction to tobacco and more about starting a bad habit that may be a slippery slope to cigarette smoking. We have to think about preteens and teens, with healthy lungs and unblemished tissues, who are inhaling addictive and unsafe substances.  This is the most important issue concerning e-cigarettes at this time:  how will e-cigarettes affect a new generation?  While the jury may be out, given the ingredients we know they contain, the verdict will not be a good one.