E-cigarettes

Study links e-cigarettes to incurable disease called ‘Popcorn Lung’

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E-cigarettes are often touted as a safer alternative to traditional cigarettes, but according to a study released by the Harvard School of Public Health, they may just pose a different threat than their nicotine-filled counterparts.

According to the study, 75 percent of flavored e-cigarettes and their refill liquids were found to contain Diacetyl, “a flavoring chemical linked to cases of severe respiratory disease” such as the incurable condition called “Popcorn Lung.”

According to Harvard, the condition otherwise known as bronchiolitis obliterans was “colloquially termed “Popcorn Lung” because it first appeared in workers who inhaled artificial butter flavor in microwave popcorn processing facilities.”

But despite the name of the disease, there is absolutely nothing savory about it. Popcorn Lung is a debilitating and irreversible respiratory disease which causes “scarring in tiny air sacs in the lungs that lead to excessive coughing and shortness of breath” similar to that seen in people with chronic obstructive pulmonary disease.

Chronic Obstructive Pulmonary Disease (COPD)

In analyzing 51 different flavored e-cigarettes, author of the study Joseph Allen and his team found at least one of three top toxins — diacetyl, acetoin and 2,3-pentanedione — in 47 of the e-cigs. Not only that, “the amount of diacetyl in 39 of the e-cigs exceeded the amount that was able to be detected by the laboratory.”

“Diacetyl and other related flavoring chemicals are used in many other flavors beyond butter-flavored popcorn, including fruit flavors, alcohol flavors, and candy flavored e-cigarettes,” said Allen, assistant professor of exposure assessment science at Harvard.

He found this particularly disturbing because of the appeal fruity e-cigarettes such as “Cotton Candy, Fruit Squirts, and Cupcake” may have to young people.

Since e-cigarettes are a fairly new technology, the study’s co-author David Christiani, Elkan Blout Professor of Environmental Genetics, warns that Popcorn Lung may be just the tip of the iceberg when it comes to the dangers e-cigs pose to their users:

Since most of the health concerns about e-cigarettes have focused on nicotine, there is still much we do not know about e-cigarettes. In addition to containing varying levels of the addictive substance nicotine, they also contain other cancer-causing chemicals, such as formaldehyde, and as our study shows, flavoring chemicals that can cause lung damage.

Do E-Cigarettes Help Smokers Quit?

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The popularity of electronic cigarettes in England may have helped as many as 18,000 people in that country quit smoking traditional cigarettes last year, researchers say.

A newly published analysis of population trends, found that rising e-cigarette use was not associated with an increase in overall quit attempts among smokers although among those who attempt to quit, e-cigarettes was linked with greater success.

In the United States, the CDC and other health agencies have generally rejected the view that e-cigarettes may be an effective smoking cessation tool, while many health groups in the United Kingdom, including the Royal College of Physicians, have embraced the notion.
Findings from the new study appear to bolster the position of the British health policymakers, but a tobacco control researcher in the United States who has been a vocal critic of e-cigarettes remains unconvinced.
“The evidence as a whole indicates that, on average, smokers who use e-cigarettes are about a third less likely to quit smoking than smokers who don’t use e-cigarettes,” Stanton Glantz, PhD, of the University of California San Francisco Center for Tobacco Control Research and Education told MedPage Today. “The evidence in the U.S. shows rapidly growing e-cigarette use among youth, many of whom go on to smoke cigarettes.”
Published Sept. 13 in BMJ, the analysis attempted to shed light on the impact of rising use of electronic cigarettes on quit rates among smokers of traditional cigarettes by analyzing data from cross-sectional, household surveys conducted in England as part of the Smoking Toolkit Study. As part of the study, monthly surveys have been conducted on a representative sample of the population, age 16 and older, since November of 2006.
“This is the first empirical study to estimate the population impact of e-cigarettes on attempts to quit smoking and their success, the use of smoking cessation pharmacotherapy, and the use of stop smoking services, using a time series approach,” researcher Emma Beard, PhD, of University College London, told MedPage Today.

Quarterly data on e-cigarette use among roughly 1,200 current smokers, including those who made a quit attempt during 2015 were recorded, and participants who reported smoking cigarettes daily were asked specific questions designed to determine if they were using e-cigarettes as a tool to help them quit smoking.
The prevalence of e-cigarette use in current smokers and during quit attempts was evaluated as a predictor of quit success, and the prevalence of e-cigarette use in current smokers was used to predict the rate of quit attempts.
Among the main study findings:
In adjusted analyses, e-cigarette use by smokers was positively associated with the success of attempts to stop. The researchers estimated that for every 1% increase in e-cigarette use, the success of quit attempts increased by 0.098% (95% CI 0.064 to 0.132; P<0.001). E-cigarette use increases of 1% during a recent quit attempt was associated with a 0.58% increase in success (95% CI 0.038 to 0.078; P<0.001).
There was no clear evidence of an association between e-cigarette use and rate of total quit attempts, use of NRT bought over the counter, use of prescription treatments or use of behavioral support.
There was a negative association between e-cigarette use during a recent quit attempt and use of NRT obtained with a prescription.
“Our findings go against concerns that e-cigarettes undermine motivation to stop smoking and attempts to quit smoking,” Beard said. “The finding of a positive association between prevalence of e-cigarette use, by current smokers and during quit attempts, is consistent with the view that e-cigarettes may increase the success of quit attempts in the short to medium term.”
Beard cited the large, representative population sample as a study strength and the self-reported nature of the study as a limitation.

“The study relied on self-reported data, and findings may not generalize to other countries because England has a strong climate of tobacco control and relatively liberal regulation of e-cigarettes,” she said.
In an editorial published with the study, John Britton, MD, of the University of Nottingham, United Kingdom, wrote that these and other uncontrolled for potential confounders – including reduced funding for smoking cessation programs by the National Health Service (NHS) in recent years – limit interpretation of the findings.
Britton led the Royal College of Physicians’ committee which concluded, in a report published in April, that e-cigarettes should be promoted as smoking cessation devices.
“It remains unclear whether, or by how much, the availability of e-cigarettes has influenced quitting behavior in the U.K.,” Britton wrote in the Sept. 13 BMJ. “However, the key arbiter of this and other controversies over the role of e-cigarettes lies less in these data than in trends in smoking prevalence, which in 2015 fell by nearly one percentage point relative to 2014. This significant year-on-year fall indicates that something in the U.K. tobacco control policy is working, and successful quitting through substitution with e-cigarettes is one likely major contributor.”

E-Cigarettes Found to Have 10 times More Cancer Causing

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E-Cigarettes Found to Have 10 times More Cancer Causing Ingredients than Regular Cigarettes
New research has found electronic cigarettes to contain even 10 times more cancer causing ingredients than the tobacco products they are supposed to save us from.

E-cigarettes are meant to replace a dangerous and life destroying habit, but they turned out to be far more dangerous. But why wasn’t there any research prior to their approval and production – a research that was supposed to prove their safety and viability? And who was responsible for that?

Here is an excerpt from the FDA website, and nowhere on its website does the FDA mention an increased cancer risk. The discussion is mostly regarding standardization or quality control.

FDA: E-Cigarettes: Questions and Answers

Q: What are electronic cigarettes?

A: Electronic cigarettes are products designed to deliver nicotine or other substances to a user in the form of a vapor. Typically, they are composed of a rechargeable, battery-operated heating element, a replaceable cartridge that may contain nicotine or other chemicals, and an atomizer that, when heated, converts the contents of the cartridge into a vapor. This vapor can then be inhaled by the user. These products are often made to look like such products as cigarettes, cigars, and pipes. They are also sometimes made to look like everyday items such as pens and USB memory sticks, for people who wish to use the product without others noticing.

Q: What concerns does FDA have regarding electronic cigarettes?

A: FDA has not evaluated any e-cigarettes for safety or effectiveness.

And there you have it.

Now we learn about this shocking information from sources outside the US. The FDA has a budget of over $4,500,000,000 (4.5 billion) and a track record of corruption and failures. Once again, it turns out that the FDA is a huge waste of taxpayers’ money.

E-cigarettes are being used by hundreds of thousands of underage children and millions of adults with the hope that they are a safer alternative to tobacco products. However, it seems that nothing could possibly be further from the truth. Now we have research, but not from the CDC/FDA – the institutes who we depend on and fund massively to keep us safe and healthy.

There’s no wonder that the cancer rate continues to increase.

E-CIGS HAVE 10 TIMES MORE CANCER CAUSING INGREDIENTS THAN REGULAR CIGARETTES

According to research conducted by Japanese scientists, e-cigarettes contain 10 times the level of cancer-causing carcinogens than regular cigarettes. Until recently, e-cigarettes were recommended as the answer to smoking without the complication of so many dangers.

These electronic nicotine products became hugely popular because people believed that they were receiving a hit of nicotine without the need to worry about any health damage that’s caused by a normal cigarette, loaded with chemicals.

But when the Japanese Ministry of Health commissioned a research, they found formaldehyde and acetaldehyde carcinogens in the liquid produced by many e-cigarette products, stated a health ministry official.

The group also found that e-cigarettes can fuel potentially life-threatening drug-resistant pathogens. This discovery comes from a lab study that tested the vapor from e-cigarettes on live methicillin-resistant Staphylococcus aureus (MRSA) and human cells.

According to the official, the formaldehyde carcinogen is much more present in the e-cigarette liquids than in the chemicals used in regular cigarettes.

The researcher Naoki Kunugita said: “In one brand of e-cigarette the team found more than 10 times the level of carcinogens contained in one regular cigarette. Especially when the wire (which vaporizes the liquid) gets overheated, higher amounts of those harmful substances seemed to be produced.”

Kunugita also added that the levels of the formaldehyde carcinogen varied in the final results.

“You call them e-cigarettes, but they are products totally different from regular tobacco. The government is now studying the possible risks associated with them, with view to looking at how they should be regulated,” the Japanese health ministry official said.

Earlier in 2015, the World Health Organization (WHO) advised governments to ban the sale of e-cigarettes to underage people because they posed a serious threat to them.

The UN health agency said that although there’s a lack of evidence regarding the damage caused by e-cigarettes, there was still enough evidence “to caution children and adolescents, pregnant women, and women of reproductive age” about their use. They also added that e-cigs should be outlawed from indoor public spaces.

The US Center for Disease Control and Prevention (CDC) stated: “More than a quarter of a million youth who had never smoked a cigarette used electronic cigarettes in 2013, according to a CDC study published in the journal Nicotine and Tobacco Research. This number reflects a three-fold increase, from about 79,000 in 2011, to more than 263,000 in 2013.”

E-cigarettes around 95% less harmful than tobacco estimates landmark review

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Expert independent review concludes that e-cigarettes have potential to help smokers quit.

An expert independent evidence review published today by Public Health England (PHE) concludes that e-cigarettes are significantly less harmful to health than tobacco and have the potential to help smokers quit smoking.

e-cigarettes

Key findings of the review include:

  • the current best estimate is that e-cigarettes are around 95% less harmful than smoking
  • nearly half the population (44.8%) don’t realise e-cigarettes are much less harmful than smoking
  • there is no evidence so far that e-cigarettes are acting as a route into smoking for children or non-smokers

The review, commissioned by PHE and led by Professor Ann McNeill (King’s College London) and Professor Peter Hajek (Queen Mary University of London), suggests that e-cigarettes may be contributing to falling smoking rates among adults and young people. Following the review PHE has published a paper on the implications of the evidence for policy and practice.

The comprehensive review of the evidence finds that almost all of the 2.6 million adults using e-cigarettes in Great Britain are current or ex-smokers, most of whom are using the devices to help them quit smoking or to prevent them going back to cigarettes. It also provides reassurance that very few adults and young people who have never smoked are becoming regular e-cigarette users (less than 1% in each group).

However, the review raises concerns that increasing numbers of people think e-cigarettes are equally or more harmful than smoking (22.1% in 2015, up from 8.1% in 2013: ASH Smokefree GB survey) or don’t know (22.7% in 2015, ASH Smokefree GB survey).

Despite this trend all current evidence finds that e-cigarettes carry a fraction of the risk of smoking.

Emerging evidence suggests some of the highest successful quit rates are now seen among smokers who use an e-cigarette and also receive additional support from their local stop smoking services.

Professor Kevin Fenton, Director of Health and Wellbeing at Public Health England said:

Smoking remains England’s number one killer and the best thing a smoker can do is to quit completely, now and forever.

E-cigarettes are not completely risk free but when compared to smoking, evidence shows they carry just a fraction of the harm. The problem is people increasingly think they are at least as harmful and this may be keeping millions of smokers from quitting. Local stop smoking services should look to support e-cigarette users in their journey to quitting completely.

Professor Ann McNeill, King’s College London and independent author of the review, said:

There is no evidence that e-cigarettes are undermining England’s falling smoking rates. Instead the evidence consistently finds that e-cigarettes are another tool for stopping smoking and in my view smokers should try vaping and vapers should stop smoking entirely.

E-cigarettes could be a game changer in public health in particular by reducing the enormous health inequalities caused by smoking.

Professor Peter Hajek, Queen Mary University London and independent author of the review said:

My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health. Smokers differ in their needs and I would advise them not to give up on e-cigarettes if they do not like the first one they try. It may take some experimentation with different products and e-liquids to find the right one.

Professor Linda Bauld, Cancer Research UK’s expert in cancer prevention, said:

Fears that e-cigarettes have made smoking seem normal again or even led to people taking up tobacco smoking are not so far being realised based on the evidence assessed by this important independent review. In fact, the overall evidence points to e-cigarettes actually helping people to give up smoking tobacco.

Free Stop Smoking Services remain the most effective way for people to quit but we recognise the potential benefits for e-cigarettes in helping large numbers of people move away from tobacco.

Cancer Research UK is funding more research to deal with the unanswered questions around these products including the longer-term impact.

Lisa Surtees, acting director at Fresh Smoke Free North East, the first region where all local stop smoking services are actively promoted as e-cigarette friendly, said:

Despite making great strides to reduce smoking, tobacco is still our biggest killer. Our region has always kept an open mind towards using electronic cigarettes as we can see the massive potential health benefits from switching.

All of our local NHS Stop Smoking Services now proactively welcome anyone who wants to use these devices as part of their quit attempt and increase their chance of success.

Vaping is ‘as bad as smoking cigarettes’ for damaging key blood vessels

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‘E-cigarettes are less harmful than traditional cigarettes but they are not harmless,’ says professor.

pp-e-cigs-getty.jpgpp-e-cigs-getty.jpgpp-e-cigs-getty.jpg
Since January, E-cigarettes have been available for GPs to prescribe to patients to quit smoking 

Vaping damages key blood vessels in the heart in a similar way to normal cigarettes, heart experts have said.

Despite the NHS backing e-cigarettes as a quitting aid, scientists have stressed that vaping is “far more dangerous than people realise”.

Heart expert Professor Robert West, of University College London toldthe Sun: “It would certainly be fair to say the study shows electronic cigarettes are not without any risk.

“The critical question is how much risk.”

Researchers at the European Society of Cardiology Congress in Rome have called the NHS decision to back e-cigarettes premature.

The team found the average vaping session has a similar impact on the stiffness of the heart’s aorta as smoking a normal cigarette.

Speaking in Rome, lead researcher Professor Charalambos Viachopoulos from the University of Athens said : “We measured aortic stiffness. If the aorta is stiff you multiply your risk of dying, either from heart diseases or from other causes.”

He added: “E-cigarettes are less harmful than traditional cigarettes but they are not harmless.

“There could be long term heart dangers.They are far more dangerous than people realise.

“I wouldn’t recommend them now as a method to give up smoking. I think the UK has rushed into adopting this method.”

Since January, e-cigarettes have been available for GPs to prescribe to patients to quit smoking.

Public Health England (PHE) inspired the decision with a 2015 report that found e-cigarettes are 95 per cent healthier than normal cigarettes.

Rosanna O’Connor, director of drugs, alcohol and tobacco at Public Health England, agreed, saying: “Vaping carries a fraction of the risk of smoking.

“Yet many smokers are still not aware, which could be keeping people smoking rather than switching to a much less harmful alternative.”

E-Cigarettes Emit Toxic Vapors

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All electronic cigarettes emit harmful chemicals, and levels of those toxic compounds are affected by factors such as temperature, type and age of the device, a new study finds.

The findings could be important to both makers of e-cigarettes and regulators who want to reduce the health threat posed by the devices, according to researchers at the Lawrence Berkeley National Laboratory in California.

“Advocates of e-cigarettes say emissions are much lower than from conventional cigarettes, so you’re better off using e-cigarettes,” study corresponding author Hugo Destaillats said in a Berkeley news release.

“I would say, that may be true for certain users — for example, long-time smokers that cannot quit — but the problem is, it doesn’t mean that they’re healthy. Regular cigarettes are super unhealthy. E-cigarettes are just unhealthy,” he explained.

In laboratory tests, scientists found that the heat-related breakdown of propylene glycol and glycerin — two solvents found in most e-cigarette liquids — causes emissions of toxic chemicals such as acrolein, acetaldehyde and formaldehyde. All three are either respiratory irritants or carcinogens, the investigators said.

“Understanding how these compounds are formed is very important. One reason is for regulatory purposes, and the second is, if you want to manufacture a less harmful e-cigarette, you have to understand what the main sources of these carcinogens are,” Destaillats said.

The researchers also found that levels of harmful chemicals in e-cigarette vapor increase between the first few puffs and later puffs as the device gets hotter, and with each use of the device.

Starting Aug. 8, the U.S. Food and Drug Administration will begin regulating e-cigarettes, as well as all cigars, hookahs (waterpipes) tobacco, pipe tobacco and nicotine gels, among other products.

More than 75% of e-cigarettes tested contain the chemical linked to ‘popcorn lung’

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With e-cigarettes booming in popularity and being marketed as a healthier alternative to traditional smoking, scientists have been investigating the chemicals used in vaping in an attempt to identify any associated health risks.

Now a new study suggests that e-cigarettes may pose significant harm to vapers, having found that more than 75 percent of the e-cigarette varieties tested contained diacetyl – a flavouring chemical that’s previously been linked to the severe respiratory disease, bronchiolitis obliterans.

The debilitating lung condition became commonly known as ‘popcorn lung’ – or ‘popcorn worker’s lung’ – back in the early 2000s, when it first appeared in food industry workers who inhaled artificial butter flavouring in microwave popcorn processing facilities.

When airborne diacetyl is inhaled from the flavouring over a long period of time, the chemical can reduce air flow in the lungs by obstructing passageways calledbronchioles. The chemical is most dangerous to those who are exposed to it persistently in the workplace, although there has been at least one case involving a heavy consumer of microwave popcorn who consumed multiple bags of the food daily for over a decade.

“Recognition of the hazards associated with inhaling flavouring chemicals started with ‘popcorn lung’ over a decade ago,” said Joseph Allen, an exposure assessment expert at the Harvard University T.H. Chan School of Public Health. “However, diacetyl and other related flavouring chemicals are used in many other flavours beyond butter-flavoured popcorn, including fruit flavours, alcohol flavours, and, we learned in our study, candy flavoured e-cigarettes.”

With more than 7,000 varieties of flavoured e-cigarettes and e-juice (used in refillable vaping devices) on the market, it would be close to impossible to test them all. For this study, Allen and his team selected 51 types of flavoured e-cigarettes sold by nine different brands, picking flavours based on their potential appeal to children, teenagers, and young adults. Each product was inserted into a sealed chamber attached to a lab-built device that drew air through the e-cigarettes for 8 seconds at a time.

Analysis of the air stream revealed that diacetyl was present in 39 of the 51 flavours tested. When testing for the presence of acetoin and 2,3-pentanedione – two other flavouring compounds that potentially pose a respiratory hazard in the workplace – at least one of the three chemicals was detected in 47 of the 51 flavours tested.

The team includes a full list of the flavours found to contain diacetyl and/or the other chemicals in their paper, published in Environmental Health Perspectives, including Cherry Crush, Peach Schnapps, Vanilla Bean, and Grape Hookah.

The findings tell us more about the potential dangers of e-cigarettes, but they also highlight how we’re really only beginning to understand the health implications of this comparatively new drug choice. While the sample size in this study is comparatively small – just 51 flavours out of more than 7,000 on the market, and only representing products from nine brands  – It’s definitely something to think about if you choose to vape because you believe that you’re not harming your body.

“Since most of the health concerns about e-cigarettes have focused on nicotine, there is still much we do not know about e-cigarettes,” said one of the researchers, David Christiani. “In addition to containing varying levels of the addictive substance nicotine, they also contain other cancer-causing chemicals, such as formaldehyde, and as our study shows, flavouring chemicals that can cause lung damage.”

Does the Risk of E-Cigarettes Exceed Potential Benefits? Yes

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E-cigarettes are a gateway to smoking for young people; inadequate as cessation aid.

The use of e-cigarettes continues to dramatically increase, and the debate over their safety and appropriate use has heated up, in parallel. We as pulmonary clinicians are called upon to advise our patients and others about e-cigarettes, which presents challenges given the current limitations of the data upon which our advice should be based. What do we say?

At first glance the use of e-cigarettes appears to be an attractive option. Evaluation of the ingredients and particulates associated with e-cigarette vapors has demonstrated a substantial decrease in carcinogens compared with the traditional cigarette [1]. E-cigarettes can deliver nicotine in a form that is familiar to the traditional smoker, yet lacks many of the harmful constituents of cigarette smoke. The optimist envisions a cohort of multi-pack year smokers switching to the e-cigarette with a resultant rapid decrease in risks of heart disease, chronic lung disease, and cancer. But is this optimism justified by empiric evidence of safety, and favorable data on patterns of use, or is this simply wishful thinking?

Too often in the debate about the e-cigarette the focus is upon the relative lack of proof of harm and the flawed assumption that lack of evidence of harm equals evidence of safety. This is the wrong perspective. Instead, the focus needs to be upon proof that e-cigarettes are safe (alone or in conjunction with active smoking, since many are dual users), that they are effective in accomplishing some good (smoking reduction or cessation), and that they don’t promote an increase in the population of nicotine-addicted individuals. At present we lack such proof.

E-cigarettes as a Gateway to the Traditional Cigarette

Most defenders of e-cigarette use base their perspective on the concept of harm-reduction, and the assumption that the only users of e-cigarettes are or will be current tobacco smokers looking for a safer cigarette. One of the early concerns with the e-cigarette, however, was that it might introduce young, nontobacco users to nicotine addiction, and there is recent evidence to support the validity of that concern. A recent cross-sectional survey-based study reported on trends of e-cigarette use from 2010 through 2013. E-cigarette use increased dramatically over this interval. The highest prevalence of use was among very young adults, ages 18-25. A third of current e-cigarette users were nonsmokers and 1.4% were never-smokers [2].

The trend toward younger groups being aware of and using e-cigarettes is also on the rise. A survey of 4,780 middle school and high school students from Connecticut identified a high rate of awareness, as well current and lifetime use, of e-cigarettes among those students 3. Additionally, a study that sought to gauge “openness” to starting tobacco products identified the use of e-cigarettes as a significant factor in being likely to try tobacco products in the future [4].

What all of these studies tell us collectively is that the cohort of e-cigarette users is growing, young, and open to using both e-cigarettes and traditional tobacco products — not a group of seasoned smokers trying to quit or looking for an alternative to the traditional cigarette. The e-cigarette may well contribute to an overall increase in nicotine addiction.

E-cigarettes as a Cessation Aide

E-cigarettes have not been marketed as cessation aids (as doing so would have implications for FDA regulation) but have been advocated for this purpose, and many smokers have purchased these products as a way to stop smoking. Despite anecdotal reports that suggest effectiveness, there is not good evidence to suggest that e-cigarettes are superior to traditional, FDA-approved approaches to smoking cessation.

Caponnetto et al. conducted a clinical study of ENDS devices in cigarette smokers not intending to quit as an extension of their previous nonrandomized pilot study [5]. The investigators randomized 300 subjects to one of three arms then followed subjects for eight visits over 52 weeks to assess for ≥50% reduction in smoking, abstinence, and adverse events. The groups were: a) 12-weeks of 7.2 mg nicotine e-cigarettes; b) 6-weeks of 7.2 mg nicotine followed by 6-weeks of 5.4 mg nicotine e-cigarettes; and c) 12-weeks of placebo e-cigarettes which looked like the nicotine-containing e-cigarettes but contained only the carrier liquid. Under the intention-to-treat analysis, there were no significant differences between the groups in terms of cessation rates or reduction in the number of cigarettes smoked at 52 weeks.

Bullen et al. conducted a pragmatic randomized controlled trial to assess the efficacy of e-cigarettes for smoking cessation compared with nicotine replacement therapy [6]: 657 smokers desiring to quit were randomized to receive 16 mg e-cigarettes, 21 mg nicotine patches daily, or placebo e-cigarettes in a 4:4:1 ratio. Though at 1 month there was a significant difference in continuous abstinence favoring e-cigarettes (relative risk [RR] 1.46 [95% CI, 1.04-2.04]), this difference did not persist at 3 and 6 months. Given inadequate safety data and other concerns, and lack of evidence of superior efficacy, we would be remiss in recommending e-cigarettes over other approaches to smoking cessation.

Direct Toxic Effects of E-cigarettes

Multiple studies have reported on the toxicities that are associated with e-cigarette use. These studies have established that e-cigarettes are associated with increased nausea, vomiting, headache, choking, and upper airway irritation [7]. One study demonstrated that after only 5 minutes of smoking an e-cigarette, subjects’ airway resistance significantly increased from baseline. In these same individuals exhaled FeNO was also decreased indicating that after only 5 minutes of exposure there was a significant change in the biologic function of the lung.

Marini et al. went on to show that the effects on NO synthesis by the lung were similar between e-cigarettes and traditional cigarettes [8] . Using an animal model of asthma, researchers have established that e-cigarettes exacerbate the basic biology that drives asthmatic symptoms by increasing the influx of eosinophils into the airway and increasing synthesis of IL-4, IL-5, IL-13 and IgE [9].

Perhaps most concerning is recent data that have established that e-cigarettes can alter gene expression in bronchial epithelial cells, leading to a higher malignant transformation, in a similar way to traditional cigarettes [10]. The early evidence for the toxic effect of e-cigarettes is clear; they are an irritant to the airway and they have direct effects on gene expression and protein synthesis that promote airway inflammation and potential malignant transformation.

Conclusion

There is no evidence that e-cigarettes are safe and there is some evidence that they may in fact be harmful, both through introducing new young users to nicotine addiction, and through direct effects upon the lung. It took decades for the medical community to recognize, prove, and accept that cigarettes are a major health hazard; we should not make the same error with e-cigarettes. We risk losing hard-won ground in the battle on smoking through the so-called ‘renormalization’ of smoking that may attend the uncritical acceptance of e-cigarettes, and that is a stated goal of the e-cigarette industry [11].

Additional research to fully understand the health effects of e-cigarettes, including among dual users of e-cigarettes and traditional cigarettes, is needed. Harm-reduction arguments are only valid if we can objectively document an overall reduction in harm, at both the individual and population levels, and at present we cannot.

When patients come to us and ask for guidance about the use of e-cigarettes, they are expecting a response informed by data. The limited data we have at present does not demonstrate benefits exceeding known risks.

E-Cigs Have 10x More Cancer Causing Ingredients Than Regular Cigarettes | Spirit Science and Metaphysics

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However, the research commissioned by the Japanese Ministry of Health found formaldehyde and acetaldehyde carcinogens in the liquid produced by a number of e-cigarette products, a health ministry official stated.

The group also learned that e-cigarettes can fuel potentially  life-threatening drug-resistant pathogens. This is based on lab study where they tested e-cigs vapor on live methicillin-resistant Staphylococcus aureus (MRSA) and human cells.

The formaldehyde carcinogen was found to be much more present in the e-cigarette liquids than in the chemicals used in regular cigarettes, according to the official.

“In one brand of e-cigarette the team found more than 10 times the level of carcinogens contained in one regular cigarette,” said researcher Naoki Kunugita.

“Especially when the wire (which vaporizes the liquid) gets overheated, higher amounts of those harmful substances seemed to be produced.”

However, Kunugita added that the levels of the formaldehyde carcinogen fluctuated in the final results.  This does not mean that regular cigarettes are safer, it just means that some types of e-cigarettes have even more cancer causing compounds.

“You call them e-cigarettes, but they are products totally different from regular tobacco,” the Japanese health ministry official said. “The government is now studying the possible risks associated with them, with view to looking at how they should be regulated.”

What is being done about this?

Earlier this year, the World Health Organisation (WHO) urged governments to ban the sale of e-cigarettes to minors because of the “serious threat” posed to them.

The UN health agency said that despite the lack of evidence on the damage caused by e-cigarettes, there was enough “to caution children and adolescents, pregnant women, and women of reproductive age” about their use, adding that they should be outlawed from indoor public spaces.

Scientists are calling for a urgent controls to be put on the selling of e-cigarettes to children after a correlation was made between e-cigarette usage and binge drinking.

According to the US Center for Disease Control and Prevention (CDC): “More than a quarter of a million youth who had never smoked a cigarette used electronic cigarettes in 2013, according to a CDC study published in the journal Nicotine and Tobacco Research. This number reflects a three-fold increase, from about 79,000 in 2011, to more than 263,000 in 2013.”

While e-cigarettes are often used as an alternative to smoking, they are far from safe.  Not to mention, we still don’t even know what the long-term effects of smoking e-cigarettes is.

E-cigarettes contain 10 times amount of carcinogens: Japan research

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E-cigarettes contain up to 10 times the amount of cancer-causing agents as regular tobacco, Japanese scientists say© Provided by AFPE-cigarettes contain up to 10 times the amount of cancer-causing agents as regular tobacco, Japanese scientists say

E-cigarettes contain 10 times the level of cancer-causing agents as regular tobacco, Japanese scientists said Thursday, the latest blow to an invention once heralded as less harmful than smoking.

The electronic devices — increasingly popular around the world, particularly among young people — function by heating flavoured liquid, which often contains nicotine, into a vapour that is inhaled, much like traditional cigarettes but without the smoke.

Researchers commissioned by Japan’s Health Ministry found carcinogens such as formaldehyde and acetaldehyde in vapour produced by several types of e-cigarette liquid, a health ministry official told AFP.

Formaldehyde — a substance found in building materials and embalming fluids — was present at much higher levels than carcinogens found in the smoke from regular cigarettes, the official said.

“In one brand of e-cigarette the team found more than 10 times the level of carcinogens contained in one regular cigarette,” said researcher Naoki Kunugita, adding that the amount of formaldehyde detected varied through the course of analysis.

“Especially when the… wire (which vaporises the liquid) gets overheated, higher amounts of those harmful substances seemed to be produced.”

Supporters of e-cigarettes say the devices are a safer alternative to traditional tobacco, whose bouquet of toxic chemicals and gases can cause cancer, heart disease and strokes© Provided by AFPSupporters of e-cigarettes say the devices are a safer alternative to traditional tobacco, whose bouquet of toxic chemicals and gases can cause cancer, heart disease and strokes

Kunugita and his team at the National Institute of Public Health submitted their report to the ministry on Thursday.

In common with many jurisdictions, Japan does not regulate non-nicotine e-cigarettes.

Nicotine e-cigarettes, or so-called Electronic Nicotine Delivery System (ENDS), are subjected to the country’s pharmaceutical laws, but they can be bought easily on the Internet, although they are not readily available in shops as they are in some Western countries.

“You call them e-cigarettes, but they are products totally different from regular tobacco,” the ministry official said.

“The government is now studying the possible risks associated with them, with view to looking at how they should be regulated.”

– ‘Serious threat’ –

In August, the World Health Organisation called on governments to ban the sale of e-cigarettes to minors, warning they pose a “serious threat” to unborn babies and young people.

Despite scant research on their effects, the WHO said there was enough evidence “to caution children and adolescents, pregnant women, and women of reproductive age” about e-cigarette use, due to the “potential for foetal and adolescent nicotine exposure (having) long-term consequences for brain development”.

The UN health body also said they should be banned from indoor public spaces.

US health authorities said earlier this year that the number of young people there who have tried e-cigarettes tripled from 2011 to 2013.

More than a quarter of a million young people who had never smoked a cigarette used e-cigarettes last year, the US Centers for Disease Control and Prevention said.

Supporters of e-cigarettes say the devices are a safer alternative to traditional tobacco, whose bouquet of toxic chemicals and gases can cause cancer, heart disease and strokes and are among the leading causes of death in many countries.

But opponents say the devices have only been around for a few years, and the long-term health impact from inhaling their industrial vapour is unclear.

Big tobacco companies are snapping up producers of e-cigarettes, wary of missing out on a snowballing global market worth about $3 billion.

Earlier this month, Oxford Dictionaries picked “vape”– the act of smoking an e-cigarette — as their new word of the year.