What’s in E-Cigarettes and Other Cutting-Edge Research on Vaping
Every month, we get into a different health topic and explore the research. Like many of you, we’ve been following the news stories on vaping: Nearly 400 vaping-related lung injuries and seven confirmed vaping-related deaths have been reported. Which is terrifying. We dug into the pressing new studies on vaping—and the findings surprised us.
JAMA Pediatrics (2017)
Vaping is suspected to be a possible gateway drug among adolescents, leading them to start smoking cigarettes earlier and more frequently. This may be due to the fact that e-cigarettes deliver a much higher dose of nicotine to users than regular cigarettes do. To investigate patterns of vaping and smoking among teens, researchers at the University of Southern California recruited 153 tenth grade students from high schools across the Los Angeles area and asked them to report their cigarette and e-cigarette use over a six-month period. The researchers found that teens who vaped higher nicotine concentrations progressed to more frequent and intense vaping and smoking by the end of the study. A particularly staggering finding was that teens who vaped high-nicotine concentrations smoked fourteen times as many cigarettes per day as their peers who did not vape nicotine at the beginning of the study. Previous studies have shown that high nicotine use during adolescence can lead to nicotine dependence, risky behaviors, and cognitive issues, such as poor attention and decision-making skills. Thus, the authors suggest that levels of nicotine in e-cigarettes should be regulated in order to prevent an uptick in cigarette smoking among adolescent vapers. While still preliminary, this research adds to the growing body of evidence suggesting that the popularity of vaping among adolescents may come with negative health consequences.
American Journal of Preventive Medicine (2019)
This study comes amid recent reports that vaping fluids have caused lung irritation and hospitalization and following an FDA warning letter sent to JUUL for falsely advertising that its products are safer than cigarettes. Researchers at Yale examined the chemical components of various flavors of JUUL e-cigarettes, which are widely used by young people. The researchers found that both the liquid itself and the vaporized aerosol contained high levels of vanillin acetals, which are lung irritants that are banned in regular cigarettes but allowed in e-cigarettes. Vanillin acetals are produced when flavors inside the refill pods react with the alcohols that are used to carry the flavor (like propylene glycol and vegetable glycerin). The researchers estimated that in one puff of a JUUL, users are exposed to amounts of vanillin that are ten times higher than the safety limits set for workers’ exposure over an entire eight-hour workday (like bakers or people in the chemical-flavor industry). Additionally, the researchers found that the JUUL Fruit Medley flavor pod contained menthol, even though this was not on the label. Which is concerning given that menthol is thought to increase nicotine intake. This study raises alarm over chemicals in e-cigarettes (other studies have found metals in the aerosol) that could form potential irritants during inhalation, causing health effects that are still largely unknown.
Tobacco Control (2018)
Using a model of cigarette smoking in the United States, an interdisciplinary team of health researchers determined that switching cigarette smokers over to vaping instead could result in almost 7 million fewer premature deaths over a simulated ten-year period. Even in their more pessimistic smoking-cessation model—assuming vaping may be worse for our health than believed or that people may take longer to make the switch completely—the researchers estimated that converting American smokers to vapers would still prevent almost two million premature deaths. (Half a million people die every year in the US from smoking.) The study also reported that the greatest benefits of vaping would be reaped by younger cigarette smokers, who would gain an average of six months back to their life expectancy by switching to vaping. These results come after a 2014 Surgeon General’s Report that stated that new strategies to stop tobacco use needed to be introduced. When this study was published in 2018, the researchers suggested that vaping be considered as a viable strategy to quickly end smoking—although clearly vaping comes with its own unique health risks, many of which have become more prevalent in just the past few months.
Journal of the American Heart Association (2019)
Although e-cigarettes are often positioned as a viable alternative to cigarette smoking or as an effective tool for quitting cigarettes, studies have suggested that e-cigarettes are not without long-term health consequences. The Center for Tobacco Control Research and Education released a study earlier this year confirming what previous studies have also found: E-cigarette users have a higher risk of heart attack than nonsmokers, regardless of how many cigarettes they smoke. Using data from a nationally representative group of more than 30,000 Americans, the study reported that people who smoked e-cigarettes every day had 125 percent higher odds of heart attack than people who never smoke. And occasional use may not even be safe: Those who used e-cigarettes on occasion still had significantly higher odds of having a heart attack than nonsmokers. People who used both e-cigarettes and cigarettes together had 564 percent higher odds of heart attack than nonsmokers. The researchers reported that switching from cigarettes to e-cigarettes did not lower risk of heart attack—a controversial finding that could change the way experts perceive vaping. Further studies from unbiased researchers are needed to confirm these findings and to determine the overall picture of health for e-cigarette smokers compared to cigarette smokers to inform future health policies and decisions.