Are e-cigarettes safe? Here’s what the most recent science says

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Vaping is on the rise especially among teens who are hitting their Juuls before, during, and after class. This newfound adolescent experimentation has kicked off a renewed interest in the safety of vaping. Often touted as a safer alternative to cigarette smoking, there is a lot of hysteria and misconception surrounding vaping and its health effects. Is vaping safe? We combed the recent medical and scientific literature to see what the latest science has to say. Here’s what we found.

Dual-using e-Cigs and cigarettes is the worst thing you can do

If you use both cigarettes and e-cigarettes, you may be putting your health at risk. A recent study published in the Journal of the American Medical Association (JAMA) showed that exposure to harmful toxicants is highest among those who both smoke and vape. The study measured biomarkers that are the result of exposure to toxicants. These biomarkers were lowest among those who only vaped and highest among dual users. Those who used cigarettes fell in the middle with up to 36 percent lower concentrations of nearly all biomarkers than those who smoked cigarettes and used e-cigs. The take home message — if you are going to use vaping to wean off cigarettes, then you should strive to transition quickly and not smoke both for an extended period.

E-cig vapor contains fewer toxic substances than cigarette smoke does

It’s been well documented that cigarette smoke contains a variety of poisonous and carcinogenic compounds, but what about the vapor from e-cigarettes? A 2014 study tested 21 different e-cig liquids and found that e-cigarette vapors did contain toxic compounds, but at a level that was 9–450 times lower than cigarette smoke. In fact, many of the vapors were no higher than the reference product which served as the baseline for measurement. That’s good news for people who are quitting smoking and vaping instead.

Toxins in e-cig vapor may be absorbed into the body

Previous studies show that e-cig vapor contains low amounts of toxic and carcinogenic compounds, but what happens to these substances when these are inhaled?  A March 2018 study published in Pediatrics examined the urine and saliva of adolescent subjects to find out. Their research showed that teens who both smoked cigarettes and vaped had the highest levels of toxins and carcinogens when compared to e-cig user and non-smokers. Teens who only smoked e-cigs were not spared as they also had elevated levels of potentially harmful compounds such as acrylonitrile, acrolein, propylene oxide, acrylamide, and crotonaldehyde.

“The presence of harmful ingredients in e-cigarette vapor has been established; we can now say that these chemicals are found in the body of human adolescents who use these products,” concluded the authors of the study. We still don’t know whether the levels of these toxic and carcinogenic chemicals will have a long-term effect on the body. Only time will tell.

Vaping may increase your risk of heart attack

Vaping may give you a buzz and calm your nerves, but what it does to your cardiovascular health is concerning. A small study by researchers at Karolinska Institute revealed that vaping with nicotine produced a significant increase in heart rate, blood pressure, and arterial stiffness. A combination that later in life can lead to heart attack and stroke.

A follow-up study in 2018 by University of California, San Francisco professor of medicine Stanton Glantz expanded the scope of the research by looking at the survey results from 70,000 people.  After taking into account other demographics and health factors such as hypertension, diabetes, and high cholesterol, Glantz found that daily e-cig use doubles your chance of a heart attack. This risk is only slightly lower than daily cigarette use which triples your risk.

The worst combination is vaping and smoking cigarettes every day, which increases your heart attack risk fivefold. There is a silver lining, though: If you only use e-cigs occasionally, then you have little to worry about as your heart attack risk does not significantly change. Another piece of good news? This risk disappears as soon as you stop vaping.

Flavorings taste good, but they’re not good for your lungs

The favorite flavoring agent Cinnamaldehyde is the chemical that gives cinnamon its characteristic smell and taste. It’s deemed safe for use in food products, and has therefore found its way into many popular e-cigarette flavors — but little research has looked what happens to Cinnamaldehyde when is it vaporized and inhaled.

A team of researchers from the University of North Carolina at Chapel Hill explored this question and discovered that Cinnamaldehyde disrupted the function of the cilia in lung cells that were grown in a lab. Inside our bodies, these cilia are critical to our respiratory system because they remove bacteria and other foreign substances from the lungs. Without functional cilia, people are at significantly higher risk of developing bronchitis and lung infections.

Lead study author Phillip Clapp, Ph.D. points out that most flavoring agents are reactive aldehydes that are similar to Cinnamaldehyde. They also are added in very high concentration. If Cinnamaldehyde has this profound of an effect on the lungs, then it is possible these other flavorings may have the same deleterious effect, too. Further study is needed to either confirm or refute these findings — though it’s worth noting that lung damage isn’t necessarily the only harm flavorings might cause. Other experiments suggest that flavoring compounds might also be harmful to blood cells.

Vaping often leads to cigarette use in teens, but not adults

Vaping was introduced as a way for people to kick the smoking habit without giving up their love of smoking. They could inhale the tasty liquid vapor of an e-cigarette and avoid the harmful toxins and carcinogens that come from tobacco smoke. While adults often stick to e-cigs after giving up regular cigarettes, teens often do the opposite. Teens are turning up their noses at cigarettes and choosing to vape instead. However, once they start using e-cigs, teens are six times more likely than non-smokers to start smoking once they reached legal age, according to a 2016 study by researchers at the University of Southern California.

More teens vaping because of peer pressure and flavors

Vaping among high school and middle school students is at an all-time high according to a recent survey by the FDA. In a single year, the number of teens vaping increased by 1.5 million. The biggest jump was among high school students who showed a 78 percent increase in vaping, as compared to a 48 percent increase among middle school students. More teens are using tobacco products as well — a radical change following years of decline.

Why are teens vaping? More than a third of the survey respondents (39 percent) cite peer pressure. They smoke e-cigs because a friend or family member also vapes. Not surprisingly the sweet taste of e-cigs also plays a significant role with 31 percent of teens claiming they are attracted by the flavorings such as mint, candy, fruit, or chocolate. A small percentage (17.1 percent) picked up vaping because they believe e-cigs are less harmful than tobacco cigarettes.

As a result of this survey, the FDA wants to limit the sales of most flavored e-cigarettes. “Our aim is to make sure no kid can access a fruity flavor product in a convenience store,” said FDA Commissioner Scott Gottlieb. The FDA plan restricts e-cig sales to retail stores that have an age-restricted entry or have areas that are not accessible to those under 18-years-old. Online sales also will be required to implement stronger age-verification procedures.

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