Because e-cigarettes have been around for a while now, we are beginning to see some scientific testing. I estimate the scientific information on e-cigarettes is equivalent to the cigarette data we had in 1985.
It wasn’t too long ago that my teenage daughter first told me about hookah pens (e-cigarettes for teenagers). It was the same e-cigarette, but just had a cooler name. According to her peers, it was a harmless little diversion of flavored oil and smoke rings.
For the uninitiated, an e-cigarette is a cigarette-shaped contraption that uses a battery-powered ultrasonic vaporizer to create a fine mist, which you inhale like smoke.
This provides a “smoking-like” experience, which according to the e-cigarette industry is a harmless dalliance. Nothing actually catches fire, rather a liquid of nicotine in glycerin is turned into a fine mist. You are vaping, not smoking, thus sidestepping 30 years of anti-smoking legislation.
These vaporizers come in purple/lime green and similar wild “youth-oriented” colors. Kids are big fans of these things, so naturally I was concerned a year ago that this was a thinly-disguised attempt at addicting another generation to nicotine. Remember Joe Camel?
Now with time, we have some science and various studies to consider regarding e-cigarettes.
Glycerin is a clear, oily substance and is slightly sweet in taste. It’s an approved food additive that is widely used in packaged food. Nicotine is added to glycerin to make “e-juice” (e-cigarette liquid). This certainly sounds appetizing. Glycerin was not intended to be run through a vaporizer and be inhaled.
Sometimes running glycerin through the ultrasonic vaporizer can break it down, and that makes formalin, which is more commonly known as formaldehyde. You probably know it is used in embalming and is also utilized as a disinfectant in nail varnish.
Formaldehyde is also a known human carcinogen and it is quite toxic. Some low voltage settings produce very little formaldehyde, while higher voltage settings produce 15 times the level of formaldehyde in cigarettes. And that is just the solution, not the actual nicotine.
So far we have just discussed the “safe” part of what you are inhaling, FDA-approved glycerin, plus or minus some formaldehyde.
We all know that nicotine has a well-known story of its own, which is anything but benign. It is a chemical naturally produced in some plants of the nightshade family. That sounds ominous, but the nightshade family also contains potatoes and many useful plants.
Nicotine is a naturally occurring chemical in tobacco plants that is 0.6 to 3.0 percent by weight in dry tobacco. It acts as a stimulant that contributes to a more focused and awake state, while increasing calm – essentially coffee without the buzz. Nicotine improves performance on memory, attention and fine motor skills. However, users quickly adapt to the benefits and they become the new normal.
There’s little wonder why nicotine is so popular and notoriously difficult to abandon once it becomes a regular habit. Who wants to have less-focused attention, a worse memory and be clumsier?
There are a few problems with nicotine as a study aid. It causes atherosclerosis heart attacks (when there is a build up and hardening of the arteries) and cancer. Studies have also shown that nicotine accelerates the growth of some tumors. The accelerated growth can be substantial (10 to 15 times the growth rate). It is important to remember that we have billions of cells and they make occasional mistakes in reproducing.
Almost all of these cells are attacked by our immune system before they really begin to grow. Make them grow faster, and that changes the outcome dramatically.
Nicotine also is quite addicting. For the record, it was once used as an insecticide, and minor variations of nicotine are still used today for poisoning insects.
As we’ve seen, the evidence on nicotine and cigarettes has built to a point where very few question the harm they cause.
The more science we have on e-cigarettes or hookah pens, the less innocent they appear.
To no one’s surprise, the e-cigarette industry has loudly criticized the scientific studies, complaining that smoking machines did the puffing (vaping), not people, so the studies aren’t accurate.
Does this remind you of the cigarette industry 20 years ago? The cigarette industry was criticizing the research showing a bunch of health problems from smoking. They wanted to talk about how filters would make cigarettes safe. They wanted to say that machines used to measure smoking toxins didn’t smoke like people. Well, it turns out filters offer no protection from cancer; cigarettes were just plain dangerous.
Now the e-cigarette industry has taken up the flag. They criticize the equipment used to test e-cigarettes and the methodology used to test “vaping.” But it’s all just smoke and mirrors. Questioning the testing methodology used is just a distraction from the facts.
I expect to see e-cigarettes go the way of conventional cigarettes, because year after year more evidence piles up and eventually no one will seriously doubt their harm.
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.
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