Tag Archive for: European Respiratory Society

The Bottom Line on E-Cigarettes

Vaping e-cigarettes is supposed to be better than smoking cigarettes because the toxic chemicals will be gone. That may be true for the chemicals released from tobacco and paper, but the third area of concern is the e-liquids that make up the flavor component of e-cigarettes. The marketing tactic often focuses on the variety of flavors available. The question is this: are they safe or do they contain chemicals that could negatively impact the lungs?

Researchers obtained a random sample of e-cigarette liquids from the most popular brands on sale in Greece, Spain, Germany, the Netherlands, the UK, Hungary, Romania, Poland, and France. The samples included a variety of different flavors and nicotine strengths. They analyzed each sample to find out exactly which chemicals were present and in what quantities.

Every liquid container that they tested contained at least one substance that has some level of health risk according to the United Nations classification system. The chemicals, with long complex names, can cause respiratory irritation, allergy or asthma symptoms, or breathing difficulties if inhaled. What they might do when heated is still to be determined.

There were several more research papers presented that also illustrated that e-cigarettes are not problem free. The belief is that they are not as harmful as conventional cigarettes, but the fact is we really don’t know because the components haven’t been tested.
 

Meanwhile There’s the FDA

And they probably never will be tested, at least in the U.S. This past July, the new head of the FDA Dr. Scott Gottlieb announced that he was suspending laws that govern e-cigarettes for five years. In the last administration, the governance over e-cigarettes was turned over to the FDA where they enacted restrictions that insisted the products be tested for safety before being brought to market. Those rules have been suspended so the industry could have time to set standards and comply with tobacco regulations.

I read Dr. Gottlieb’s ruling. As a physician who has treated cancer patients, he has seen what cigarettes do first hand. His belief is that nicotine addiction is the primary issue and that vaping, while not as good as not smoking, may help people quit smoking by using these products to help reduce reliance on nicotine. Gottlieb seems to believe that nicotine, while still addictive, does not kill people; it’s the 5,000 other chemicals in cigarettes that do.

I simply do not understand his reasoning. There are hazards to nicotine, as the research this week has shown. There are chemicals in the e-liquids that have not been identified, have not been tested, and we have no history with their use to investigate. How do we know what health issues we’re facing without finding answers to those questions?

One more thing. Dr. Gottlieb is an investor in a vaping products company called Kure. He has said that he will divest his interest and recuse himself from decisions on vaping for one year. I guess physician years are like dog years; he seems to have made a big decision on vaping after being in office just a few months.
 

The Bottom Line

As a former smoker, I understand the addiction. If vaping products had been available when I quit, maybe I would have used them. As a healthcare professional today, there is not a chance. We’re talking about inhaling substances that have never been subjected to any form of safety or toxicity testing. It’s unreasonable to do that. The studies I reviewed this week clearly show there is doubt. We know how long it took the tobacco industry to finally admit that tobacco was addictive when they had the data all along. The e-cigarette industry has no data at all.

You are a free-living human being. It’s your body, and what you choose to put in it is your choice. I just hope none of it comes from tobacco or e-cigarette products.

What are you prepared to do today?

Dr. Chet

 

Reference: European Respiratory Society. 2017. Abstract OA1978.

 

Update: E-Cigarettes Put Lungs at Risk

The second study presented at the European Respiratory Conference on e-cigarettes that caught my attention was a study done in Sweden. Researchers questioned over 30,000 people, randomly selected from the Swedish population. The purpose was to ask the subjects about smoking: did they smoke, what did they smoke, and what type of respiratory symptoms did they have? Here’s what they found.

Only 12.6% of those surveyed said they smoked, and the numbers broke down this way: 11% smoked only conventional cigarettes, 0.6% vaped only, and 1.2% said they used both. Researchers speculated they smoked cigarettes when allowed and vaped in public or other settings.

What about respiratory conditions? As you might expect, the highest percentage of respiratory issues came from those subjects who smoked both conventional and e-cigarettes at 56%; 46% of those who smoked only cigarettes had respiratory issues, and 34% of those who exclusively used e-cigarettes. How many non-smokers had respiratory conditions? Only 24%. The results clearly show that vaping causes the same respiratory issues such as wheezing or productive coughs as might be found in tobacco cigarettes.

What might be contributing to the issues with e-cigarettes? I’ll cover that on Saturday. One thing is clear so far: vaping is not innocuous as has been sold to consumers.

What are you prepared to do today?

Dr. Chet

 

Reference: ERS 2017. Abstract PA4485

 

Update: E-Cigarette Safety

As the European Respiratory Society held their annual convention, several research studies made the health news, including e-cigarettes and vaping. The appeal of e-cigarettes is that they seem to be safe–you’re not actually burning tobacco with its associated chemicals and inhaling that into your lungs. E-cigarettes remove all that bad stuff and associated negative health effects. Or do they?

In the first study, researchers recruited 15 subjects who had smoked cigarettes occasionally, fewer then 10 per month; subjects had also never used e-cigarettes. They were asked to smoke e-cigarettes for 30 minutes in a random order on different days; once with nicotine, the other without. The researchers measured blood pressure, heart rate, and arterial stiffness immediately after smoking the e-cigarettes and then two and four hours later.

In the first 30 minutes after smoking e-cigarettes with nicotine, there was a significant increase in blood pressure, heart rate, and arterial stiffness. That didn’t happen after the e-cigarettes without nicotine. While this is a small pilot study, it seems that vaping nicotine can impact the cardiovascular system in the same way regular cigarettes do.

What are you prepared to do today?

Dr. Chet

 

Reference: ERS 2017; Abstract OA1979.