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Queens Chronicle

How dangerous are e-cigarettes, if at all?

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Posted: Wednesday, August 14, 2013 10:30 am

The growing use of electronic cigarettes is sparking serious debate among health professionals, regulators, users and the public.

E-cigarettes, which contain nicotene but not tobacco, are battery-powered devices that use heat to produce a vapor and smoking sensation designed to be similar to regular cigarettes.

But are they an effective smoking substitute and cessation device? Are they just the opposite, a gateway product that leads to real smoking? Is the vapor they emit harmful to second-hand inhalers?

These are some of the questions that have been the focus of recent studies and news reports on e-cigarettes.

The city, which has aggressively regulated the use and sale of traditional cigarettes, and has more legislation in the pipeline, has no regulation against the use of e-cigarettes in places like bars and restaurants where regular smoking is banned.

A notice on NYC311, a city website, reads in full:

“There is no regulation in the City that prohibits the use of electronic cigarettes (e-cigarettes) by patrons in food service establishments or individuals in other private businesses. It is up to individual establishments to set rules about whether e-cigarettes may be used on their premises. However, food establishment workers are prohibited from smoking any substance in food service establishments. E-cigarettes may not be sold to minors under the age of 18 anywhere in New York State.”

That could change, however, under two pieces of legislation that have been sitting in the City Council — if the warnings from a group called the Consumer Advocates for Smoke-Free Alternatives Association are correct. The CASAA says the bills “would effectively outlaw e-cigarettes by regulating them into extinction.”

They would do that by redefining “tobacco products” to include e-cigarettes and related components, parts and accessories, the group said.

How dangerous e-cigarettes are is up for debate, however. While some studies have noted that the vapor contains harmful chemicals, a new analysis by Drexel University says the concerns are overblown.

According to the Drexel study, the exposures to chemicals from e-cigarette vapor “fall well below the threshold for concern for compounds with known toxicity. That is, even ignoring the benefits of e-cigarette use and the fact that the exposure is actively chosen, and even comparing to the levels that are considered unacceptable to people who are not benefiting from the exposure and do not want it, the exposures would not generate concern or call for remedial action.”

The study cited other evidence that e-cigarettes are not harmful, but did say that exposure to two chemicals used in them, propylene glycol and glycerin, warrants further study because “the magnitude of the exposure is novel.”

The study was funded by the CASAA.

On the other end of the spectrum is the American Cancer Society, which contends that e-cigarettes may be harmful on their own or could lead to the use of traditional cigarettes.

“There is no scientific evidence that e-cigarettes are a safe substitute for traditional cigarettes or an effective smoking cessation tool,” Russ Sciandra, the ACS New York State director of advocacy said in a recent web post on the topic. “In fact, they may entice young people into trying traditional cigarettes. We also have questions about the safety of these devices. In lab tests, the FDA found some samples contain carcinogens and other toxic chemicals. Using e-cigarettes can be like trading one deadly behavior for another.”

In the middle, perhaps, is The Clinical Advisor, a magazine and website geared toward nurse practitioners and physician assistants.

“Although e-cigarette vapor is likely less toxic than cigarette smoke, calling it safe is a stretch,” a report posted to the site on July 16 said.

The author’s suggestion? More research.

Welcome to the discussion.

3 comments:

  • Dbl_Gee posted at 6:57 pm on Sat, Aug 17, 2013.

    Dbl_Gee Posts: 1

    "The study cited other evidence that e-cigarettes are not harmful, but did say that exposure to two chemicals used in them, propylene glycol and glycerin, warrants further study because “the magnitude of the exposure is novel.”

    Both of these chemicals are common everyday Food Additives. Both are approved by the FDA. How does this constitute "“the magnitude of the exposure" as "novel" ?

     
  • Peter Fournier posted at 5:06 pm on Thu, Aug 15, 2013.

    Peter Fournier Posts: 1

    “There is no scientific evidence that e-cigarettes are a safe substitute for traditional cigarettes or an effective smoking cessation tool,”

    Russ Scandria does indeed need to keep up before making scary pronouncements.

    I would also be interested in Russ Scandria's opinions about the following three points, but first the background (references available on request).

    Background: The medical literature estimates that every cigarette smoked reduces the smokers life expectancy by 11 minutes. That's 70 days per year. Given that the Cancer Society is scaring people into not using e-cigarettes, actually Personal Vaping Devices, I would like to know the following:

    Points
    1) Has the American Cancer Society commissioned a medical ethics assessment on causing a known harm (11 minutes per cigarette, 70 days per year of smoking) by delaying the adoption of e-cigarettes by current smokers with their scary pronouncements? If so, what was the result? Are these scary statements ethical? The problem is that the Cancer Society and others demand scientific proof of effectiveness while remaining blind to the know, scientifically provable result of their own statements. They make statements about a POSSIBLE harm and delay people from adopting a technology that reduces a KNOWN harm. As far as I know there is no scientific evidence that would justify encouraging the maintenance of a KNOWN harmful behaviour (smoking) when weighed against a POSSIBLE harm (no evidence so far) from e-cigarettes. The ethics of these "health" groups is in serious doubt as far as I can see.

    2) Pressure from "health" groups such as the American Cancer Society to "regulate" e-cigarettes, either through various legislation or by classifying them as medical devices will obviously make it very very expensive indeed for any company to a) remain in the business of selling e-cigarettes and associated products or (b) to enter into the market. This will have the effect of handing the e-cigarette market over to Big Tobacco and or drug companies, the only ones with pockets deep enough to survive the legislation. So the question is "When did the American Cancer Society change it's policy and decide to support Big Tobacco?"

    3) I believe that e-cigarettes have the potential of competing so successfully against tobacco cigarettes that they can over a decade or two completely destroy to tobacco market. BUT, to do that the e-cigarettes have to be much cheaper than tobacco cigarettes. Has the American Cancer Society estimated what the price points are that would allow e-cigarettes to supplant tobacco cigarettes? If not, why not? I thought the American Cancer Society was all about ending the use of tobacco cigarettes. Does this organization plan to lobby for cheap alternatives to smoked tobacco? If not, why not? Smoked tobacco is the villain here.

    Finally, the canard about "effective smoking cessation tool" ... If someone switches from tobacco cigarettes to e-cigarettes (AKA personal vaping devices) they have quit smoking entirely. If they use e-cigarettes and tobacco cigarettes, they have reduced their smoking at the very least. I say this for the very obvious reason that you cannot "smoke" an e-cigarette -- there is no smoke involved in using e-cigarettes. So, "smoking cessation" is a red herring. The Cancer Society likely thinks it makes sense because they confuse "smoking" and "nicotine ingestion" and they would like to create the same confusion in the public. This tactic is, as far as I can see, simply dishonest.

    A better discussion would be "Is using nicotine regularly any better or worse than using caffeine or any of the anti-depressants currently being flogged to the American public?"

    "Health" groups are trying to use "science" to resist and regulate e-cigarettes. They risk discrediting themselves, and in the process, discrediting science.

     
  • Elaine_Keller posted at 9:05 am on Thu, Aug 15, 2013.

    Elaine_Keller Posts: 1

    Russ Sciandra needs to keep up with published research. Dr. Riccardo Polosa has successfully used e-cigarettes as a substitute for smoking with several groups of subjects. Some were followed for as long as 24 months, and experienced no major side effects. So it is incorrect to say that there is no scientific evidence to show that they are a safe substitute. When used with a group of 300 smokers who did not want to quit, "smoking reduction was documented in 22.3% and 10.3% at week-12 and week-52 respectively. Complete abstinence from tobacco smoking was documented in 10.7% and 8.7% at week-12 and week-52 respectively. " That's a phenomenal result for a group that had no intention of quitting.

    On the other hand, Sciandra claims, "they may entice young people into trying traditional cigarettes." I have seen no reports in the scientific literature that support this theory. Surveys have reported that youth who already smoke are the ones trying e-cigarettes--perhaps in an effort to switch to something less harmful. It would be a shame if the ACS encouraged these youngsters to stick with traditional cigarettes by convincing them that e-cigarettes are just as hazardous as inhaling smoke.