Monday, March 11, 2013

New Study of Electronic Cigarette Vapor Confirms that E-Cigs are Much Safer than Regular Cigarettes

A new study of the chemical constituents of the vapor produced by 12 brands of electronic cigarettes reports that these products greatly reduce exposure to the harmful chemicals in tobacco cigarettes and that e-cigarettes therefore show promise as a harm reduction strategy for tobacco control.

(See: Goniewicz ML, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tobacco Control. Published online ahead of print on March 6, 2013. doi: 10.1136/tobaccocontrol-2012-050859.)

In the study, levels of selected carbonyl compounds, volatile organic compounds, tobacco-specific nitrosamines, and metals were analyzed in the vapor of 12 brands of electronic cigarettes and compared to levels of the same compounds in a medicinal nicotine inhaler and in regular tobacco cigarettes.

The results of the study were as follows: "levels of selected toxic compounds found in the smoke from a conventional cigarette were 9-450-fold higher than levels in the vapour of an e-cigarette. ... Smoking an e-cigarette (also referred to as 'vaping') can result in exposure to carcinogenic formaldehyde comparable with that received from cigarette smoking. Formaldehyde was also found in the vapour of medicinal inhalators, at levels that overlapped with those found in e-cigarette vapour. Exposure to acrolein, an oxidant and respiratory irritant thought to be a major contributor to cardiovascular disease from smoking, is 15 times lower on average in e-cigarette vapour compared with cigarette smoke. The amounts of toxic metals and aldehydes in e-cigarettes are trace amounts and are comparable with amounts contained in an examined therapeutic product."

The abstract concludes as follows: "Our findings are consistent with the idea that substituting tobacco cigarettes with e-cigarettes may substantially reduce exposure to selected tobacco-specific toxicants. E-cigarettes as a harm reduction strategy among smokers unwilling to quit, warrants further study."

With regard to the safety of electronic cigarettes compared to real ones, the study concludes: "The results of this study support the proposition that the vapour from e-cigarettes is less injurious than the smoke from cigarettes. Thus one would expect that if a person switched from conventional cigarettes to e-cigarettes the exposure to toxic chemicals and related adverse health effects would be reduced."

The Rest of the Story

In my opinion, this study provides strong confirmation that electronic cigarettes are much safer than regular cigarettes. At this point, the totality of the scientific evidence is sufficient to conclude that switching from tobacco cigarettes to electronic cigarettes will substantially reduce the health risks associated with smoking. The FDA should allow electronic cigarette companies to make this claim, since it is sufficiently substantiated by scientific studies of the components of electronic cigarette vapor.

It is also important to emphasize that while few electronic cigarette companies are claiming that vaping reduces the hazards associated with smoking, they would not be making a fraudulent, misleading, or unsubstantiated claim if they did make such a statement in their marketing.

Likewise, any anti-smoking advocate or group that continues to claim that there is not evidence that using e-cigarettes is substantially safer than smoking is either unaware of or ignoring the evidence, and possibly making a fraudulent statement themselves.

Note also that this is an independent study which was not funded by any electronic cigarette company. The two funding sources were the Ministry of Science and Higher Education of Poland and the National Institutes of Health.This adds objectivity and credibility to the work.

Although this study demonstrates that e-cigarettes are safer than  tobacco cigarettes, it also refutes the idea that e-cigarettes are safe in an absolute sense. It appears that the main risk associated with vaping is the potential inhalation of formaldehyde. Formaldehyde may result from the heating of propylene glycol or the oxidation or hydrolysis of glycerin. Of interest, the levels of formaldehyde among the 12 brands of electronic cigarettes ranged from just 3.2 micrograms per 150 puffs (about the same as a nicotine inhaler) to 56.1 micrograms per 150 puffs. This presents an opportunity to examine the reasons for these significant differences and hopefully, to find ways to produce e-cigarette liquid that does not produce high levels of formaldehyde. This should be a research priority for the FDA

The other health concern related to e-cigarette use is the risks associated with long-term inhalation of propylene glycol. If an excipient can be found which allows vaporization of nicotine but avoids propylene glycol and limits the formation of carbonyl compounds such as formaldehyde, it will be a huge advance and may lead to the development of an electronic cigarette product that is not merely safer than smoking, but is essentially safe as well (comparable to a medicinal nicotine product). The development of such a product should also be a priority for the FDA's Center for Tobacco Products.


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