Friday, May 24, 2013

German Cancer Research Center Lies about Health Effects of Electronic Cigarettes to Scare Users and Unfairly Influence EU Directive

According to the German Cancer Research Center, the inhalation of glycerin can cause lipoid pneumonia. Lipoid pneumonia is a form of pneumonia - lung inflammation - in which lipids (oils) accumulate in the bronchial tree. It can be caused by exogenous factors, such as the inhalation of oils.

A report on electronic cigarettes from the German Cancer Research Center states: "Glycerine may cause lipoid pneumonia on inhalation."

This is a serious assertion because if true, then the use of electronic cigarettes would be quite unsafe. Glycerin is a common component of a huge majority of electronic cigarettes on the market and it is inhaled in significant quantities by electronic cigarette users. If this inhalation of glycerin could cause lipoid pneumonia, then electronic use would be unduly risky. In fact, if the German Cancer Research Center's assertion is true, I would have to reverse my recommendation that these products are a viable alternative for smoking cessation.

The major purpose of the release of this report by the German Cancer Research Center was to influence the upcoming European Union deliberations on its proposed tobacco product directive. The initial draft of that directive bans electronic cigarettes. Based in part on its conclusion that the inhalation of one of the most common ingredients in electronic cigarettes causes lipoid pneumonia, the report recommends that electronic cigarettes be banned, unless they are shown to be safe in clinical trials. However, if it is true that glycerin inhalation causes lipoid pneumonia, then these products would not (and should not) ever be approved as smoking cessation drugs or devices.

The Rest of the Story

Since I've noted that if the inhalation of glycerin causes lipoid pneumonia I would discontinue my support for electronic cigarettes as a smoking cessation product and since the German Cancer Research Center asserts that glycerin does cause lipoid pneumonia, I suppose it is time for me to make a major announcement:

I hereby withdraw my support of electronic cigarettes as a viable and relatively safe smoking cessation product.

Cancel that.

Because there is a rest of the story.

The rest of the story is that the German Cancer Research Center is lying.

It is not true that glycerin causes, or can cause, lipoid pneumonia. In fact, it is impossible for glycerin inhalation to cause lipoid pneumonia.

The reason?

Lipoid pneumonia is caused by the inhalation of oils. But glycerin is not an oil!

Basic chemistry tells us that glycerin is an alcohol. Specifically, it is a polyol, which is a compound with multiple hydroxyl groups. The hydroxyl group (OH) is the hallmark of an alcohol. Oils, on the other hand, are characterized by the presence of either a carboxyl group (COOH) or a sterol. The bottom line is that glycerin is not an oil, but an alcohol.

In fact, glycerin is soluble in water and alcohol, but not in oil. This is because of the three hydroxyl groups.

If glycerin was in fact a cause of lipoid pneumonia, the FDA would not have approved its widespread use in medications such as cough syrups, expectorants, and mouthwashes, because of the risk that accidental aspiration of these products could cause lipoid pneumonia.

It will be interesting to see if the German Cancer Research Center corrects this serious error. It is particularly serious because it is the difference between electronic cigarettes being relatively safe and electronic cigarettes being absolutely unsafe and unsuitable for use.

Of course, if the German Cancer Research Center's statement were true, we would have seen many cases of lipoid pneumonia in vapers by now because there are millions of people who inhale glycerin daily from these products. 

It is theoretically possible that lipoid pneumonia could result from an electronic cigarette product that used oils in its formulation. For example, a product that used essential oils in a flavoring or fragrance would introduce a real - although still very small - risk. It is certainly legitimate to ask regulators to ensure that oils are not used in these products. However, the contention that glycerin itself does or can cause lipoid pneumonia is a manufactured lie.

It is unfortunate that this report is providing such extreme misinformation in an apparent attempt to influence the European Union's consideration of the tobacco product directive. It would be a shame if the EU were to ban electronic cigarettes because of this absolutely false information.

This appears to be another example of an anti-smoking organization which is manipulating the truth (i.e., lying) in order to promote its apparently pre-determined, ideology-based opposition to electronic cigarettes.

If the German Cancer Research Center wanted to do one thing to prevent cancer, it would start by embracing this product - which has the potential to save thousands of lives - as an alternative to smoking and a viable harm reduction strategy. Instead of being regulated as pharmaceuticals (which would result in a de facto ban of the product), they should be regulated as alternative (much safer) nicotine delivery products.

(Special thanks to Dr. Konstantinos Farsalinos for scientific insights that I incorporated into this post.)

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