Tuesday, May 05, 2015

E-Cigarette Opponent Claims that E-Cigarettes are Causing Permanent Brain Damage among Youth Experimenters

According to an article on the Voice of America web site, e-cigarette use among youth can lead to permanent brain damage.

According to the article:

"Dr. Jonathan Winickoff, at Massachusetts General Hospital for Children and Harvard Medical School, compared teens' experimenting with any nicotine product, including electronic cigarettes, to "playing Russian roulette with the brain." Winickoff works with the American Academy of Pediatrics to protect children from tobacco and secondhand smoke. "Essentially, this drug creates a biologic need that can be permanent,” he told VOA. He said the effects include decreased working memory, tension problems as adults, and increased rates of depression and anxiety."

In the article, Jennifer Duke from RTI International made it clear that there is actually no evidence that e-cigarettes are a gateway to smoking. However, Dr. Winickoff apparently believes otherwise:

"Duke said there was "no definitive proof that the use of e-cigarettes will lead to the use of tobacco products," a statement shared in the Tobacco Control report. But Winickoff said his studies and experiences have led him to a different conclusion. "It also sets up the adolescent brain for more durable and stronger addiction pathways," he said, "not just for nicotine, but for other substances such as cocaine, marijuana and other drugs." Winickoff said the teen brain becomes dependent on nicotine much more rapidly than the adult brain. "The most susceptible youth will lose autonomy over tobacco use after just a few times. So before they even know they’re addicted, they’ll first start wanting, then craving nicotine whenever they go too long between uses," he said, "And more exposure to nicotine at an early age will up-regulate nicotine receptors more rapidly in those developing centers of the brain than in adults. More receptors mean more craving."

The Rest of the Story

It is very important for readers and the public to understand that this is hysterical propaganda that is completely unsupported by any actual scientific evidence. The e-cigarette opponents are just basically making this stuff up, and they are distorting the science in the process.

Here are the few kernels of truth in the above claims:

First, it is true that in animal studies, nicotine administration can cause impaired brain development. In "adolescent" animals, the main concern is interference with full development of the pre-frontal cortex. In the few studies that have examined potential effects related to nicotine's interference with pre-frontal cortex development in humans, these effects have been demonstrated only in smokers, and they are most profound in smokers who initiated at an early age.

It is critical to recognize that there is no existing evidence that nicotine exposure itself is capable of impairing brain development in human adolescents. More importantly, there is no evidence that occasional and sporadic exposure to nicotine, as seems to occur with virtually all nonsmoking youth who experiment with e-cigarettes, causes any acute or permanent brain damage.

The second kernel of truth is that youth are more susceptible to smoking addiction than adults, and that a youth could become addicted to smoking after as few as 4 cigarettes. However, this relates to addiction to smoking, not addiction to e-cigarettes. There have never been any studies which have shown that exposure to a small number of e-cigarettes can cause a nonsmoking youth to become addicted to nicotine.

In fact, evidence from the UK suggests that virtually all regular e-cigarette users, who might potentially be addicted, are pre-existing smokers. Researchers were unable to find any nonsmoking youth who experimented with e-cigarettes and then became addicted to nicotine. Furthermore, no study has documented that any nonsmoking youth became addicted to smoking because of their having experimented with e-cigarettes.

The rest of the story is that at this point, e-cigarette opponents are essentially making up the facts as they go along in order to scare policy makers and the public about fictitious risks of electronic cigarette use.

Sadly, this is doing substantial public health damage because it is undermining the public's (including youth's) appreciation of the severe hazards of smoking. It is also discouraging youth smokers from switching to e-cigarettes. Moreover, it is discouraging adult smokers from quitting via e-cigarettes. And finally, it is encouraging smokers to continue smoking rather than try quitting using e-cigarettes.

After all, if e-cigarettes cause permanent brain damage, then why would anyone bother to switch from real cigarettes to fake ones. You might as well take on the risks of heart disease, lung obstruction, stroke, and cancer. Doesn't that seem better than permanent brain damage?

Ironically, while the American Academy of Pediatrics is warning the public that occasional exposure to almost pure nicotine in e-cigarettes is going to cause permanent brain damage, nowhere on their web site can I find any similar claim that smoking can cause brain damage!

The only place I can find the AAP speaking out about nicotine's effects on the developing brain are in the context of maternal smoking and secondhand smoke exposure among youth. Apparently, the fact that smoking is causing permanent brain damage to adolescents is not something of particular concern.

Frankly, the e-cigarette opponents have become so singularly obsessed with their personal attack on these products that they have completely forgotten about the devastating impact of smoking on both youth and adults. Smoking, and not e-cigarette use, is the single greatest threat to adolescent health that we face in 2015.

Not so if you listen to the e-cigarette opponents. Apparently, the biggest problem is the permanent brain damage that is occurring to millions of youth who are experimenting with e-cigarettes. Ironically, perhaps if youth going back to using real cigarettes instead of fake ones, the e-cig opponents will stop scaring the public about nicotine and adolescent brain damage.

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