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Risks of E-Cigarette Use, Ingredients Highlighted

E-cogarette and refill

(Horst Winkler, Pixabay)

11 September 2017. Several sessions at a scientific meeting on respiratory diseases report on effects of electronic cigarettes on people’s health, including those who also smoke conventional cigarettes. The papers are scheduled to be delivered this week at the European Respiratory Society congress in Milan, Italy.

Electronic cigarettes are battery-powered nicotine delivery devices, that heat a liquid containing nicotine, moisturizing agents — propylene glycol or glycerol — and flavoring agents, as well as preservatives and artificial colorings. Makers of e-cigarettes often market the devices as safer alternatives to tobacco-burning cigarettes and sometimes as a technique to help tobacco smokers quit conventional cigarettes.

A team led by public health researcher Constantine Vardavas at American College of Greece in Athens analyzed the ingredients in e-cigarette liquid refills. The researchers looked at 122 of the most commonly sold refills in 9 European countries, using liquid and gas chromatography, forms of mass spectrometry.

The results show large percentages of the samples contain chemicals known to cause respiratory problems. Some 43 percent of the samples had menthol and 17 percent had ethyl vanillin, both classified as respiratory irritants, according to the UN’s Globally Harmonized System of Classification and Labelling of Chemicals. Plus, 26 percent of the samples contained methyl cyclopentanolone, considered a threat to cause asthma or allergy symptoms if inhaled. Other chemicals associated with these irritations or symptoms were found in 10 percent or less of the samples.

Researchers led by Magnus Lundbäck of Danderyd University Hospital, affiliated with Karolinska Institute in Stockholm, Sweden, studied effects of e-cigarette smoking on blood vessels and pressure with a group of 15 young, healthy volunteers. Participants in the study did not use e-cigarettes before and smoked less than 10 tobacco cigarettes a month.

The volunteers were asked to smoke e-cigarettes for 30 minutes, with the devices randomly assigned to deliver nicotine or only the flavored vapor. Participants then had their blood pressure and heart rate measured, as well as pulse wave velocity — an indicator of artery stiffness — immediately after the smoking session. The measures were repeated 2 and 4 hours later.

The results show participants using e-cigarettes with nicotine experienced a three-fold increase in artery stiffness, measured by pulse wave velocity, in the 30 minutes after using the devices, along with higher blood pressure and heart rate. Among volunteers using e-cigarettes without nicotine, however, artery stiffness and heart rate remained about the same as before.

Linnéa Hedman, a public health researcher at Umeå University in Sweden, and colleagues studied results of two health surveys conducted in Sweden, with more than 30,200 respondents. The team analyzed results of non-smokers, compared to 12 percent of the samples who smoked conventional cigarettes, 2 percent who used e-cigarettes, and 1.2 percent who both smoked tobacco cigarettes and used e-cigarettes.

These users of both forms of cigarettes represent about 10 percent of tobacco smokers. However, only about 1 percent each of former or non-smokers used e-cigarettes. “One argument for e-cigarettes,” says Hedman in an ERS statement, “is that they could help smokers to quit, but our study does not support this argument. If that was the case, e-cigarette use would have been most common among former smokers.”

In addition, more than half (56%) of dual-users reported respiratory problems, such as wheezing or chronic coughing, compared to about 46 percent who smoked cigarettes, one-third (34%) of e-cigarette users, and a quarter (26%) of non-users of either cigarette forms.

“It is very important that the results of this and other studies reach the general public and the health care professionals working in preventive health care, for example in smoking cessation,” notes Lundbäck in a separate ERS statement. “E-cigarette users should be aware of the potential dangers of this product, so that they can decide whether to continue or quit based on scientific facts.”

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