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Juul Delivers More Nicotine than Cigarettes, Other E-Cigs

Juul e-cigarette

Juul e-cigarette device (Mylesclark96, Wikimedia Commons)

7 Jan. 2020. Tests of aerosol compounds inhaled by lab animals show Juul devices send more nicotine into the blood stream than other e-cigarettes and ordinary cigarettes as well. A separate analysis of online forum messages indicates lung damage from e-cigarettes may have gone unreported for several years.

Researchers from University of California in San Francisco led by cardiology professor Matthew Springer, reported on health effects of e-cigarettes, which are gaining more use among teens and young adults, in yesterday’s issue of Tobacco Regulatory Science. E-cigarettes are battery-powered nicotine delivery devices that heat a liquid containing nicotine, moisturizing, and flavoring agents, as well as preservatives and artificial coloring. 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.

The UC-San Francisco team exposed eight lab rats to aerosol vapors emitted from Juul e-cigarettes, the most popular brand among teens, which as noted in Science & Enterprise in November 2018, shapes its device like a flash memory drive, making it easier to conceal. The researchers also exposed the animals to equal amounts of generic e-cigarette vapors, smoke from conventional cigarettes, and clean air.

The team tested blood samples from the animals 20 minutes after exposure to these substances, and measured the performance of endothelial tissue that lines blood vessels, an indicator of circulatory functions and future heart disease. The results show rats breathing Juul vapors have eight times more nicotine in their blood than those breathing generic e-cigarette vapors, and five times more nicotine than conventional cigarettes. And while rats breathing Juul vapors had less endothelial functioning than those breathing generic vapors or cigarette smoke, the differences were not large enough to be statistically reliable.

Springer notes the results do not support claims of manufacturers that e-cigarettes, particularly Juul devices, may be safer alternatives than conventional cigarettes. “Our findings show,” says Springer in a UC-San Francisco statement, “that the adverse effect of cigarettes on vascular endothelial function, which has been a known consequence of cigarette smoking since the 1990s, is not prevented by using Juul.”

Years of vaping injuries

A study in the 3 January issue of the Journal of Medical Internet Research indicates damage to the lungs of e-cigarette smokers may have started several years earlier than previously known. Researchers from University of California in Riverside report that a review of online forum posts indicates e-cigarette smokers were reporting symptoms consistent with vaping injuries as long ago as 2008.

A team from the lab of cell biologist Prue Talbot is seeking to discover the extent of lung damage, known as e-cigarette or vaping product use-associated lung injury, or Evali, among e-cigarette users. Centers for Disease Control and Prevention reports that an outbreak of emergency hospitalizations from Evali began in June 2019, and peaked in September, with a decline since then. CDC says as of the end of December 2019, more than 2,500 people were hospitalized with Evali, leading to 55 deaths. The disorder is characterized by coughing, shortness of breath, chest pain, headache, fever, chills, diarrhea, nausea, and vomiting.

Talbot and colleagues gained access to a large online discussion forum for e-cigarette users, and analyzed posts to the forum between January 2008 and July 2015. To analyze the posts, the researchers constructed a web crawler, a software program designed to extract and parse information from web site pages, in this case symptoms of Evali. The team focused on seven sub-forums dealing with health topics, containing more than 41,000 posts.

In these posts, the UC-Riverside researchers found between 500 and 1,000 references to symptoms consistent with Evali, including headache, coughing, malaise, asthma, dry mouth, and sore throat, as well as many reports of multiple symptoms. And most of these reports from e-cigarette users were cast in a negative, i.e. disapproving, manner.

Talbot says the findings suggest health authorities may have missed evidence in plain sight of health problems from e-cigarettes. “Our data, which shows many of the symptoms characterizing the current patients,” says Talbot in a UC-Riverside statement, “have been reported online for at least seven years, suggests cases similar to those in the current [Evali] epidemic have existed previously and been unreported or simply not linked to vaping.”

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