(MENAFN - The Conversation) The rise in cases of otherwise healthy young adults who have been hospitalized or even died fromvaping-associated lung injuryis alarming.
Many people don't know what is contained in these vaping devices, what the reported health effects actually mean, and, most importantly, why all of thisdeveloped so quickly, considering that e-cigarettes have only been popular for fewer than 10 years.
Vaping describes the process of inhaling aerosols generated by devices such as e-cigarettes.
Whene-cigarettes first came to the U.S.in 2006, many smoking cessation experts were optimistic. They viewed the delivery of nicotine through e-cigarettes to be a useful alternative to traditional cigarettes. That is because e-cigarettes did not have all of the other harmful combustion products inhaled through cigarette smoke.Since there is no doubt that smoking traditional cigarettes is harmful to your health – and the number one cause of preventable death in the U.S. – e-cigarettes were marketed as a 'safer' alternative.
As aninhalation toxicologist , I study how inhaled chemicals, particles and other agents affect human health. Since e-cigarettes were introduced, I have been concerned about how the scientific community could possibly know the full spectrum of their dangers. After all, it took decades for epidemiologists to discover that regularly inhaling the smoke from burning plant material, tobacco, caused lung cancer. Why would the scientific community be so quick do assume e-cigarettes would not have hidden dangers that might take years to manifest too?
Do e-cigarettes even work as a cessation tool?
Smoking is notoriously hard to quit, and tobacco companies have been ruthless in concealing its dangers. Some public health officials thus hailed e-cigarettes as a tool to help people stop.
Many smokers have reported that switching from cigarettes to e-cigarettes has helped their physical well-being, includingreduced coughing .
But a few randomized clinical trials examining the use of e-cigarettes as a cessation tool have shown mixed results. While some trialsdemonstrate a significant increasein cessation success (from 9.9% to 18%), people using e-cigarettes were much more likely to remain dependent on nicotine as compared to those randomized for more traditional nicotine replacement products, such as nicotine patch, gum and nasal spray. Or, they were more likely torelapse to using cigarettes .
In short, whether, how, and to what extent e-cigarettes have the potential use as a cessation tool is not yet settled, especially considering that more than 80% of smokers randomized to use e-cigarettescontinued to smokeafter the cessation trial.
Safer than a spitting cobra
Cessation claims aside, the messaging of e-cigarettes as a'safer' alternativemay have led many of the 3.6 million teenagers in the U.S. who use e-cigarettes today to believe these devices are 'safe.'Safer' does not equal 'safe,' and the messaging of 'safer' was based on comparisons to cigarettes.
Public Health England, the equivalent of the FDA in the U.K., stated in 2015 that 'while vaping may not be 100% safe,most of the chemicals causing smoking-related disease are absentand the chemicals that are present pose limited danger.'
This statement did not consider the fact that health effects of inhaling flavoring chemicals contained in popular e-cigarettes are completely unknown, or that heating liquids in these devices causes thermal decomposition of those e-cigarette chemicals that 'pose limited danger' intoknown toxicants . It also did not consider that e-cigarettes are a fast evolving consumer product with ever-changing devices and chemicals, creating mixtures and exposures of unknown health consequences.
This mistake was further advanced by assessing the adverse health effects caused by using e-cigarettes as a comparison to what occurs when someone smokes cigarettes for several years. It is well established that smoking cigarettes causes diseases such aschronic obstructive pulmonary disease, chronic bronchitis, emphysema and cancer . Many of these diseasesdo not manifest clinically until many yearsafter the first cigarette has been smoked.
No controlled studies were ever conducted assessing whether using e-cigarettes causes any adverse health effects in people who never smoke. To this day, scientists do not know the potential long-term health consequences of using e-cigarettes for decades.
E-cigarettes cause very different health effects than cigarettes
Cigarette smoking-related diseases such as lung cancer and emphysema took years to develop. The same may not be true for diseases from e-cigarettes.
I think that scientists and policymakers should completely stop comparing vaping outcomes to smoking outcomes. The now 450-plus confirmed cases of vaping-associated lung injuriesprove this point . Theclinical manifestationsin these patients arenot something a doctor would ever seein somebody who has been smoking cigarettes for a few months.
Similarly, these clinical outcomes have not been reported in marijuana users, even though THC, the psychoactive ingredient in marijuana, has now been associated with a large percentage of these cases.
Furthermore, the onset of these significant health problems is much faster than one would anticipate from smoking-related diseases. Since doctors are seeing severe diseases after relatively short exposures, does that make vaping more harmful than cigarettes?
Considering that the compounds inhaled through cigarette smoke are very different from those inhaled through the vast number of different flavored e-cigarettes and vaping devices, wouldn't that be like comparing apples and oranges? Nobody would consider it reasonable to compare health effects caused by smoking cigarettes to those induced by smoking crack.
A lot of attention is now being placed on identifying thepotential 'culprit'for the observed health effects in the more than 450 cases of vaping-induced lung injury. Additives contained in THC liquids have emerged as apotential cause .
However, not all cases identified by the CDC have a documented history of vaping THC, and some have only reported ahistory of using nicotine products . Furthermore, case reports of vaping-associated lung injury with symptoms similar to those reported by the Centers for Disease Control and Prevention but no history of THC usehave been documentedbefore, suggesting that vaping-associated lung injury has been detected before this recent rise in reported cases.
In addition, othervaping-associated clinical outcomeshave been reported as well, indicating thatvaping-inducedadverse health effects can vary. Hence, it is premature to draw any conclusions regarding which compounds – and there are likely several – inhaled by vaping nicotine or THC containing products are causing specific types of lung injury.
While it is too early to say whether or to what extent e-cigarettes can be used to support smoking cessation, one conclusion can already be drawn: Vaping is not without health effects.
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