Health

Why E-Cigs are So Deceptive

Their danger could lie in their 'sweet' flavors

Peter Denholtz smoked cigarettes for 36 years. Though his mother died of lung cancer and he desperately wanted to stop smoking, Denholtz, now age 55, thought he’d never be able to kick the habit.

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“I tried to stop hundreds of times, and never was able to really quit,” he told LifeZette.

In 2010, he saw an online ad for an early model electronic cigarette. He decided to give the product a try.

“And I haven’t had a cigarette going on six years now,” he said. 

He was so enthusiastic about the product and his ability to quit smoking by using it that he started his own e-cigarette company. He owns two shops in Manhattan, has a large online business, and manufacturers e-cigarette components and nicotine liquids. He still smokes e-cigarettes (or “vapes”) and remains addicted to nicotine, but Denholtz said he feels better and doesn’t get out of breath.

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The health risks of smoking traditional cigarettes are well-known. Nearly 6 million people worldwide die each year from tobacco-related illnesses, says the Centers for Disease Control and Prevention. Educational campaigns against cigarette smoking seem to be working — fewer teens are picking up cigarettes, and in many places, smoking is becoming taboo.

“The best option is to quit smoking by yourself or by using currently approved medications.”

While the percentage of Americans who smoke traditional cigarettes continues to decline, however, the number of people turning to e-cigarettes is rising. A recent study found that 1 in 10 American adults now use e-cigarettes.

There are questions about whether electronic cigarettes are actually safe, of course. Because e-cigarettes are new, no long-term studies on the health effects over time have been completed, and the medical profession is split on the subject.

Opponents argue the e-cigarette is just another harmful and addictive nicotine-delivery device, as well as a gateway for teens to start smoking regular cigarettes. These opponents point to the increasing number of teen vapers.

Proponents of the devices say the e-cigarettes mimic smoking without the harmful chemicals and tar. They call e-cigarettes the best smoking cessation device on the market.

“There is no doubt cigarettes are less harmful than smoking,” Dr Konstantinos Farsalinos, a cardiologist and researcher who authored several studies on e-cigarettes, told LifeZette.

“The best option is to quit smoking by yourself or by using currently approved medications. But for those who cannot or do not want to quit smoking by such methods, e-cigarettes represent a very good choice to significantly reduce the risk of smoking-related disease,” he said.

Farsalinos also said people who’ve never smoked cigarettes should leave e-cigarettes alone. This is about “risk reduction,” he said.

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But in recent weeks, several new studies have come out showing that e-cigarettes may be riskier than previously thought. The main object of concern is the flavor chemicals used in the nicotine liquid, also called e-juice or e-liquid.

When a person puffs on an electronic cigarette, the battery heats up the nicotine liquid, turning it into vapor, which the user inhales. Flavored nicotine liquids — butterscotch, vanilla tobacco, cherry, or bubblegum and more — have become increasingly popular as the e-cigarette market has developed. There are now some 7,700 different e-cigarette flavors being sold under more than 450 brands.

Farsalinos and colleagues at the Onassis Cardiac Surgery Center in Athens, Greece, found that, of the 159 “sweet-flavored” e-liquids they tested, more than 74 percent contained diacteyl or a common chemical substitute, acetyl propionyl. Diacetyl is the buttery flavor chemical that, while safe to ingest in small amounts (it’s found in many food products), has also been shown to cause serious and irreversible lung damage when inhaled in larger quantities.

Diacetyl is often associated with bronchiolitis obliterans, otherwise known as “popcorn lung.”

Diacetyl is often associated with bronchiolitis obliterans, otherwise known as “popcorn lung,” because workers in a Missouri popcorn plant in the late 1990s came down with the deadly pulmonary condition as a result of breathing in the buttery flavor chemical at work. Half of those who developed “popcorn lung” at that plant have needed lung transplants; five have died of respiratory illness.

While there have been no confirmed cases of  “popcorn lung” related to e-cigarette use so far, Farsalinos, who himself uses e-cigarettes, warns that diacetyl and other potentially toxic chemicals should not be in e-juices.

“E-cigarettes should become as safe as possible so that the risk reduction will be as high as possible,” he told LifeZette. “Every manufacturer should use ingredients of pharmaceutical grade. For flavors, food-approved flavors are the best option. We need to learn more about flavors and their effect when inhaled, but this will take years. It is important for smokers to know that liquids with pharmaceutical-grade ingredients, food-grade flavors, and no diacetyl or acetyl propionyl are the best choices right now, and they are by far less harmful than smoking.”

Currently, there are no regulations on the manufacturing, testing, and packaging of e-cigarettes, their component parts, or the refillable nicotine fluids. The ingredients listed on the label of the e-juice you buy may show little of what’s actually inside the bottle. Studies have shown, for example, that even those e-juices labeled “diacetyl-free” sometimes contain the buttery flavoring.

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“The health risks are hard to quantify without knowing exactly what is in the liquid used,” said Dr. Graham Atkins, a lead researcher in a recent study published in the journal Chest about the health risks of e-cigarettes. ”Personally, I do not recommend e-cigarettes as a smoking cessation tool.”

The Food and Drug Administration, which has been studying e-cigarettes for the past few years, is considering a series of sweeping regulations.

Dunholtz said he welcomes some regulation on the industry, particularly for its manufacturing and packaging. He welcomes higher standards. But he’s worried the FDA will go too far in its proposals.

“I’m one of those people who didn’t believe that (New York City’s former mayor Michael) Bloomberg and the Nanny State should be banning 32-ouncesoft drinks,” he said. “Who is he to tell me what I should put in my body?”

He doesn’t want the federal government telling him he can’t vape flavored e-juice, either.

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