A sweeping new analysis of the health risks of electronic cigarettes has conclueded the benefit of using such devices instead of tobacco products far outweigh any hazards they may pose and that there is little scientific evidence to warrant closer federal regulation.
The Virginia Commonwealth University review, which examined 81 studies on e-cigarettes, also suggested that allowing the nicotine-delivering devices to compete with conventional cigarettes would cut tobacco-related deaths and illness significantly. But the study has done little to put the e-cigarette debate to rest and, in fact, has reinvigorated calls by advocacy groups and the World Health Organization for tighter regulation of the devices by the Food and Drug Administration and other regulators worldwide.
Ravindra Rajmane, M.D., a professor of medicine at NYU Langone Medical Center, tells Newsmax TV's Meet the Doctors program there is no question that e-cigarettes are a safer alternative to tobacco use and may be beneficial in helping smokers quit tobacco. But that doesn’t mean the devices don’t pose health risks of their own.
“While most of the [research findings] indicate that e-cigarettes are certainly useful as harm reduction for patients who want to quit smoking and also verify that the constituents are relatively harmless, my concern is that we don’t really know exactly the long-term effects,” he explains.
Dr. Rajmane notes, for instance, that a recent study by Boston University and the University of California-Los Angeles found that vapors from e-cigarettes caused abnormalities in lung cells exposed to them in laboratory experiments.
In addition, at least some e-cigarette vapors contain low levels of formaldehyde, which has been classified as a known human carcinogen by the International Agency for Research on Cancer and as a probable human carcinogen by the U.S. Environmental Protection Agency.
Second-hand vapors from electronic cigarettes are less harmful than tobacco smoke, but they still release toxins into the air, according to new research.
New research by the University of Southern California has also found that vapors from e-cigarettes do not contain as many cancer-causing compounds as tobacco smoke, do contain chromium and nickel at levels four times higher than tobacco cigarettes. Lead and zinc were also found in the smoke, but they occurred at levels lower than regular cigarettes.
Another concern: Since e-cigarettes are virtually unregulated there is no way to know precisely what chemicals and contaminant might be in the vapors users are inhaling.
“I think it’s important to understand … that we’re talking about harm reduction so we’re talking about specifically an alternative to cigarette smoking,” he adds. “I’d like to underscore … our governing bodies [and] advisory bodies — including the American Lung Association but also the American Thoracic Society — have both strongly come out with [warnings of] caution about e-cigarettes and specifically that there should be more oversight by the FDA.
“Part of the difficulty is that there is really no regulation about what constituents are within a vapor cigarette. You can pretty much add whatever you’d like and flavor it … to appeal to, perhaps, younger consumers with interesting spices or fruit flavors. Having said that, though, nicotine is usually a mainstay of most of these cigarettes. Again, but the amount of nicotine is not readily quantified.”
Zachargy Bregman, M.D., a New York-based internist and pulmonologist, agrees that e-cigarettes are a lesser of two evils and may help tobacco users quite. But he is concerned that their popularity might encourage young people who do not smoke to start using them, in the absence of regulation.
“Of course the use of e-cigarettes as part of smoking cessation is really not necessarily the largest group of people who are using e-cigarettes,” he says. “Unfortunately there is a whole new population of people who are starting out by smoking — or vaping — e-cigarettes. There’s no regulation … so when these are available to people, including unfortunately children, they will get used and therefore will be introducing a new substance that doesn’t seem to be dangerous at this point. But that whole population would otherwise not be smoking anything.”
A new study by the Centers for Disease Control and Prevention echoes that point, finding that electronic cigarettes may be more tempting to non-smoking youths than conventional cigarettes, and once young people have tried them they are more inclined to give regular cigarettes a try.
For this reason, the World Health Organization this month (August) called for a ban on sales to minors of the popular nicotine-vapor products, and to forbid or keep to a minimum any advertising, promotion, or sponsorship.
In a report to its 194 member nations, the United Nations health agency also urged nations to regulate electronic cigarettes and ban them from use indoors until the exhaled vapor is proven not to harm bystanders.
The Geneva-based agency said the booming $3 billion global market for more than 400 brands of e-cigarettes is increasingly becoming a competition between independent companies and transnational tobacco companies aggressively muscling for market share.
Regulation “is a necessary precondition for establishing a scientific basis on which to judge the effects of their use, and for ensuring that adequate research is conducted and the public health is protected and people made aware of the potential risks and benefits,” the report said.
Proponents and manufacturers of e-cigarettes argue that the health risks are overblown and aggressive regulation is unwarranted and may even be counter-productive. As the Virginia Commonwealth study suggested, tighter regulation by the FDA and other regulatory agencies around the world would likely raise costs for e-cigarettes, which encourage smokers to continue using tobacco.
Even the American Heart Association’s first policy statement on electronic cigarettes has attempted to stake out a middle ground — backing them as a last resort to help smokers quit, but raising concerns about potential long-term risks. The American Cancer Society has no formal policy but quietly took a similar stance in May.
But as the debate over e-cigarettes rages, Dr. Bregman says there is one thing upon which nearly all health experts agree.
“It’s better not to be exposing the very fragile tissue of your lungs to anything other than clean air, if possible,” he says.
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