Tuesday, February 1, 2011

E-cigarette safety: A particle of doubt leaves us in a fragrant vapor of confusion

Now you can "pimp your vape" to create cooler flavors and a cloudier cloud!

Buy a special e-cig for every outfit and mood, in yummy lollipop flavors!
    (UPDATE: Dec. 20, 2013) In "The E-Cigarette Seduction -- Are We Blowing It?" (http://kronstantinople.blogspot.com/2013/08/the-e-cigarette-seduction-are-we.html), I described this exuberant, colorful, delicious and diabolical new industry.
    In some respects, it has displayed entrepreneurialism at its best: A scramble of creative fervor, technological innovation and marketing genius.
    I expressed my concern, as have many in the public-health sector, about the possible downside of these yummy products, and urged rigorous study.
    Now I have found distressing new research that says e-cigarettes may expose smokers and those around them to PARTICULATE POLLUTION, possibly containing heavy metals. Please be wrong, you guys!


    The latest big thing at Henley Vaporium in Manhattan is the art of "pimping your vape" -- a sort of communal hacking project in which screwdrivers, wires and small metal tubes are used to re-engineer and customize "mods." By hacking these devices, they're able to produce stronger flavors, and new flavors, and — more importantly — create more impressive vapor clouds. http://mashable.com/2014/01/25/vaping-subculture/   
    Since there have been so few studies, and since they have been so poorly publicized, cities, towns and states have understandably been imposing various restrictions on where and by whom e-cigarettes can be enjoyed. But a number of  people -- some of them credible -- have warned against excessive regulation, insisting that if tobacco-smokers switched to e-cigarettes, millions of lives could be saved.
    On September 23, 2013, 40 state attorneys general petitioned the FDA, which shouldn't have needed this prodding, to study the ingredients, marketing and sale to minors of  e-cigarettes. 
    The FDA has been informally "considering" a ban on online sales of e-cigarettes to cut down on sales to minors, according to Bloomberg Businessweek, and discussing whether to curtail advertising. A roster of proposed rules was "expected" in October, but as one would predict, that didn't happen.
    What HAS happened is that I heard a surprisingly casual mention in a New York City Council meeting earlier this month to the particulates produced by e-cigarettes. Never in all my research had the subject of particulates been raised. It was very disturbing. I thought e-cigarettes emitted nothing but flavored vapor with a bit of nicotine. No problemo.
    I am a clean-air advocate. I know what particulate pollution does to our bodies. It is devastating (http://www.epa.gov/pmdesignations/basicinfo.htm).
    City Health Commissioner, Dr. Thomas A. Farley, said electronic cigarettes put out fine particles and chemicals, and “I certainly can’t guarantee that that is safe.”
    Farley did acknowledge, seeming to contradict himself, that there is no evidence the vapor poses a risk to "vapers" or bystanders, citing an interesting but limited study of an e-cigarette marketed in New Zealand (http://casaa.org/uploads/DublinEcigBenchtopHandout.pdf). This study found that no particulates were produced by e-cigarettes.
    Forbes contributor Jacob Sullum has written that cooking, perfume, and diner flatulence emit particulates similar to those that may (or may not) be dispersed by e-cigarettes (http://www.forbes.com/sites/jacobsullum/2013/12/05/nyc-health-commissioner-says-e-cigarettes-must-be-banned-because-they-look-like-the-real-thing/.
    So this may be a semantic issue. Aerosol particulates may pose quite different health  problems than solid fine particles produced by industry and auto exhaust, for example.
    Even so, Dr. Stanton Glantz, of the Center for Tobacco Control and Education at UCSF repeated the disturbing opinion in a September Time magazine article that e-cigarette vapor emits harmful fine particles in the air. 
   “If you look at absolute levels of risk [of electronic cigarettes], they are pretty bad, because a cigarette is just ridiculously toxic and ridiculously polluting,” he said. “If you go into a bar or casino where there is a lot of smoking, the only way to get the air that polluted outdoors is to be downwind from a large forest fire. If you say an electronic cigarette is only 10 percent to 20 percent less polluting than a massive forest fire, that’s not so good.”
    However, I checked the Oxford Journals research paper on which he bases this statement, and it seems to contradict his conclusion (http://ntr.oxfordjournals.org/content/early/2013/12/10/ntr.ntt203.abstract.html):

    "Results: The study showed that e-cigarettes are a source of secondhand exposure to nicotine but not to combustion toxicants. 

    Conclusions: Using an e-cigarette in indoor environments may involuntarily expose nonusers to nicotine but not to toxic tobacco-specific combustion products."
     Consumer Reports endorsed this conclusion in a December 18 overview of this study and a similar one in Poland: "They found that the e-cigarette vapor contained nicotine but not the particle pollutants and other, toxic compounds found in tobacco smoke, which are byproducts of combustion."

    I contacted the chief author of the Oxford Journals study for clarification. On Dec. 19, 2013: Maciej L. Goniewicz, PhD, emailed me to report that secondhand exposure is not a problem, due to the rapid dispersal and dissolution of the vapors. HOWEVER, HE ADDS A TROUBLING INSIGHT:

"Little is know about the chemical composition of particulates from e-cigarettes. Is it just droplets of PG/VG (propylene glycol/vegetable glycerine)? Or it may contain some traces of toxic substances. We need to do more research to understand the nature of these particles.
    Of course, I remain concerned. I just read another paper, published by PLOS One in March, and it also raises questions about safety. The researchers concluded:

"The aerosol (in e-cigarettes) contained particles >1 ┬Ám comprised of tin, silver, iron, nickel, aluminum, and silicate and nanoparticles (<100 nm) of tin, chromium and nickel. The concentrations of nine of eleven elements in EC aerosol were higher than or equal to the corresponding concentrations in conventional cigarette smoke. Many of the elements identified in EC aerosol are known to cause respiratory distress and disease. http://www.plosone.org/article/info:doi/10.1371/journal.pone.0057987).

AND NOW, a new study finds that e-cigs produce about 1/7 the fine particulate matter of tobacco cigarettes. To me, even that is disturbing. http://www.reuters.com/article/2014/01/03/us-e-cigarette-idUSBREA020K820140103

    I hope these people are mistaken! Please: Isn't that possible?? There do seem to be many experts who deny these scary conclsions. But I'm sure the researchers didn't just make them up! We need to have these various investigations reconciled. Meanwhile, I am staggering about in a fragrant cloud of confusion.