Blowing e-smoke up your ass

Safe, Sane and Consensual

The taste of maple syrup vapor enfolds my tongue as I inhale. Then it’s fresh blueberries and the sweet taste of warm honeycombed waffles. I can’t resist trying my roommate’s blueberry waffle-flavored e-cigarette as he ponders his next move. Should he procure some wood or a sheep for his board-game farm? He puffs thoughtfully.

As I breathe in the irresistible sweetness of an imaginary breakfast, I feel like Violet in “Charlie and the Chocolate Factory,” munching on gum that tastes like Thanksgiving dinner and waiting for my skin to turn a Technicolor blue and my torso to inflate into a blueberry.

Nothing happens. I feel a tad more alert, and my hands tremble the way they do after a cup of coffee, fingers dancing to inaudible music. I’m only slightly disappointed I won’t be rolling around the house as a blue balloon.

The question is, are e-cigarettes really a better alternative to cigarettes? It turns out, it’s how we define “better.”

The most obvious advantage, leveraged as a marketing ploy, is that e-cigarettes can be a form of harm reduction. That is, it could minimize the negative health consequences associated with a behavior. One example of harm reduction is from the local nonprofit Needle Exchange, which provides clean needles to injection-drug users to curb risks of disease transmission from needle-sharing and infection and scarring from needle reuse.

For someone smoking a pack a day, vaping nicotine without tar and the numerous other additives in cigarettes might be a good thing. E-cigarettes, however, attract people who might never have considered smoking cigarettes in the first place.

Even worse, there is inconclusive research on the long-term health risks and consequences of prolonged e-cigarette use. Furthermore, the flavor additives and colors are unregulated, which means there’s a good chance that whatever’s making the nicotine taste like rainbow sherbet (another one of my roommate’s favorites) are synthetic chemicals that might be detrimental for my health.

One thing we do know is that nicotine is a neurotoxin. The Centers for Disease Control and Prevention gets hundreds of calls every month reporting liquid nicotine poisonings, roughly half from children 5 and under, most of whom mistake it for candy. If it looks, smells and tastes like candy, what else are small children to think? The other half are adults who spill the liquid while refilling e-cigarette cartridges. Although these are not the nicotine’s intended uses, because it is a concentrated liquid, the body absorbs it rapidly, even through the skin, inducing nausea and vomiting within minutes.

For smokers, there are numerous advantages: People can legally smoke e-cigarettes almost everywhere, although a growing number of major cities are banning them in places where smoking is illegal. Just yesterday, Philadelphia joined New York, Chicago and Los Angeles in enacting e-cigarette bans. Another draw is that the smell doesn’t linger the way cigarette smoke does. Then there’s the cost: Buying nicotine in bulk is cheaper than buying cigarettes.

The variety of flavors also proves enticing for the legions of loyal e-cigarette users, known as “vapers.” By law, regular cigarettes cannot be flavored, and the FDA is considering tightening regulations on menthol cigarettes, following the European Union’s lead — the EU banned menthol cigarettes October last year. They’ve found that menthol cigarettes aren’t more toxic than regular cigarettes, but the flavor makes it easier to smoke more of it and to get addicted. In fact, half of all young smokers use menthol cigarettes.

Flavored nicotine poses the exact same risks. Health advocates worry that the hundreds of varieties of flavors appeal to youth and pose an inviting introduction to the joys and perils of nicotine use — and abuse. Thirty-eight states to date prohibit the sale of e-cigarette products to minors. Their fears aren’t unfounded: I could easily have sat contentedly puffing away on blueberry waffles for an hour or more without considering how much nicotine I was inhaling.

The FDA proposed a rule in April that would categorize e-cigarettes as a tobacco product, allowing for federal regulation. The proposal, which will prohibit the sale of e-cigarettes to minors and from vending machines as well as requiring companies to disclose their ingredients, will likely take years to come into effect.

At the moment, most questions about e-cigarettes remain unanswered. How bad is secondhand vapor? Do e-cigarettes cause cancer? Tobacco companies are happy to keep things this way, while getting in on the action. If the interests of tobacco companies have always been at direct odds with the general populace’s health, why would they start caring now? E-cigarettes represent just another way for them to boost the bottom line.

Inconclusive research and lack of regulation means we might be hit with a wave of health problems as our vaping generation ages, much as the smokers of our grandparents’ generation met a tsunami of health complications they never imagined while puffing and chewing away as young adults.

How many times will history repeat itself before we realize there’s always a price tag for substance use, and especially addiction, and that our youth does not protect us from the possibility that we’re bankrupting our own health with fragrant clouds of milk and honey and pina colada vapor?

 

Contact Sophie Lee at [email protected] and follow her on Twitter @sophieylee.

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  • Pixilicious

    The bottom-line is that it is not the nicotine which is the problem in smoking it is the delivery-system and society *should* be encouraging systems which are not harmful, like vapor. “Not harmful”? Yep, because aside from the scare stories about nicotine (“it’s a neurotoxin”) and vaping (it hasn’t been proven to be non-harmful) there’s really nothing more at work here than some misguided religious fervor that something which brings pleasure *must* be bad.

    Rather than banning vapor products society should be subsidizing them through higher taxes on tobacco products. Raise their cost and give it to vapor products.

  • Dr. Igor Burstyn, PHD.

    Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks.

    Department of Environmental and Occupational Health, School of Public Health, Drexel University, Nesbitt Hall, 3215 Market St, Floor 6, Office 614, Philadelphia, PA 19104, USA. [email protected].

    http://www.ncbi.nlm.nih.gov/pubmed/24406205

    Abstract

    BACKGROUND:

    Electronic cigarettes (e-cigarettes) are generally recognized as a safer alternative to combusted tobacco products, but there are conflicting claims about the degree to which these products warrant concern for the health of the vapers (e-cigarette users). This paper reviews available data on chemistry of aerosols and liquids of electronic cigarettes and compares modeled exposure of vapers with occupational safety standards.

    METHODS:

    Both peer-reviewed and “grey” literature were accessed and more than 9,000 observations of highly variable quality were extracted. Comparisons to the most universally recognized workplace exposure standards, Threshold Limit Values (TLVs), were conducted under “worst case” assumptions about both chemical content of aerosol and liquids as well as behavior of vapers.

    RESULTS:

    There was no evidence of potential for exposures of e-cigarette users to contaminants that are associated with risk to health at a level that would warrant attention if it were an involuntary workplace exposures. The vast majority of predicted exposures are < <1% of TLV. Predicted exposures to acrolein and formaldehyde are typically <5% TLV. Considering exposure to the aerosol as a mixture of contaminants did not indicate that exceeding half of TLV for mixtures was plausible. Only exposures to the declared major ingredients–propylene glycol and glycerin–warrant attention because of precautionary nature of TLVs for exposures to hydrocarbons with no established toxicity.

    CONCLUSIONS:

    Current state of knowledge about chemistry of liquids and aerosols associated with electronic cigarettes indicates that there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces. However, the aerosol generated during vaping as a whole (contaminants plus declared ingredients) creates personal exposures that would justify surveillance of health among exposed persons in conjunction with investigation of means to keep any adverse health effects as low as reasonably achievable. Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern

  • castello

    Cold turkey works better than nicotine patches, gum or dangerous drugs that are prescribed for quitting smoking. http://www.bbc.com/news/health-27485954

  • castello

    What is the first thing your doctor asks you. http://www.bbc.com/news/health-24914473

  • castello
  • Sophie,
    I read your article twice, then waited a few minutes before I wrote this comment.
    Personally, I do not use any menthol products internally. It is a crystalline substance and I don’t want that in my lungs. See: http://www.usp.org/search/site/menthol for the chemical characteristics.

    There is more than enough empirical evidence that addresses your fears: no danger of exposure to exhaled vapor/ being around vapers. USP grade liquid nicotine is the same that is used in the currently marketed Nicotine Replacement Therapies, OTC and prescription. Refilling “cartridges” is on par with using WD-40. You get some on your skin, you wash it off. Committed vapers use tanks, not cartridges. They are designed for re-filling.

    Vaping is for adults. Adults do what they do to get through the day, whether with caffeine, nicotine, sugar, carbs, hard work, exercise, drinking, etc. Those of us who struggle with mood disorders benefit from nicotine use.
    Moderation is key.
    That is where an adult uses common sense. That is where parents think ahead and keep things out of reach or mete out the right portion of sugary, fatty foods, cleaning products, tools etc.

    Your piece ends with a lot of “what if” rather than what is.
    What is, is that committed smokers, especially those closer to middle age than to twenty have been in desperate need of an effective smokeless alternative to combustion cigarettes.

    Patches, gums, & lozenges come in mint and fruit flavors which are attractive to children, yet I haven’t heard much ado about that. If one were to actually ingest e-liquid, the effect would be immediate: the awful taste would be rejected by the body without any conscious thought involved as opposed to the nicotine gums and lozenges.

    Having to work hard to fish for reasons to be fearful of vaping devices and their use is something you need to examine about yourself, not so much the products.

  • crunchy2k

    “Even worse, there is inconclusive research on the long-term health risks and consequences of prolonged e-cigarette use.”
    The ingredients in e-liquid devices each have been studied for long-term health effects for inhalation and ingestion and are considered GRAS (Generally Regarded As Safe) by the FDA. Even nicotine at the levels used in e-liquid is considered safe. These chemicals have been studied for decades. The earliest study I know of is Rogers 1947 study of the effects of propylene glycol aerosol on monkeys. A good anti-smoking book on nicotine is ‘Nicotine and Health'(2013) by the American Council on Science and Health. The book is well documented and Free Online. There have been no deaths from e-liquid in the entire 11 years it has been on the market. Nicotine is not the poison the anti-smoking activists have been telling us all these years.

    Sophie, if you must be afraid, then fear other peoples breath. You and I breath out more of the same e-cig chems per breath than an entire e-cigarette. I base this on a 2011 paper on the VOCs in human breath done at at UCLA and the 2014 review of e-cigarette emissions by Dr. Igor Burstyn at Drexel University, Pennsylvania.

    “I feel a tad more alert, and my hands tremble the way they do after a cup of coffee,….”
    Sophie, you shouldn’t lie about using an e-cigarette. Nicotine is known to increase motor skills and therefore, doesn’t have the same shaking effect of caffeine. You can find nicotine profiled on PubMed, the US Library of Medicine web site. But, it is good to know you don’t have any experience with nicotine. You should only use a non-nicotine e-liquid and you will find you can enjoy it just as much.

    • Clyde O’Reilly

      Crunchy2k is correct. Sophie, you are reporting what is either an excess of artistic license misrepresenting facts that are material to your thesis, or the “placebo effect” that you are expecting to occur out of nicotine naivete. You never mentioned the actual nicotine content of the e-juice product you were vaporizing – for all we know, you’re using e-juice which actually has no nicotine; this is very common on the market. Furthermore, the effect you mentioned actually runs contradictory to the known effects of nicotine, which can stabilize trembling hands. Long-term research done on nicotine users actually shows both the long term risk of Parkinson’s disease and the occurence of side-effect Parkinsonism (associated with long term use of neuroleptic and antipsychotic medications) are drastically reduced compared to people who do not use nicotine products. Slight trembling/twitching of the hands, feet, and face are medically relevant symptoms of nicotine withdrawal – not effects of nicotine.

      Nicotine is a chemical. It is not “all good” and it is not “all bad”. Furthermore, the concept of human use of psychoactive substances is horribly misrepresented in your argument without a shred of the sociological implications across the more than 100,000 years of known human psychoactive use or for that matter, animal psychoactive use. That’s right, the creatures we evolved with have found recreational chemical use to be beneficial to their lives as well, from reindeer seeking out hallucinogenic mushrooms to monkeys eating spiders and millipedes for a high, to your pet cat’s love of recreational nepetalactone (whose awful and wrong substance abuse problem you encourage every time you give him catnip). Even foods we eat on a daily basis have some level of psychoactivity. Stop spreading propaganda and wait for the facts to settle before you go trying to morph them to suit your ignorance.