"Long before it's in the papers"
January 27, 2015


Burning debate lights up over safety of electronic cigarettes

Dec. 17, 2010
World Science staff

A heat­ed de­bate is de­vel­op­ing over the safe­ty of “e-cig­a­rettes” or elec­tron­ic cig­a­rettes, billed as a sup­posedly safer sub­sti­tute for or­di­nary smokes.

Two sci­en­tif­ic re­ports this month take op­pos­ing sides on wheth­er that safe­ty claim is val­id. Uni­vers­ity of Cal­i­for­nia-River
­side re­search­ers is­sued an ur­gent warn­ing about e-cig­a­rettes in a study pub­lished this mon­th’s is­sue of the re­search jour­nal To­bac­co Con­trol. But a Bos­ton Uni­vers­ity School of Pub­lic Health sci­ent­ist, in a re­port for the Jour­nal of Pub­lic Health Pol­i­cy, de­clared those con­cerns far overblown.

Uni­vers­ity of Cal­i­for­nia-River­side re­search­ers cite this pho­to as a de­mon­stra­tion of how e-cig­ar­ette fluid can leak out of a cart­ridge, mak­ing it hard to han­dle without touchi­ng the nico­tine solu­tion in­side. (Cred­it: Tal­bot lab, UC River­side)

While fur­ther re­search is cer­tainly needed, “a pre­pon­der­ance of the avail­a­ble ev­i­dence shows [e-cig­a­rettes] to be much safer than to­bac­co cig­a­rettes,” wrote the school’s Mi­chael Siegel with a co-author.

Where­as con­ven­tion­al cig­a­rettes burn to­bac­co, the to­bac­co-less e-cig­a­rettes use bat­tery-gen­er­at­ed heat to va­por­ize nic­o­tine along with oth­er chem­i­cals pre­s­ent in a car­tridge.

Since com­ing on­to the mar­ket in the Un­ited States more than three years ago, e-cig­a­rettes have prov­en contro­versial, Siegel said; the U.S. Food and Drug Ad­min­istra­t­ion has threat­ened to ban their sale and six na­tional an­ti-smok­ing groups have op­posed them. They wor­ry that the FDA has­n’t eval­u­at­ed e-cig­a­rettes for safe­ty or ef­fec­tive­ness, that they may con­tain dan­ger­ous chem­i­cals, and that they’re mar­keted to­ward chil­dren.

The Uni­vers­ity of Cal­i­for­nia re­search­ers, in their stu­dy, eval­u­at­ed five e-cig­a­rette brands and found what they de­scribed as de­sign flaws, lack of ad­e­quate la­bel­ing, and sev­er­al con­cerns about qual­ity con­trol and health. They con­clud­ed that e-cig­a­rettes may be harm­ful and urged reg­u­la­tors to con­sid­er re­mov­ing e-cig­a­rettes from the mar­ket un­til their safe­ty is ad­e­quately eval­u­at­ed.

Noth­ing is known about the chem­i­cals in the aerosolized va­pors from e-cig­a­rettes, ac­cord­ing to the Uni­vers­ity of Cal­i­for­nia au­thors of the To­bac­co Con­trol pa­per.

“There are vir­tu­ally no sci­en­tif­ic stud­ies on e-cig­a­rettes and their safe­ty. Our study – one of the first stud­ies to eval­u­ate e-cig­a­rettes – shows that this prod­uct has many flaws, which could cause se­ri­ous pub­lic health prob­lems in the fu­ture if the flaws go un­cor­rect­ed,” said Prue Tal­bot, the di­rec­tor of the school’s Stem Cell Cen­ter, whose lab led the re­search. 

Tal­bot, a cell bi­ol­o­gist and neu­ro­sci­entist, said he ex­am­ined the de­sign, ac­cu­ra­cy and clar­ity of la­bel­ing, nic­o­tine con­tent, leak­i­ness, de­fec­tive parts, dis­pos­al, er­rors in fill­ing or­ders, in­struc­tion man­u­al qual­ity and ad­ver­tis­ing for the fol­low­ing brands of e-cig­a­rettes: NJOY, Lib­er­ty Stix, Crown Sev­en, Smok­ing Eve­ry­where and Vap­Cigs.

The sci­ent­ists con­tend that bat­ter­ies, at­om­iz­ers, car­tridges, car­tridge wrap­pers, packs and in­struc­tion man­u­als lack im­por­tant in­forma­t­ion re­gard­ing e-cig­a­rette con­tent, use and es­sen­tial warn­ings; that car­tridges leak, which could ex­pose ad­dic­tive and dan­ger­ous nic­o­tine to chil­dren, adults and pets; that there are cur­rently no meth­ods for prop­er dis­pos­al of e-cig­a­rettes and ac­ces­sories, cre­at­ing a risk of en­vi­ron­men­tal nic­o­tine con­tamina­t­ion; and that the ma­n­u­fac­ture, qual­ity con­trol, sales, and ad­ver­tise­ment of e-cig­a­rettes are un­reg­u­lat­ed.

“Con­trary to the claims of the ma­n­u­fac­turers and mar­keters of e-cig­a­rettes be­ing ‘safe’... vir­tu­ally noth­ing is known about the tox­icity of the va­pors gen­er­at­ed by these e-cig­a­rettes. Un­til we know any thing about the po­ten­tial health risks of the tox­ins gen­er­at­ed up­on heat­ing the nic­o­tine-con­tain­ing con­tent of the e-cig­a­rette car­tridges, the ‘safe­ty’ claims of the ma­n­u­fac­turers are du­bi­ous at best,” said Kam­lesh Aso­tra, a re­search ad­min­is­tra­tor at the in­sti­tu­tion.

Bos­ton Uni­vers­ity’s Siegel, on the oth­er hand, re­viewed 16 lab­o­r­a­to­ry stud­ies that iden­ti­fied the com­po­nents in elec­tron­ic cig­a­rette liq­uid and va­por. He said his stu­dy, pub­lished on­line ahead of print in the jour­nal, found that car­cin­o­gen lev­els in elec­tron­ic cig­a­rettes are up to 1,000 times low­er than in to­bac­co cig­a­rettes.

“The FDA and ma­jor an­ti-smok­ing groups keep say­ing that we don’t know an­ything about what is in elec­tron­ic cig­a­rettes,” said Siegel, who added that he has no fi­nan­cial in­ter­est in e-cig­a­rettes. “The truth is, we know a lot more about what is in elec­tron­ic cig­a­rettes than reg­u­lar cig­a­rettes.”

“Tak­ing these prod­ucts off the mar­ket would force thou­sands of users to re­turn to cig­a­rette smok­ing,” Siegel said. “Why would the FDA and the an­ti-smok­ing groups want to take an ac­tion that is go­ing to se­ri­ously harm the pub­lic’s health? The only ones who would be pro­tected by a ban on e-cig­a­rettes are the to­bac­co com­pa­nies, as these new prod­ucts repre­s­ent the first real threat to their prof­its in dec­ades.”

The re­port al­so re­views what Siegel said is pre­lim­i­nar­y ev­i­dence that elec­tron­ic cig­a­rettes can be ef­fec­tive in sup­press­ing the urge to smoke, largely be­cause they sim­u­late the act of smok­ing a real cig­a­rette.

* * *

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A heated debate is developing over the safety of “e-cigarettes” or electronic cigarettes, billed as a supposedly safer substitute for ordinary smokes. Two scientific reports this month take opposing sides on whether that safety claim is valid. University of California-Riverside researchers issued an urgent warning about e-cigarettes in a study published this month’s issue of the research journal Tobacco Control. But a Boston University School of Public Health scientist, in a report for the Journal of Public Health Policy, declared those concerns far overblown. While further research is certainly needed, “a preponderance of the available evidence shows [e-cigarettes] to be much safer than tobacco cigarettes,” wrote the school’s Michael Siegel with a co-author. Whereas conventional cigarettes burn tobacco, the tobacco-less e-cigarettes use battery-generated heat to vaporize nicotine along with other chemicals present in a cartridge. Since coming onto the market in the United States more than three years ago, e-cigarettes have proven controversial, Siegel said; the U.S. Food and Drug Administration has threatened to ban their sale and six national anti-smoking groups have opposed them. The groups worry that the FDA hasn’t evaluated e-cigarettes for safety or effectiveness, that they may contain dangerous chemicals, and that they’re marketed toward children. The University of California researchers, in their study, evaluated five e-cigarette brands and found what they described as design flaws, lack of adequate labeling, and several concerns about quality control and health. They concluded that e-cigarettes may be harmful and urged regulators to consider removing e-cigarettes from the market until their safety is adequately evaluated. Nothing is known about the chemicals in the aerosolized vapors from e-cigarettes, according to the University of California authors of the Tobacco Control paper. “There are virtually no scientific studies on e-cigarettes and their safety. Our study – one of the first studies to evaluate e-cigarettes – shows that this product has many flaws, which could cause serious public health problems in the future if the flaws go uncorrected,” said Prue Talbot, the director of the school’s Stem Cell Center, whose lab led the research. Talbot, a professor of cell biology and neuroscience, examined the design, accuracy and clarity of labeling, nicotine content, leakiness, defective parts, disposal, errors in filling orders, instruction manual quality and advertising for the following brands of e-cigarettes: NJOY, Liberty Stix, Crown Seven, Smoking Everywhere and VapCigs. The scientists contend that batteries, atomizers, cartridges, cartridge wrappers, packs and instruction manuals lack important information regarding e-cigarette content, use and essential warnings; that cartridges leak, which could expose addictive and dangerous nicotine to children, adults and pets; that there are currently no methods for proper disposal of e-cigarettes and accessories, creating a risk of environmental nicotine contamination; and that the manufacture, quality control, sales, and advertisement of e-cigarettes are unregulated. “Contrary to the claims of the manufacturers and marketers of e-cigarettes being ‘safe,’ in fact, virtually nothing is known about the toxicity of the vapors generated by these e-cigarettes. Until we know any thing about the potential health risks of the toxins generated upon heating the nicotine-containing content of the e-cigarette cartridges, the ‘safety’ claims of the manufactureres are dubious at best,” said Kamlesh Asotra, a research administrator at the institution. Boston University’s Siegel, on the other hand, reviewed 16 laboratory studies that identified the components in electronic cigarette liquid and vapor. He said his study, published online ahead of print in the journal, found that carcinogen levels in electronic cigarettes are up to 1,000 times lower than in tobacco cigarettes. “The FDA and major anti-smoking groups keep saying that we don’t know anything about what is in electronic cigarettes,” said Siegel, who added that he has no financial interest in e-cigarettes. “The truth is, we know a lot more about what is in electronic cigarettes than regular cigarettes.” “Taking these products off the market would force thousands of users to return to cigarette smoking,” Siegel said. “Why would the FDA and the anti-smoking groups want to take an action that is going to seriously harm the public’s health? The only ones who would be protected by a ban on e-cigarettes are the tobacco companies, as these new products represent the first real threat to their profits in decades.” The report also reviews what Siegel said is preliminary evidence that electronic cigarettes can be effective in suppressing the urge to smoke, largely because they simulate the act of smoking a real cigarette.