Vim & Vigor - Fall 2021 - 18

18
TIME WILL TELL
" E-cigarettes don't have
decades of people using
their products, " says
Panagis Galiatsatos,
MD, a pulmonary
and critical care
physician who is a
national spokesman
for the American Lung
Association. With conventional
cigarettes, he
says, the most dire ramifi cations
appear aſt er decades of use.
E-cigarettes, by contrast, " have the
appearance of safety " because they
are new and there hasn't been enough
time for potential health consequences
to come to light.
Federal health agencies have only
been tracking e-cigarette smokers
since 2014. Th at year, for the fi rst time,
the National Health Interview Survey
began asking people age 18 and older
about their use of e-cigarettes.
" A lot of people are really interested
in the long-term health consequences
of vaping, " says Jeff rey Hardesty, a
public health expert and an e-cigarette
researcher on the faculty at the Johns
Hopkins Bloomberg School of Public
Health. " But the jury is still out on
many of those eff ects, including cancer
and mortality. "
A spate of vaping-related injuries
and deaths among youths in 2019
gained widespread attention but later
was determined to be linked with
products containing THC, the psychoactive
ingredient in marijuana,
and most of the products were purchased
on the black market.
VAPING SAFETY
COMPARED WITH
SMOKING
One of the most pressing questions
about e-cigarettes is how they stack
up, safety-wise, against conventional
cigarettes.
" All we have for e-cigarettes are
lab tests, no observational studies, "
Galiatsatos says, noting that lung
cancer was never proved to be
caused by cigarettes in a laboratory
setting.
Observational studies involve
watching the eff ects of a risk factor
or behavior without trying to
change the exposure to it, while
laboratory studies introduce
something new and then study
the eff ects.
Th e link between smoking
conventional cigarettes and lung
cancer was determined through
an observational trial in the 1950s
with nearly 200,000 recruited participants,
which showed that lung
cancer was linked to both age and
years of exposure to cigarettes.
And lung cancer is only one possible
bad outcome. Galiatsatos says
vaping has the potential to cause
other pulmonary diseases, including
chronic obstructive pulmonary
disease and emphysema.
Findings from a study in JAMA
Network Open bear that out. Study
participants who previously used
e-cigarettes were 21 percent more
likely to develop a respiratory
disease-including chronic
bronchitis, emphysema, chronic
obstructive pulmonary disease and
asthma-while current users saw
their risk increase by 43 percent.
" Vaping is not safe, full stop, "
Hardesty says. " Th e vapor that users
inhale contains known toxicants that
we know can damage your health
and almost always has nicotine,
which we know is addictive. Th e
caveat is that while these products
contain toxicants, they do contain
lower levels of toxicants than
cigarettes. Th at does not equate to
lower risk, though. "
Th e aerosol from vaping can
contain heavy metals such as lead,
volatile organic compounds and
cancer-causing agents, according
to the Centers for Disease Control
and Prevention.
SAFER VERSUS SAFE
Lynn Kozlowski says one of
the challenges is " helping people
understand the distinction
between safer and safe. " Kozlowski
is a founding member of the
Society for Research on Nicotine
& Tobacco who has contributed to
four surgeon general's reports on
smoking and health since 1981.
Kozlowski believes that when
experts say vaping is much less
harmful than conventional cigarettes,
people falsely equate that
to being safe.
" No, it's harmful, " Kozlowski
says. He views it through a lens
of harm reduction: If someone
decides to use a tobacco product,
he says, it's best to use something
that's much less harmful.
" I think the balance of the
evidence still demonstrates
that properly manufactured
e-cigarettes are much safer than
tobacco cigarettes. "
Kozlowski says that's because
conventional cigarettes contain far
more toxins than vaping products.
" It's a dramatic diff erence in the
doses of poisons. "
E-CIGARETTES AND
QUITTING SMOKING
Because of the perception that vaping,
with its fewer toxins, might be
safer than conventional smoking, it
is being studied for its effi cacy as a
smoking cessation tool.
FALL 2021 VIM & VIGOR
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