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Stanton Glantz

Why Smoking in Films Harms Children

We want to believe we’re raising our kids to think for themselves, and not to do dumb or unhealthy things just because the cool kids are doing them.

https://www.nytimes.com/2017/07/17/well/family/why-smoking-in-films-harms-children.html

But research shows that when it comes to smoking, children are heavily influenced by some of the folks they consider the coolest of the cool: actors in movies.

“There’s a dose-response relationship: The more smoking kids see onscreen, the more likely they are to smoke,” said Dr. Stanton Glantz, a professor and director of the University of California, San Francisco, Center for Tobacco Control Research and Education. He is one of the authors of a new study that found that popular movies are showing more tobacco use onscreen.

“The evidence shows it’s the largest single stimulus,” for smoking, he said; “it overpowers good parental role modeling, it’s more powerful than peer influence or even cigarette advertising.”

He said that epidemiological studies have shown that if you control for all the other risk factors of smoking (whether parents smoke, attitudes toward risk taking, socioeconomic status, and so on), younger adolescents who are more heavily exposed to smoking on film are two to three times as likely to start smoking, compared with the kids who are more lightly exposed.

Those whose parents smoke are more likely to smoke, he said, but exposure to smoking in movies can overcome the benefit of having nonsmoking parents. In one study, the children of nonsmoking parents with heavy exposure to movie smoking were as likely to smoke as the children of smoking parents with heavy movie exposure.

To Dr. Glantz, and the other people who study this topic, that makes smoking in movies an “environmental toxin,” a factor endangering children.

“There’s no excuse for continuing to have smoking in movies that are rated to be sold to kids, and so the policy objective we have is there should be no smoking in movies that are rated for kids,” said Dr. Glantz, who maintains a website called Smoke Free Movies. “The studios have it in their power to fix this with a phone call.” The rating system needs to start treating smoking like a proscribed obscenity, he said; if it’s in the movie, the movie gets an R rating.

The Centers for Disease Control and Prevention’s fact sheet on smoking in the movies estimates that taking smoking out of films rated for children would save 18 percent of the 5.6 million young people alive today who will otherwise die of tobacco-related diseases – a million lives. “There’s nothing you could do that would be so cheap and save so many lives,” Dr. Glantz said.

This has been studied in 17 different countries, he said, and though policies vary widely and cultures are very different, the results are remarkably similar. “You consistently see this two to three times risk in kids who are exposed to a lot of onscreen smoking, all over the world.”

Five years ago, the people who worry about the impact on the young of seeing smoking in the movies thought things were looking good. In movies rated for a young audience (that is, G or PG or PG-13), there had been a steady drop in the number of “onscreen tobacco incidents.” Not only that, but in 2012, convinced by a heavy array of scientific evidence, the Surgeon General issued a report saying explicitly that seeing people smoke in movies caused kids to start smoking: “longitudinal studies have found that adolescents whose favorite movie stars smoke on screen or who are exposed to a large number of movies portraying smokers are at a high risk of smoking initiation.”

But after 2010, despite the accumulating evidence, the rate of cinematic smoking started to rise in those youth-rated movies, according to the new study, published this month in the C.D.C.’s Morbidity and Mortality Weekly Report, which looked at incidents of tobacco use in top-grossing movies from 2010 to 2016.

As far as movies rated G, PG, and PG-13, “When we compared 2010 to 2016, there was a slight decrease in the number of movies, but an increase in the number of incidents,” said Michael Tynan, a public health analyst in the office on smoking and health at the C.D.C., and the lead author of the new study. Dr. Glantz is also an author, and he and two of the four other authors have received grants from the Truth Initiative, an antismoking group.

The number of times that an actor used a tobacco product in a top-grossing movie “increased 72 percent among all movies and 43 percent among PG-13 movies,” Mr. Tynan said. In other words, he said, by 2016 there were “more tobacco incidents concentrated in fewer movies.”

One out of every four movies rated for youth today continues to feature tobacco use, Mr. Tynan said, “and we know this is harmful to youth and causes youth to start using tobacco.”

And the policies that the studios have in place, which seemed to be working as of 2012, are clearly not sufficient, Mr. Tynan said. “The frequency of tobacco use in PG-13 movies is a public health concern.” So what should be done? “One change is to rate movies with tobacco use with an R rating,” he suggested. Other steps that might help would be to have studios certify that there was no paid product placement, and to end the use of any actual tobacco brands on the screen. All of these strategies are supported by the American Academy of Pediatrics, which has issued a statement calling the new study “alarming.”

In a study done back in the ’90s, researchers pointed to some of the differences between who smokes on screen and who smokes in the real world. In the real world, smokers are likely to be “poor people, people with mental illness,” Dr. Glantz said. “If you look at the power players, the rich people, people who are in control, they’re not smoking.” But in movies, it tends to be more desirable or powerful characters, even if they’re the bad guys, and in that way, movie images may reinforce images in cigarette advertising.

And movie images are powerful. In one experiment, young people who were smokers were shown montages of clips from recent movies; the participants were randomized so that some saw clips with smoking in them and some did not. Then they were given a 10-minute break, and the people who saw the smoking images were significantly more likely to smoke during the break than the smokers who had not seen the images.

“Keeping smoking onscreen is like putting arsenic in the popcorn,” Dr. Glantz said. The new study “shows they’ve taken half of the arsenic out,” he said. “Now they need to take the rest out.”

Is Vaping As Harmful As Smoking Cigarettes? Here’s What You Need To Know

Vaping seems to have taken the mantle of becoming the healthier alternative to smoking, along with the fact that they were designed with the motive to help smokers eventually quit.

http://www.indiatimes.com/health/healthyliving/is-vaping-as-harmful-as-smoking-cigarettes-here-s-what-you-need-to-know-324703.html

In fact, the trend has caught on so rampantly that it’s set to outsell traditional cigarettes by the end of 2023!

With the FDA regulating these products since 2016, it comes as no surprise that vaping is due to become the norm, surpassing traditional smoking in time to come.

In a report on the use of e-cigarettes in Canada, a report previously stated that “Among those whose primary reason for use is to help to quit tobacco, a similar proportion no longer smoke (24%), and this may be considered the success rate for this method of smoking cessation.”

How is vaping different from smoking?

To differentiate itself from tobacco products, vaping is the process of smoking nicotine without inhaling the other harmful substances in tobacco—out of which there 70 known carcinogens. Some products contain little to no nicotine in them. Canada for instance still does not approve of nicotine-containing e-cigarettes.

These battery-powered devices heat the liquid that contains nicotine and/or other flavours, which in turn is inhaled as the vapour.

There is no smoke without fire, however

Since the key objective of switching to e-cigarettes is to cut down the number of cigarettes you smoke, researchers have been assessing the ‘relative harm’ vaping can cause to your tissues.

A study conducted by Jessica Wang-Rodriguez, a head and neck cancer specialist at the University of California at San Diego and her team found that cells lining human organs sustained up to twice the DNA damage seen in unexposed cells. They were also five to 10 times more likely to wither and die than unexposed cells even if the vapour contained no nicotine, the addictive ingredient in conventional and most electronic cigarettes, as reported in New Scientist.

“Without the nicotine, the damage is slightly less, but still statistically significant compared with control cells,” says Wang-Rodriguez, who led the research.

The toxins from the flavouring are another cause of concern

“E-cigarette vapour is known to contain a range of toxins which include impurities in the e-cigarette liquids and toxins generated when solutions are heated to generate vapour,” says John Britton, a toxicologist at the University of Nottingham, UK. “Some are carcinogenic, so it’s likely some long-term users of e-cigarettes will experience adverse effects on their health, and the authors fo the study conducted by Rodriguez and company are correct to point out that these products should not be considered risk-free,” he says. But if smokers can’t give up completely, e-cigarettes are safer than smoking, he says, as reported in New Scientist.

They caused considerable damage to your key blood vessels; similar to normal cigarettes

A study conducted by researchers at the European Society of Cardiology Congress in Rome states that vaping has an impact similar to the what normal cigarettes have on the stiffening of you heart’s aorta, as reported the Independent, UK.

The lead researcher, Professor Charalambos Viachopoulos of the University of Athens said, “We measured aortic stiffness. If the aorta is stiff you multiply your risk of dying, either from heart diseases or from other causes. “There could be long-term heart dangers. They are far more dangerous than people realise.”

The problem lies with the rising number of teens taking to smoking E-cigarettes

A 2014 high school survey conducted in the US found that 17 percent of 12th graders reported the use of e-cigarettes compared to 14 percent who smoked traditional cigarettes. The lower price points at which they are promoted, their perception of being safer than traditional cigarettes, the various flavours they come in and the fact they’re in trend make it a very attractive option for the youth.

Adolescents and young adults who try e-cigarettes are more than three times as likely to take up smoking traditional cigarettes as their peers who haven’t tried the devices, states a recent research review published in Reuters Health.

E-cigarette use, or vaping, was as least as strong a risk factor for smoking traditional cigarettes as having a parent or sibling who smokes or having a risk-taking and thrill-seeking personality, the researchers found.

“E-cigarette use among teens and young adults could increase the future burden of tobacco by creating a new generation of adult smokers who might have otherwise not begun smoking,” said lead study author Samir Soneji of the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire.

“To the extent that e-cigarette use mimics the behaviour of smoking a cigarette—handling the e-cigarette, the action of puffing, and the inhalation of smoke—it sets the adolescent up for easily transitioning to smoking,” added Soneji. “Like transitioning from driving a Tesla to driving a Chevy.”

Dr Brian Primack, a researcher at the University of Pittsburgh stated that “Young people report that there is a lot of pressure among e-cigarette only users to smoke a ‘real’ cigarette,” Primack said by email. “It may be somewhat analogous to the fact that teens who use flavoured alcohol are often pressured socially to step up their game to harder forms of alcohol.”

Although e-cigarettes claim to be less harmful than conventional cigarettes it could make sense to pay heed to the lack of conclusive long-term evidence

Cigarette smokers are well aware of the perils of smoking normal cigarettes. The New England Journal of Medicine states that smoking tobacco reduces your life span by at least 10 years. But studies on smoking e-cigarettes remain largely inconclusive.

A review of studies published in the journal Tobacco Control reveals that the long-term effects of the vaporised form are not known yet. For instance, it is not known if the chemical propylene glycol, which is mixed with the other chemicals in e-cigarettes known to irritate the respiratory tract, could result in lung problems after decades of vaping, says Dr Michael Siegel, a tobacco researcher and professor of community health sciences at the Boston University School of Public Health in Live Science.

Besides, “because e-cigarettes have been on the market for only about 10 years, there have been no long-term studies of people who have used them for 30 to 40 years. Therefore, the full extent of e-cigs’ effects on heart and lung health, as well as their cancer-causing potential, over time is not known,” says Stanton Glantz a professor of medicine and the director of the Center for Tobacco Control Research and Education at the University of California, San Francisco to Live Science.

 

When Public Health and Big Tobacco Align

Nobody trusts the tobacco industry, and it’s easy to understand why. For decades, industry executives knew that smoking caused cancer and heart disease yet publicly denied the dangers of cigarettes. It relentlessly attacked its critics. Documents that emerged in the 1990s showed that the industry targeted teenagers, knowing that the earlier someone became addicted to cigarettes, the more likely they would be lifelong smokers. And so on.

https://www.bloomberg.com/view/articles/2017-03-09/when-public-health-and-big-tobacco-align

In the 1980s and 1990s, the public health community went to war with the tobacco industry. Though the war largely ended in 1998 with Big Tobacco agreeing to a multi-billion-dollar settlement with the states, it remains a powerful memory for public health.

To this day, most tobacco-control advocates view the cigarette companies as being every bit as duplicitous and evil as they were in the bad old days. Some years ago, I asked Stanton Glantz, perhaps the leading anti-tobacco scientist in the U.S., what his ultimate goal was. He didn’t say it was to eliminate the scourge of smoking. He said: “To destroy the tobacco industry.”

What brings this to mind is an excellent cover story in the upcoming issue of Bloomberg Businessweek about the efforts of the tobacco industry to devise and market so-called reduced risk products like electronic cigarettes — products that give users their nicotine fix without most of the attendant carcinogens that come with combustible tobacco.

Although the tobacco companies have done decades of R&D on smokeless products, the business was dominated early on by startups like NJOY, which is today the largest independent e-cigarette company in America. From the start NJOY has said that a big part of its mission was “to end smoking-related death and disease.” And from the start, messages like that have been scorned by the public health community.

Ingesting nicotine in some smokeless fashion is vastly safer than smoking a combustible cigarette. (In the words of the late South African tobacco scientist Michael Russell, “People smoke for the nicotine but die from the tar.”) Last year, the Royal College of Medicine issued a report saying that e-cigarettes were some 95 percent safer than cigarettes.

Even so, the public health community in the U.S., led by the Centers for Disease Control and Prevention, has done everything it can to demonize smokeless products. Some of this has been with good reason: to try to keep kids from picking up an addictive habit. But this effort has also helped to create the impression that smokeless products are as dangerous as cigarettes. One result, sadly, is that many long time smokers have refused to try them, even though they could save their lives.

My sense in talking to tobacco-control officials over the years is that too many of them simply don’t believe in a reduced-harm approach. We give heroin addicts methadone not because methadone is good but because it is better than heroin. With cigarettes, however, the public health mindset appears to be all or nothing — that the only “right” thing for smokers to do is to go cold turkey.

But the lingering distrust of the tobacco industry has also had a lot to do with public health’s unwillingness to acknowledge the potential benefits of alternative products. Matt Myers, the president of the Campaign for Tobacco Free Kids, has often complained, for instance, about the marketing of e-cigarettes, saying that companies are using the same tactics to hook teenagers that Big Tobacco once used.

With the e-cigarette market clearly established, the four big tobacco companies — BAT, Reynolds American, Altria (formerly Philip Morris) and Philip Morris International (spun off from Altria) — have proclaimed themselves all in.

Philip Morris International is an especially interesting case: Not only does it have an array of e-cigarettes and other smokeless products, but as the Bloomberg Businessweek story points out, it has publicly proclaimed that its goal is to lead the world into “a smoke-free future.” The home page of its website asks, “How long will the world’s leading cigarette company be in the cigarette business?”

As astonishing as it is that a company with $26 billion in tobacco revenue last year would be calling for the end of cigarettes, I believe Philip Morris is sincere. It has spent around $3 billion in research. Its new flagship product, called IQOS, heats tobacco but doesn’t burn it — which the company believes will be more satisfying to smokers than vaping. IQOS already has 7 percent of the tobacco market in Japan, and is being rolled out in other countries.

Philip Morris recently asked the British government that tobacco products “be taxed according to their risk profile.” In other words, it wants the government to impose higher taxes on cigarettes to encourage smokers to move to reduced-risk products. What tobacco company has ever done that before?

In the U.S., Philip Morris has done something extraordinary: It has made a submission to the Food and Drug Administration to get the right to market IQOS as a reduced risk product. The expensive submission consumed 2.3 million pages and is backed by a great deal of research, including several clinical trials. So far, none of the U.S. e-cigarette companies have attempted to get such a designation, and it is a big problem. How do you sell a reduced risk product when you can’t tell anybody it reduces risk?

The business case for diving into this market is that it’s a product category that’s growing, while the cigarette market is shrinking. Philip Morris doesn’t want to be left behind. But there is no particular need for the company to set out such a transformative agenda, at least not yet. The small smokeless companies are not much of a threat. NJOY filed for bankruptcy last fall. And under a 2009 law, every company in the e-cigarette industry will have to file something called a premarket tobacco application with the FDA by August 2018. The submissions will cost, on average, over $450,000, and the companies will have to show that their products have some public health benefit. There is a legitimate chance that some small companies won’t be able to clear the hurdle.

No, Philip Morris is pushing as hard as it is, I believe, because it wants to get on the right side of the issue, finally — to be viewed as a good corporate citizen. When I spoke to Glantz the other day about the company’s new anti-smoking agenda, he said, “I don’t believe them.” (He added, “If they were serious, they would stop marketing cigarettes right now.”)

No doubt many others in the tobacco-control community feel the same way. They still loathe Big Tobacco, and view Philip Morris’s new strategy as just another deception. But the truth is, if there is ever going to be a serious move from cigarettes to less dangerous products, it will have to come from Big Tobacco. They have the R&D resources, they have the marketing apparatus — and, it appears, they have the will.

Public-health advocates don’t have to trust Philip Morris, or any other tobacco company. They don’t have to believe what I believe in order to arrive at the same conclusion: that the advocates should be rooting for the companies’ innovations — pushing them, double-checking their data, making sure regulations are in place to prevent their products from being marketed to kids. The advocates should also be spreading the word that there is an alternative to cigarettes. Who really cares whether it’s Big Tobacco or some other entity that reduces smoking deaths? What matters is that it happens.

The tobacco wars are long over. Continuing to fight the cigarette companies may bring a certain satisfaction to the veterans on the public-health side. But joining forces is the way to save lives.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Joe Nocera at jnocera3@bloomberg.net

To contact the editor responsible for this story:
Philip Gray at philipgray@bloomberg.net

Vapers beware: 10 things to know about e-cigarettes

With catchy names like Smurf Cake and Unicorn Puke and sweet flavors like bubble gum and strawberry, electronic cigarettes may have special appeal to young people, but that doesn’t mean they are safe.

https://www.universityofcalifornia.edu/news/vapers-beware-ten-things-know-about-e-cigarettes

Evidence is mounting that e-cigarettes are exposing a new generation to nicotine addiction and may be leading users toward a cigarette habit. As a result, the U.S. surgeon general last month issued a report declaring youth e-cigarette use “a major public health concern.”

“All Americans need to know that e-cigarettes are dangerous to youth and young adults,” said Surgeon General Vivek Murthy, in releasing the report. “Any tobacco use, including e-cigarettes, is a health threat, particularly to young people.”

The battery-powered devices heat a liquid typically containing nicotine mixed with the chemicals propylene glycol and glycerin as well as flavorings to deliver an aerosol inhaled by the user. While e-cigarettes deliver nicotine without the tar and smoke of traditional tobacco cigarettes, they still are considered tobacco products.

But their healthy halo has helped propel their popularity: E-cigarettes are now so popular that more American youth vape than smoke cigarettes. In just a decade, e-cigarettes have become a multibillion-dollar business led by multinational tobacco companies with outlets not just online but everywhere from vape shops to convenience stores and retail giants like Wal-Mart.

Ads tout them as a cool, harmless alternative to cigarettes. E-cigarette users, or vapers, have contests to see who can blow the largest cloud of vapor.

But there’s more to e-cigarettes than meets the eye. The surgeon general’s report aligns with increasing scrutiny of e-cigarettes, from new regulations to a growing body of research into health effects.

Here are 10 things to know about e-cigarettes:

E-cigarettes contain nicotine

E-cigarettes contain nicotine, which is addictive and can harm the developing adolescent brain, said UC San Francisco professor of medicine Stanton Glantz.

A lot of the kids who take up vaping are at low risk for smoking, but once they start using e-cigarettes, they are three to four times more likely to start using cigarettes, Glantz said.

“The biggest health concern with e-cigarettes is they are prolonging and expanding the tobacco industry,” Glantz said.

Glantz, director of UCSF’s Center for Tobacco Control Research and Education, said he was initially neutral on e-cigarettes, but now finds them concerning. Among other hazards, e-cigarettes produce ultrafine particles than can trigger inflammatory problems and lead to heart and lung disease.

“The data is just becoming overwhelming,” Glantz said.

E-cigarettes expose people to more than ‘harmless water vapor’

E-cigarettes are billed as producing “harmless water vapor,” but, strictly speaking, the vapor produced when users exhale is actually an aerosol that contains a mixture of nicotine, flavorings and other ingredients that can be toxic.

Stanford University pediatrics professor Bonnie Halpern-Felsher has studied young people’s perceptions of e-cigarettes. In September, she launched a free, downloadable youth tobacco prevention toolkit with an e-cigarette module, funded by the UC Tobacco-Related Disease Research Program (TRDRP) and the California Department of Education.

“Youth are definitely using e-cigarettes because they think they are cool,” Halpern-Felsher said. “Adolescents and young adults don’t know a lot about e-cigarettes. They think it’s just water or water vapor. They don’t understand it’s an aerosol. They don’t understand that e-cigarettes can have nicotine. They don’t understand that flavorants themselves can be harmful.”

The flavors can be toxic

More than 7,000 varieties of flavored e-cigarettes are on the market.

UC Riverside professor of cell biology Prue Talbot screened the cytotoxicity (quality of being toxic to cells) of 36 refill fluids and found that some were highly toxic. The most cytotoxic flavor, Cinnamon Ceylon, contained a chemical called cinnamaldehyde, which gives cinnamon its flavor and whose side effects may include coughing and sore throats. Talbot has been studying more flavors and is building a database to help determine the most dangerous ones.

“Flavors are something that could be potentially regulated,” Talbot said.

Vaping has secondhand and thirdhand effects

Unlike cigarettes, which emit smoke from the lit end, e-cigarettes don’t produce sidestream emissions between puffs, but they still generate secondhand and thirdhand effects when users exhale the mainstream vapor.

In a TRDRP-funded study, Berkeley Lab researcher Hugo Destaillats led a team that found 31 chemicals that include several toxicants at significant levels in e-cigarette vapor. The most toxic chemicals included acrolein, a severe eye and respiratory irritant; and formaldehyde, an irritant and probable carcinogen.

Emissions varied by type of device and voltage.

“The way you heat the liquid drastically determines if you produce a lot of compounds or just a few,” Destaillats said. “As you increase the voltage, toxic byproduct concentrations increase exponentially.”

The batteries can explode

There were 134 reports of e-cigarette batteries overheating, catching fire or exploding between 2009 and January 2016, according to the Food and Drug Administration, which will host a public workshop in April to gather information about e-cigarette battery safety concerns.

E-cigarette batteries “can explode without notice,” Talbot said. “People can be quite severely injured.”

E-liquids are poisonous if swallowed

Calls to poison control centers about e-cigarette exposure in young children have skyrocketed nationally in recent years. In California, the number of calls involving e-cigarettes increased from 19 in 2012 to 243 in 2014, according to the UC-administered California Poison Control System. More than 60 percent of those e-cigarette calls were related to nicotine poisoning in children 5 and under.

E-cigarettes show mixed results in helping smokers quit

While some people have quit smoking with e-cigarettes, on average, adult smokers who use e-cigarettes are about 30 percent less likely to stop smoking cigarettes, Glantz said. Also, e-cigarettes are associated with more, not less, cigarette smoking among adolescents.

“If you are a middle-aged person who has been smoking for 20 years, maybe it is good to switch to e-cigarettes,” Destaillats said. “But if you are a teenager and never have smoked, then it is not a good idea to use e-cigarettes.”

The minimum age has risen

In June, California became the nation’s second state, following Hawaii, to raise the minimum age for tobacco sales to 21, and for the first time added e-cigarettes to the definition of tobacco products. In August, the FDA extended its tobacco oversight to e-cigarettes, banning sales to those under 18.

“It sends a message to youth that e-cigarettes are in the same category of all tobacco products,” Halpern-Felsher said.

E-cigarettes will be taxed

Under Proposition 56, the tobacco tax passed by California voters in November, the state will tax e-cigarettes for the first time, starting April 1. It’s estimated that the price of a typical 30-milliliter bottle of e-liquid could increase to about $30 from $20.

“Anytime you increase the price, people buy less,” Glantz said.

The tax revenue will enhance education efforts by boosting funding for the state Tobacco Control Program. The surgeon general’s report also will make it easier for states to integrate e-cigarettes into tobacco education campaigns and could lead to more regulations, Glantz said.

E-cigarettes may be safer than cigarettes, but unknown risks remain

Expect more information to emerge about e-cigarettes as studies examine long-term effects.

“It’s often assumed that e-cigarettes are safer than cigarettes, but that could be an incorrect assumption,” Talbot said. “We don’t yet know the long-term health effects of e-cigarettes.”

Decades of research have helped scientists determine that cigarette smoke creates more than 7,000 chemicals, at least 69 of which are known to cause cancer and many of which are poisonous.

So, while e-cigarettes deliver fewer cancer-causing chemicals than cigarettes, research has yet to reveal how e-cigarettes fully impact heart and lung health and their cancer-causing potential, Glantz said.

He estimates that e-cigarettes are about one-third to one-half as dangerous as cigarettes.

In other words, they are still plenty dangerous.

“Regular cigarettes are super unhealthy,” Destaillats said. “E-cigarettes are just unhealthy.”

Vaping’s Long-Term Effects: Here’s what the experts say

The debate over electronic cigarettes rages on, despite the vaping industry’s best efforts to promote its value in decreasing the use of tobacco cigarettes. Proponents of e-cigs argue that the technology is safer than traditional cigarettes and can be used to quit smoking altogether. The scientific community is beginning to see things differently, however. Its consensus: vaping is a scam.

https://mic.com/articles/161221/vaping-s-long-term-effects-here-s-what-the-experts-say#.oZe252gbh

The myth of e-cigarettes as a safe alternative

“The evidence consistently shows that, while some people successfully quit smoking with e-cigarettes, most people using e-cigarettes have their chances of quitting conventional cigarettes reduced by about 30%,” Dr. Stanton Glantz, Professor of Medicine at the University of California, San Francisco’s Center of Tobacco Control Research and Education, told Mic. “The most dangerous thing about e-cigarettes is that they keep people smoking cigarettes.”

Dr. Glantz conceded the possibility of e-cigs as a way to transition from tobacco cigarettes, but argued that the bulk of e-cig users are what are referred to as “dual users” — consumers who smoke both e-cigs and traditional cigarettes.

That notion is backed by a 2012 study published in the American Journal of Public Health, in which researchers found that e-cig utilization was highest among current tobacco cigarette smokers at a rate of 11.4%, compared to 3.4% of the total population surveyed, 2% of former smokers and 0.8% of those who never smoked a traditional cigarette. Furthermore, a study in scientific journal Tobacco Control found that 75% of dual use smokers do not even believe vaping will help them quit cigarettes and “reported planning to quit within the next 6 months less often than adults who smoke cigarettes exclusively.” A substantial 42.3% said they never plan to quit smoking whatsoever.

That continued use means that e-cigarettes will have long-term health effects on users, but it’s still too early to tell exactly what they will be (the first e-cigarette was invented in 2003). Dr. Glantz suggests another 5-10 years are required to conduct definitive research, but his research has led him to develop an understanding of the short-term epidemiological impact, and how it relates to potential long-term risks.

Vaping’s damaging effect on the cardiovascular system

“My current thinking is that e-cigarettes are going to cause less damage than conventional cigarettes in terms of cancer, but they’re probably just as dangerous – if not more – when it comes to heart disease and non-cancer lung disease and asthma,” Glantz said.

According to the Center for Disease Control and Prevention, approximately 610,000 people die of heart disease in the United States every year — that equates to one in every four deaths. In fact, heart disease is the leading cause of death for both men and women in the United States. The spreading popularity of e-cigarettes are likely to increase those numbers.

“One of the main things about smoking that causes heart disease is the ultrafine particles that are delivered through the smoke, which trigger inflammatory processes and damage the cardiovascular system,” Glantz said. “E-cigarettes deliver as much or more ultrafine particles as the ones found in cigarettes. That’s something you can’t get rid of because of the way cigarettes work — you generate an aerosol of ultrafine particles that carry the nicotine down into your lungs where it’s absorbed. You do that by burning the tobacco.

“The way e-cigarettes work is by heating up a liquid solution — propylene, glycol, glycerol, nicotine and flavorants – and that generates the ultrafine particles that go into your lungs,” Glantz continued. “The e-cigarettes that work the best in terms of delivering nicotine generate more and smaller particles than a conventional cigarette, and the smaller these particles are, the more dangerous they are. They have immediate effects on your blood and blood vessels, which we have already been able to measure and quantify.”

“The similarities between e-cigarettes and conventional cigarettes in terms of vascular effects are extremely troubling,” Glantz said, bluntly, as he concluded his explanation.

Vaping’s influence on teenage smoking

Perhaps most troubling aspect is the e-cigarette industry’s hold on adolescents. A July 2016 study published by the American Academy of Pediatrics examined prevalence rates in Southern California and concluded that “the high prevalence of combined e-cigarette or cigarette use in 2014, compared with historical Southern California smoking prevalence, suggests that e-cigarettes are not merely substituting for cigarettes and indicates that e-cigarette use is occurring in adolescents who would not otherwise have used tobacco products.”

Dr. Glantz partially attributes this phenomenon to marketing techniques utilized by the vaping industry, as well as a plethora of enticing “flavors” which attract younger users. This is highly irresponsible because, even if these teenagers aren’t converting to tobacco cigarettes, “Nicotine is still really bad for the developing brain,” according to Glantz.

Between early use among adolescents and adults’ insistence on dual use smoking, e-cigarettes are bound to have long-term effects — both physiologically and culturally. What exactly they will be cannot yet be definitively quantified, but one thing’s for sure: they won’t be good.

**PART 2** | POLITICIZING SCIENCE | SIEGEL ON GLANTZ & E-CIGS

PART 2 | GLANTZ ON E-CIGS | PROMOTING THE TOBACCO EPIDEMIC

PROMOTING THE TOBACCO EPIDEMIC | GLANTZ ON E-CIGS | PART 1