Research Paper

Phantom smoking among young adult bar patrons

Apr 5th, 2016

http://tobaccocontrol.bmj.com/content/early/2016/04/05/tobaccocontrol-2015-052821.short?g=w_tobaccocontrol_ahead_tab

Abstract

Objective

To explore the prevalence and sociodemographic makeup of smokers who do not self-identify as smokers (ie, phantom smokers) compared with self-identifying smokers in a sample of bar-going young adults aged 18–30 years to more accurately assess young adult prevalence of smoking and inform cessation message targeting.

Methods

Cross-sectional surveys of smokers (n=3089) were conducted in randomly selected bars/nightclubs in seven US cities. Logistic regression models assessed associations between phantom smoking (past 30-day smoking and denial of being a smoker), tobacco and alcohol use behaviours (eg, social smoking, nicotine dependence, smoking while drinking, past 30-day alcohol use) and demographics.

Results

Compared with smokers, phantom smokers were more likely to be college graduates (OR=1.43, 95% CI 1.03 to 1.98) and to identify themselves as social smokers (OR=1.60, 95% CI 1.27 to 2.12). Phantom smokers had lower odds of smoking while drinking (OR=0.28, 95% CI 0.25 to 0.32), being nicotine dependent (OR=0.36, 95% CI 0.22 to 0.76) and having quit for at least 1 day in the last year (OR=0.46, 95% CI 0.36 to 0.69) compared with smokers.

Conclusions

This research extends phantom smoking literature on college students to provide a broader picture of phantom smoking among young adults in high-risk contexts and of varying levels of educational attainment. Phantom smokers may be particularly sensitive to social pressures against smoking, suggesting the importance of identifying smoking as a behaviour (rather than identity) in cessation messaging to ensure that phantom smokers are reached.

Tobacco point-of-sale advertising in downtown Buenos Aires, Argentina and compliance with the new tobacco advertising restrictions

Mar 30th, 2016

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http://tobaccocontrol.bmj.com/content/early/2016/03/30/tobaccocontrol-2015-052870.short?g=w_tobaccocontrol_ahead_tab

Background

Despite increased awareness of the health threat posed by tobacco use, Latin America continues to experience high smoking rates. Argentina is no exception, where an estimated 22.1% of adults were smokers in 2012.1 Prior to 2011, few limitations were placed on the advertisement of tobacco products in Argentina, and any restrictions were largely self-imposed by the tobacco companies.2

On 14 June 2011, Argentina enacted the ‘National Law of Tobacco Control: Law 26.687’. This law provides 42 articles that address tobacco advertising, packaging, product composition, sale/distribution, secondhand smoke, and preventive education. Notably, it largely prohibits all forms of tobacco advertisements except for those indoors at the point of sale (PoS) (table 1).3 Unfortunately it is unclear how many convenience stores are compliant with its provisions.

Methods

To investigate the compliance with the new restrictions, we surveyed all convenience stores (n=137) found in an 8 by 7 block area of Buenos Aires from July to August of 2014. This area was selected due …

Responsibility for Environmental Waste

Mar 5th, 2016

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The tobacco industry has not only designed and marketed a product that is deadly when used as directed, but it also causes substantial and dangerous environmental pollution, says the Smokefree Coalition. New research findings released in the Tobacco …Tobacco companies should take responsibility for environmental waste, say smokefree advocates

http://business.scoop.co.nz/2016/03/05/responsibility-for-environmental-waste/

The tobacco industry has not only designed and marketed a product that is deadly when used as directed, but it also causes substantial and dangerous environmental pollution, says the Smokefree Coalition. New research findings released in the Tobacco Control Journal today show 98 percent of all cigarettes contain plastic non-biodegradable filters.

“When smokers discard their butts into the surrounding environment, they may not realise they collectively leave behind them a huge carbon footprint – perhaps 2-4 trillion non-biodegradable butts each year around the world,” says Smokefree Coalition Executive Director Dr Prudence Stone.

“It’s time for new regulations to force the tobacco industry to be legally responsible for their environmentally unsafe design. Ironically, this design was introduced in the 1960s to purposefully mislead consumers into thinking cigarettes would be less harmful. In fact, the product doubled its potential to harm; both to the consumer’s health and also to our shared environment.”

The researchers reveal the serious environmental concerns regarding the production and use of tobacco products throughout their lifecycle, especially involving tobacco product waste (TPW).

There are 7000 chemicals contained in cigarettes, with at least 50 known carcinogens. These chemicals have been found to be acutely toxic to marine and freshwater organisms, and poisonous to humans and domestic animals.

The writers say the current level of corporate accountability by the tobacco industry is cynical, and simply isn’t working. The Smokefree Coalition agrees new laws and regulations are necessary to hold the industry to account for preventing, reducing and mitigating the unacceptable harms done to the environment, from their product’s farming, manufacturing, shipping and distribution, and finally the discarded waste left by their consumers.

“This is not an industry we can rely on to do the right and ethical thing voluntarily. If it was, it would have recalled all tobacco products decades ago, when it was first known they caused cancer, respiratory illness and heart disease,” says Dr Stone.

“Reversing the harm this industry causes will require action from decision makers in Government, the mistrust of civil society, and green industries, scientists and other conscientious citizens working together to hold the tobacco industry accountable.”

No ifs, ands or butts, e-cigarettes not welcome here

Mar 1st, 2016

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http://www.chinadailyasia.com/focus/2016-03/01/content_15392153.html

Hong Kong is moving rapidly to join others in snuffing out the e-cigarette craze, as new, local research reveals the smoking alternatives contain toxic chemicals. Sylvia Chang reports.

Latest research, undertaken by Hong Kong Baptist University reveals that electronic cigarettes, marketed as the safer alternative to tobacco, are not safe at all. Studies of 13 randomly selected brands of electronic cigarettes contain formaldehyde, polycyclic aromatic hydrocarbons (PAH), and polybrominated diphenyl ethers (PBDEs), flame retardants used on furniture, automobile interiors, textiles and plastic products. Health risks include a list of maladies ranging from impaired fetal development to cancers

The research findings are clear validation of the administration’s determination to play it safe on the subject of e-cigarettes. Of equal concern was the fear that e-cigarettes might be seen as chic, fashionable and stylish, and could undermine years of effort to make Hong Kong one among the most smoke-free cities in the world.

The final verdict on the health hazards associated with e-cigarettes remains in abeyance as scientific tests are carried out around the world. The question of whether or not to sell has been whirling around for a few years and is now the subject of a heated controversy. People have been arrested, puffing on e-cigarettes at sites where smoking is prohibited by law, all the while protesting that they are not smoking, but “vaping”.

The battery powered e-cigarettes create a vapor from replaceable cartridges, offering an experience similar to smoking. Sales of e-cigarettes hit $3 billion globally in 2013, according to figures produced by the World Health Organization. Market projections anticipate retail sales will be seven times that amount by 2030.

The School of Public Health at the University of Hong Kong covered e-cigarettes for the first time in its annual household survey of smoking patterns, released in early February.

The survey revealed that among 41,000 students from 92 secondary schools surveyed, nine percent said they had smoked e-cigarettes when they are not even legally on sale in the SAR.

Researchers interpreted the finding as a “red alert” to health authorities and urged greater efforts to raise awareness of the potential risks of e-cigarettes.

Catch ‘em young

Teenagers are prone to smoking addiction. By the time they’ve smoked about 100 cigarettes, they are hooked as life-long smokers, says anti-tobacco advocate Judith Mackay, director of the Asian Consultancy on Tobacco Control. Mackay is also a senior policy adviser to the World Health Organization.

Many e-cigarettes contain nicotine, the same addictive substance found in normal cigarettes, but in lowered concentrations. Many other brands claim their products contain no nicotine. Another argument in favor of e-cigarettes is that they produce vapor instead of highly toxic smoke. Still, latest studies show that both “vaping” and smoking suppress the normal function of 53 genes of the body’s immune system. Alarmingly, 305 more immune genes were shown to have mutated under exposure to e-cigarettes, leading many researchers to believe that e-cigarettes pose serious, long-term health hazards.

That study was presented on Feb 12 at the annual conference of the American Association for the Advancement of Science in Washington. Lead researcher Ilona Jaspers of the University of North Carolina at Chapel Hill was quoted by Ars Technica as saying that it was still unclear whether the changed immune response will lead to more infection risks or other immunological diseases.

Despite all these findings, even experts seem a bit ambivalent about the issue. “If all smokers changed to smoking e-cigarettes, it would mean a lot of lives being saved. But it’s not as simple as that,” Mackay told China Daily. “Only in the next three or five years will we have a clear understanding of the effects of e-cigarettes.”

Health authorities fear that non-smokers, mistakenly believing e-cigarettes are safe, will be enthused to take up the habit and that people who have quit smoking may pick up the vaping habit, exposing themselves to the same sort of Pandora’s Box that can afflict regular smokers. This is a matter for the social sciences, and as Mackay explained, there have been no definitive studies as to how e-cigarettes will affect the market if they were to become fashionable.

Fashion statement

With their attractive design and multiplicity of flavors, e-cigarettes are targeted at the youth market. There are more than 8,000 e-cigarette flavors available in the global market, with approximately 200 new flavors being added every month.

The majority of e-cigarette manufacturers have argued their products contain no nicotine at all and thus shouldn’t even require licensing or the levying of any “sin tax”. The selling price is usually 60 percent less than that of normal cigarettes, another way to attract young people.

Also there are several instances of batteries exploding during recharging, and getting inside the clothes of e-cigarette smokers, raising dangers of serious burns or fire outbreaks.

As the debate goes on, the tobacco industry already is moving in, buying e-cigarette manufacturing companies, recalling days gone by when smoking was portrayed as sexy, cool, refreshing and sophisticated. As medical evidence condemning tobacco piled up, the tobacco industry changed tactics promoting “better filters”, “low tar and nicotine”, and commissioned spurious research aimed at undermining the influence of serious scientific findings.

In 2012, a US Federal Court judge ordered that tobacco companies publicly confess to lying to consumers in their efforts to minimize health concerns.

Mackay supported the Hong Kong government’s adoption of a “precocious principle”—to ban e-cigarettes completely. “When we don’t know, when we’re not sure, it’s better to be really careful, and to get more science before allowing them to go market,” Mackay emphasized.

Under Secretary for Food and Health Sophia Chan Siu-chee said that the department will finalize an initial amendment on e-cigarettes by the end of the year for presentation to the Legislative Council for approval. The prohibition is expected to cover importing and manufacturing, selling, distributing and advertising.

Under the current law, only e-cigarettes cartridges containing nicotine are banned. The new rule seeks to ban all cartridges, even those containing no nicotine.

And you thought tobacco was toxic?

Tests by Hong Kong Baptist University (HKBU) show controversial e-cigarettes, pushing hard for admission into the Hong Kong market, contain deadly chemicals.

The polycyclic aromatic hydrocarbons (PAHs), among other toxins found in the samples tested, are derived from petroleum hydrocarbon contamination and the burning of other organic materials known as carcinogens. Inhaling carcinogens could lead to malformation of human tissue, potentially leading to cancer.

The result showed that the highest level of PAHs concentration in fumes rising from a concentrated solution reaches 504.5 nanograms/ml, almost 1 million times more concentrated than its presence in Hong Kong’s outdoor urban environment.

Tested e-cigarettes were also found to contain high amounts of polybrominated diphenyl ethers (PBDEs). PBDEs create a risk of disruption of thyroid hormones and reduced fertility. They also pose risks for fetal development and may cause cancers.

This is the first time electronic cigarettes have been scientifically proven to contain PBDEs, said Chung Shan-shan, assistant professor of Croucher Institute for Environmental Sciences from HKBU.

The discovery hints that other harmful substances, which may have been ignored in previous studies, will be found in the future, Chung added.

This is a “clear sign” that e-cigarettes affect human health, said Lam Tai-hing, chair professor of Community Medicine in the School of Public Health, the University of Hong Kong. The Council urges the government to ban e-cigarettes.

“The more you look into it, the more problems are indicated,” Lam said, citing that quick changes in technology have resulted in more variations of e-cigarettes in terms of temperature, chemical components and so on.

The Hong Kong Council on Smoking and Health also released a survey conducted by the School of Public Health at the University of Hong Kong to monitor the prevalence of e-cigarettes use.

The survey shows that smokers in the age group of 15 to 29 comprised the biggest chunk (7.9 percent) of e-cigarette smokers.

The study is alarming and is a step forward on extending our understanding on those potentially cancer-causing substances in e-cigarettes, said Judith Mackay, director of the Asian Consultancy on Tobacco Control.

“It clearly sends out the message that e-cigarettes need strict regulation before there is a clear and comprehensive understanding on what they contain, how they work, how dangerous they are, particularly to pregnant women and young people,” Mackay said.

‘Brain movies’ show nicotine affects men and women differently

Feb 18th, 2016

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http://www.timesofisrael.com/brain-movies-show-nicotine-affects-men-and-women-differently/

Innovative research being done in Israel demonstrates, on film, how short-term bursts of brain activity are prompted by stimulants

A ‘dopamine movie’ (screenshot)

Addictions are hard to kick. Just ask all cigarette smokers who keep puffing away despite the boatload of evidence that they are killing themselves.

Now, new research being conducted in Israel shows that addictions work differently in women and men. A study being conducted largely in Israel by Evan Morris, an associate professor of Radiology, Biomedical Engineering, and Psychiatry at Yale University, shows this clearly. In fact, Morris and his students have even made a movie out of it.

“Our dopamine movies show the effect of nicotine on the dopamine levels in the body, and those movies – which essentially show how the brain reacts when the chemical is released – shows clearly that there is a difference in brain activity for men and women who smoke.”

Those findings are interesting, Morris told The Times of Israel, but the real point is to show “how short-term bursts of brain activity are prompted by chemical changes. This could have all sorts of implications for treating symptoms like PTSD and other stress-induced conditions, where there can be radical changes in brain activity for short periods of time.”

Morris is a world-renowned expert on Positron Emission Tomography (PET) imaging using tracer kinetic modeling to create functional images of the brain.

“With PET, you can see in how the brain changes – based on mathematical formulas – in response to induced changes,” said Morris. “One of the most difficult challenges facing researchers is developing models of short-term changes – changes in the brain that pass quickly, perhaps in just a few minutes or so.”

It’s clear that with a supercharged emotion taking over the body – anger, ecstasy, or anything in between – there are changes to the brain, “but generally researchers have been able to capture only changes that linger, with the imaging of the short-term changes unattainable.”

That’s what makes a study of smoking so attractive. “When a person smokes, the chemicals they inhale – especially nicotine – engender a response that releases dopamine, the brain’s primary motivation neurotransmitter.”

Dopamine is released in response to environmental and internal stimuli – food, sex, or pleasurable events – as well as in response to chemicals that stimulate the central nervous system, like nicotine.

The sensation involved with nicotine – as with other drugs – is fleeting, with dopamine levels rising sharply but briefly. PET scans, said Morris, provide an opportunity to see how this fleeting sensation physically affects the brain.

“We are able to scan the brain’s reaction using a tracer that mimics dopamine. With our method, we are able to see how brains react to the chemically induced changes associated with addiction over time, creating a movie which shows the changes – and that is where we noticed how male and female brains differ when it comes to smoking.”

The results of the study, which was largely carried out at Hadassah Ein Kerem Hospital in Jerusalem with Dr. Nanette Freedman of the Nuclear Medicine Dept., were published in a recent edition of the Journal of Neuroscience.

The findings, according to the report, show that “male smokers smoking in the PET scanner activate dopamine in the right ventral striatum during smoking but female smokers do not. This finding—men activating more ventrally than women—is consistent with the established notion that men smoke for the reinforcing drug effect of cigarettes whereas women smoke for other reasons, such as mood regulation and cue reactivity.”

Based on these results, said Morris, who collaborated on developing the method with Yale co-researcher Prof. Kelly Cosgrove, researchers will be better able to understand what makes smokers tick – and develop more effective ways to get them to kick the habit. “It could be, for example, that you need different kinds of nicotine patches designed for men and women, since they react differently to nicotine.”

But besides what the study means for smokers, it also has implications far beyond nicotine addiction.

“Any short-term event that affects the brain could be ‘filmed’ for analysis, to see which part of the brain is affected, and how,” added Morris.

Just like adrenaline flows in a moment of danger providing extra strength in a moment of need, brain changes in response to those dangers could teach researchers about how people think and react – and how to “turn on” parts of the brain that can enhance thinking, among other things.

“PTSD, ADHD, and other conditions in which an individual’s mood and actions change depending on stimuli could be better understood using this method,” said Morris.

Morris, an associate professor of diagnostic radiology, biomedical engineering and psychiatry at Yale University, is in Israel on a Fulbright exchange program scholarship, which each years brings dozens of American researchers to Israel to work on innovative medical and technology projects in the start-up nation for a year, while sending Israeli researchers to work in the US for the same amount of time.

One reason Morris chose Israel is that he needed a young adult population that had recently taken up smoking in order to find recently addicted people.

“Part of what we are trying to determine is the development of addiction. Are there people more prone to addiction?” he said. “To see that kind of progression, you want people who are recent smokers so you can see over time what their brain patterns are, and how they change the more they are exposed to the cause of their addiction.

“In the US, most of these early stage smokers are kids – under 18 years of age, study of which entails all sorts of legal and disclosure issues. In Israel, many of the young smokers pick up the habit in the army – so they are already over 18, and it is much easier legally to recruit them for studies like these, that entail using the radioactive material we need for the PET tracer,” he added.

Morris will be discussing this and other findings of his research, along with other uses and research being conducted with PET, at a special event at Hadassah Ein Kerem Hospital on February 29, in a one-day symposium on Advances in Brain Imaging. The symposium is funded by Fulbright, Yale, Hadassah, and the US National Institutes of Health, which is also helping to fund Morris’s Hadassah research.

“Smoking was a good place to start, but we certainly don’t intend to stop there. The movies we created showing brain changes induced by stimuli can ‘star’ many more chemicals besides dopamine, giving us more insight into how the brain works.”

Variable and potentially fatal amounts of nicotine in e-cigarette nicotine solutions

Feb 13th, 2016

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E-cigarettes ‘as dangerous for unborn babies as regular tobacco’

Feb 11th, 2016

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Research finds that exposure to volatile chemicals from the devices disrupts the activity of thousands of genes in the developing frontal cortex

Pregnant women who smoke may harm their babies’ brain development if they turn to e-cigarettes to satisfy their nicotine craving, scientists have warned.

New research suggests that e-cigarette vapour may be as damaging as tobacco smoke to the nervous systems of the foetus or newborn infant.

The early findings, based on studies of mice, show that exposure to volatile chemicals from the devices disrupts the activity of thousands of genes in the developing frontal cortex, the brain region responsible for higher mental functions.

Analysis of the altered gene activity patterns indicated that they could lead to reductions in learning, memory and co-ordination, and increases in hyperactive behaviour.

These are just the sort of neurological effects seen in children whose mothers smoked during pregnancy and who are known to be at risk of attention deficit hyperactivity disorder (ADHD) and learning difficulties.

A further study, still on-going, has shown that older mice exposed to e-cigarettes in the womb or just after birth do indeed appear to be hyperactive, running around at a faster rate than normal.

Lead scientist Professor Judith Zelikoff, from New York University in the US, said: “This is ground-breaking research. What it shows is that there is certainly some concern over the safety of e-cigarettes, particularly in relation to pregnant women or young infants.

“There are potential dangers revealed by these studies indicating a possible impact to the unborn child that may be seen at birth but may occur later in the life of the child.

“Women may be turning to these products as an alternative because they think they’re safe. Well, they’re not.”

Colleague Dana Lauterstein, a PhD student at the university who did much of the work, added: “Most people view e-cigarettes as a safe way to smoke. For women who are pregnant, this could be dangerous. They could unwittingly be endangering their child.”

Prof Zelikoff’s team started out expecting to see effects from nicotine, which previous research has suggested may have an impact on brain development.

The whole point of e-cigarettes is that they deliver a dose of nicotine minus the highly damaging cocktail of other chemicals found in tobacco.

For this reason they have been touted as a “healthier” alternative for smokers who lack the will to quit, or a cessation aid that can help to wean them off tobacco.

But recent studies have challenged the view that apart from its addictive properties, nicotine on its own is harmless.

And the new research shows that other e-cigarette chemicals besides nicotine have an even bigger effect on developing nervous systems than the tobacco compound.

In the gene activity study, mice exposed to e-cigarette vapour with its nicotine removed experienced the largest number of changes, with some genes being boosted and others suppressed. Females were more affected than males.

Prof Zelikoff said: “That was really surprising. We were shocked. But what people don’t realise is that even without nicotine there are many things that are given off when you heat up and vaporise these products.”

Two major components in e-cigarettes are propylene glycol and vegetable glycerin. In addition, various flavourings may be added.

The findings were presented at the start of the American Association for the Advancement of Science (AAAS) annual conference in Washington DC, the world’s largest general science meeting.

In the first study, 30 to 40 normal pregnant mice were exposed to e-cigarette vapour from the popular “Blu” brand, with or without nicotine, or allowed to breathe ordinary air. Dose levels were “relatively low”, said the scientists.

The exposure lasted the full length of the mothers’ pregnancies, about three weeks. Four days after birth, their offspring underwent the same exposures for another three weeks.

Tissue samples from the animals’ brains were then tested for gene activity. Intelligent software was used to predict the likely effects of the patterns seen, based on the results of previous genetic research.

The second study involved around 60 three-month-old mice. Activity levels were found to be significantly higher in male and female mice that had been exposed to e-cigarette vapour, with or without nicotine. This time refillable “tank” e-cigarettes were used.

E-cigarette exposure was also associated with greater “vertical time” – how much time the mice spent rearing on two legs, which is linked to exploratory behaviour and curiosity.

The implications of this are not certain but it could indicate a propensity for risk taking, the scientists believe.

Prof Zelikoff challenged the idea that e-cigarettes played a valuable role in helping people quit tobacco.

“Many people who use e-cigarettes are dual users,” she said. “They enjoy e-cigarettes and they smoke. And e-cigarettes can be a gateway – there are concerns that adolescents are starting with e-cigarettes and going onto real cigarettes.

“It’s not straightforward. There isn’t hard evidence that e-cigarettes are working in that regard.”

Professor Adam Balen, chairman of the British Fertility Society, said: “Whilst e-cigarettes may help some people to stop smoking real cigarettes, one cannot escape the reality that various chemicals are still being inhaled that have potentially harmful effects both to health, fertility and also the non-consenting participant, that is the baby.

“It may therefore be wrong to switch during pregnancy and best to avoid all kinds of smoking.”

In the UK, a hi-tech e-cigarette called Evoke – which can communicate with smartphones – has recently been licensed as a medicine by the Medicines and Healthcare products Regulatory Agency (MHRA).

A spokesman for the agency said: “It is a product of acceptable quality and can be an effective aid to smoking cessation.

“We hope to see more e-cigarettes and next generation nicotine delivery product medicines licensing applications in the future.”

Other research by the same US team has suggested that exposure to e-cigarettes may have a harmful effect on male fertility.

In another mouse study, three to five-week-old male offspring whose mothers had been exposed to e-cigarette vapour were found to have lower concentrations of sperm. Their sperm was also significantly less active than non-exposed mice.

Secondhand smoke exposure at home among one billion children in 21 countries

Feb 11th, 2016

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Chemical That Can Irritate Lungs Found in Flavored E-Cigarettes

Jan 29th, 2016

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Highest levels seen in cherry versions, but levels still far below federal safety standards

http://consumer.healthday.com/environmental-health-information-12/chemical-health-news-730/high-levels-of-cough-linked-chemical-in-some-flavored-e-cigarettes-707522.html

People using flavored e-cigarettes, particularly ones that taste like cherry, are likely inhaling a chemical that can irritate their airways, a new study suggests.

“It might be the case that if the user of an electronic cigarette experiences some side effects, like coughing, it might be attributed to the flavorings,” since the chemical benzaldehyde was detected in 108 of the 145 flavored cigarettes tested in the study, said senior author Maciej Goniewicz. He is an assistant professor of oncology at Roswell Park Cancer Institute in Buffalo, N.Y.

Benzaldehyde is a widely used flavoring agent found in foods as well as medicines, such as cough syrup, Goniewicz said. It can taste like cherries or almonds.

“It’s safe when we eat it, or when we apply it to our skin, but inhalation is a completely different mode of exposure,” Goniewicz explained.

Benzaldehyde can irritate the airways when inhaled, and vapor from the chemical also can irritate the eyes, he said.

However, the researchers also noted that the estimated daily inhaled dose of benzaldehyde from even cherry flavored e-cigarettes was more than 1,000 times lower than the maximum workplace exposure level set by federal regulators.

And the Smoke-Free Alternatives Trade Association, an e-cigarette industry group, said in a statement that these findings prove e-cigs are a better alternative to traditional tobacco cigarettes.

“Let’s not lose sight that vaping presents substantially less risk than combustion cigarettes, which expose smokers to over 7,000 chemicals including more than 60 known or suspected carcinogens,” the statement said. “This research shows that even with cherry e-cigs, it would take three years of vaping to reach the 8-hour work shift permissible occupational exposure limit.”

But Dr. Norman Edelman, senior scientific advisor for the American Lung Association, said the study really shows the need for proper regulation of e-cigarettes.

“To me, it’s another piece of evidence that we don’t know what’s in those things,” Edelman said. “It’s terribly important that the U.S. Food and Drug Administration use its power to regulate them. The first thing they can do is find out what is in them.”

E-cigarettes work by heating a liquid solution to its boiling point, creating a vapor that users inhale. The liquid often contains nicotine, and sometimes also contains other flavorings.

Goniewicz and his colleagues measured the benzaldehyde contained in 30 puffs taken from 145 different e-cigarette liquids. In this study, they used an automatic smoke inhaler to measure the chemicals in the e-cigarettes.

The findings are published online Jan. 28 in the journal Thorax.

The researchers found benzaldehyde in three out of four e-liquid vapors tested. But the highest levels were in cherry-flavored products — likely a sign that those liquids use the cherry-tasting chemical more heavily, Goniewicz said.

Goniewicz said “vapers” should know about this and switch if a flavored e-cigarette starts causing them to cough.

“If someone is using electronic cigarettes right now and experiences some of these side effects, this study suggests that they should try a different flavoring that might be less irritating to the users,” he said.

But Goniewicz stopped short of calling on e-cigarette users to quit the devices, particularly if they are likely to take up tobacco cigarettes as an alternative.

“The evidence is really strong that the electronic cigarettes are less harmful than tobacco cigarettes,” he said.

But Edelman noted that there’s no solid scientific evidence showing that e-cigarettes help smokers quit, and that the devices instead help them maintain their nicotine addiction.

“People shouldn’t vape,” Edelman said. “If they’re trying to stop smoking, there are FDA-approved nicotine-replacement products. If e-cigs are effective at smoking cessation — and there’s no evidence of that yet — then they’re no more effective than FDA-approved products already on the market.”

Edelman added that flavorings are a way to entice young people to try e-cigarettes, which is one reason why the FDA has banned the use of flavorings other than menthol in tobacco cigarettes.

“There is a way to deal with this, and that’s for the FDA to issue regulations,” he said. “They said they were going to a year ago, and they haven’t done it yet.”

More information

For more on e-cigarettes, visit the U.S. Food and Drug Administration.

SOURCES: Maciej Goniewicz, Ph.D., PharmD, assistant professor, oncology, Roswell Park Cancer Institute, Buffalo, N.Y.; Norman Edelman, M.D., senior scientific advisor, American Lung Association; Jan. 26, 2016, statement, Smoke-Free Alternatives Trade Association; Jan. 28, 2016, Thorax, online