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Vaping may put your smile at risk

Nov 14th, 2016
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New cell study shows e-cigarette vapors damage cells of the mouth

https://www.sciencenewsforstudents.org/article/vaping-may-put-your-smile-risk

Here’s news that could put a frown on your face. New data show that electronic cigarettes pose a threat to cells in the mouth — and ultimately a vaper’s smile.

Electronic-cigarette use, or vaping, among teens is on the rise. The number of kids that tried vaping quadrupled between 2013 and 2015. In the United States, more kids now vape than smoke tobacco cigarettes. Ads on TV and the internet show e-cigarettes as being safe and fun. However, scientists have been turning up evidence that vaping is not harmless. And now researchers have found that e-cigarette vapors can pose risks to the gums and teeth.

Irfan Rahman works at the University of Rochester in New York. This biochemist studies the potential harm posed by-products and pollutants, including e-cigs. Last year, Rahman told Science News that many teens and young adults said vaping made their throats dry and scratchy. Some told his group that vaping made them cough and their mouths bleed. “We’ve got to start looking into these things and see what’s going on,” Rahman concluded.

E-cigarettes are battery-operated devices. A metal coil inside the device gets very hot. When a flavored liquid passes over these coils, it vaporizes into a gas that users breathe in. E-liquids contain mixtures of chemicals that produce different flavors. Most mixes contain some nicotine, too. (Nicotine is the addictive substance that gives cigarettes their “buzz.”) The liquids tend to be labeled as food grade, which means they are safe enough to eat. But heating these liquids can change their chemical composition. Experts say these chemical changes can make the vapors more toxic — more harmful — than the e-liquids themselves.

His team has now started to do just that.

The researchers have begun to probe what e-cig vapors do to cells of the mouth. They started by growing different types of human mouth cells in the lab. They looked at cells that make up the gums. They also looked at ligament cells that attach teeth to the gums. They exposed each type of cells to the chemicals from e-cigarette vapors.

Those vapors can alter the DNA in these cells, the scientists found. Exposing the cells to e-cig vapors damaged their DNA. DNA damage can change the genetic instructions that tell a cell how to grow and function. Over time, such changes might trigger the development of cancer. The vapors also can harm the cells by causing sustained inflammation.

Taken together, these changes point to a risk of cancer, gum disease and possibly tooth loss for anyone using e-cigarettes. Rahman’s team described its new findings in a paper published October 24 in the journal Oncotarget.

Inflammation — a chemical ‘red flag’ of danger

Mouth cells exposed to e-cigarette vapors gave off warning signals known as inflammatory markers. These markers signal that a process called inflammation is underway. Flavored e-cigs caused more of these inflammatory markers and signs of DNA damage to appear than did unflavored e-cig vapors. Because these flavor chemicals are not present in regular cigarettes, Rahman calls this finding especially worrisome. Indeed, he says, the flavored vapors may pose cellular risks that are unique to e-cigarettes.

Overall, Rahman saw lower levels of inflammation in cells treated with e-cig vapors than would be expected from treating cells with smoke from tobacco cigarettes. Still, that doesn’t mean e-cigs are safer than regular cigarettes, Rahman cautions, because researchers still don’t know what the long-term health effects of e-cig use might be.

Inflammatory markers are chemicals that “tell our bodies that something is going wrong. They send signals that these cells have been damaged,” explains Maciej Goniewicz. He’s a toxicologist at the Roswell Park Cancer Institute in Buffalo, N.Y. Like Rahman, he studies the health effects of e-cigarette vapors. Goniewicz was not involved in the new research on mouth cells.

Inflammation can be helpful. It helps turn on the body’s immune system. This allows it to fight off foreign invaders that don’t belong in the body, such as bacteria and viruses. Inflammation also can help the body heal itself after an injury.

But chronic inflammation, the type that doesn’t go away, is not good. And chronic inflammation is what Rahman and his colleagues worry might occur in a vaper’s mouth. Long-term inflammation of the gums can cause disease. Gum disease can destroy the tissue and bone that hold teeth in place. Severe gum disease even can lead to tooth loss.

The new research corroborates a study Goniewicz published earlier this fall. The bronchial (BRON-kee-ul) tubes are airways that lead to the lungs. Flavored e-cigarette vapors caused similar signs of inflammation to bronchial tube cells as Rahman’s group now reports in mouth cells. The e-cig vapors caused less damage to the bronchial cells than tobacco smoke did. Still, Goniewicz emphasizes, “We are seeing that the e-cigarettes do some harm to cells.”

Looking for the big picture

Fawad Javed is a dentist at the University of Rochester. Studying cells in the lab are important for several reasons, he says. “If somebody that smokes or vapes comes to me with oral disease, I need to understand why this is happening.” Javed worked with Rahman on the new study. Seeing changes on the chemical level can point dentists to the root cause of disease, he argues. And once that’s known, he explains, heath professionals can begin to figure out how to prevent disease.

In the lab, scientists can control and manipulate growing conditions. This allows them to scout for specific effects. Still, the scientists know there are many more things at play in the body than can be probed with dishes of cells in some laboratory. To get the full picture of what the new research means for oral health, scientists will have to combine what they learn in cell studies with data from human vapers.

Rahman and Javed have begun doing just that. They have started collecting samples from the mouths of vapers. Called gingival (JIN-jih-vul) crevicular (Kreh-VIC-u-ler) fluid, this watery substance comes from the tiny pockets between the gums and the teeth. That fluid shows evidence that vaping has caused similar inflammation in the saliva and gum fluid of e-cigarette users that Rahman’s team has seen in the cells they exposed in the lab.

But their work is far from over. More research is needed before they will know for sure what potential threats vaping poses to the mouth and gums, Rahman says.

E-cigs ‘no help to youths’

Nov 11th, 2016
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Younger smokers are more prone to the lure of e-cigarettes, a University of Hong Kong study suggests.

http://www.thestandard.com.hk/section-news.php?id=176207&story_id=47118855&d_str=20161111&sid=4

HKU researchers interviewed 469 of the 622 participants who joined the Youth Quitline between January 2014 and last April on their knowledge, attitude and practice of using e-cigarettes. About 60 percent have used e-cigarettes, with their mean age at 17.8 years.

Lam Tai-hing, chair professor of community medicine at HKU’s school of public health, said it shows younger smokers are more prone to the threat of e-cigarettes.

It was found they also have lower confidence in quitting and the nicotine dependence level was also significantly higher than for the rest of the youth smokers, which Lam said shows e-cigarettes cannot help smokers quit.

“Basically, other than nicotine, we do not know exactly what other toxic substances may be present,” Lam said, adding that e-cigarettes come in thousands of flavors and whose compositions are unknown.

He called on the government to speed up its work to bring a total ban on e-cigarettes.

Jointly established by the university and the Hong Kong Council on Smoking and Health, the scheme has helped 23.3 percent of participants kick the habit within the six-month follow-up period.

Hazardous chemicals discovered in flavored e-cigarette vapor

Nov 10th, 2016
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Building on more than 30 years of air quality research in some of the most polluted urban environments on Earth, a team of atmospheric scientists has turned their attention toward the growing e-cigarette industry and the unidentified effects of vaping on human health.

https://www.sciencedaily.com/releases/2016/11/161110085644.htm

Building on more than 30 years of air quality research in some of the most polluted urban environments on Earth, a team of atmospheric scientists at the Desert Research Institute (DRI) has turned their attention toward the growing e-cigarette industry and the unidentified effects of vaping on human health.

New research published this week in Environmental Science & Technology (ES&T), a journal of the American Chemical Society, reports that the aerosols (commonly called vapors) produced by flavored e-cigarettes liquids contain dangerous levels of hazardous chemicals known to cause cancer in humans.

The study “Flavoring compounds dominate toxic aldehyde production during e-cigarette vaping” confirms that these toxic aldehydes, such as formaldehyde, are formed not by evaporation, but rather during the chemical breakdown of the flavored e-liquid during the rapid heating process (pyrolysis) that occurs inside e-cigarettes or electronic nicotine delivery systems (ENDS).

“How these flavoring compounds in e-cigarette liquids affect the chemical composition and toxicity of the vapor that e-cigarettes produce is practically unknown,” explained Andrey Khylstov, Ph.D., an associate research professor of atmospheric sciences at DRI. “Our results show that production of toxic aldehydes is exponentially dependent on the concentration of flavoring compounds.”

E-cigarette liquids have been marketed in nearly 8,000 different flavors, according to a 2014 report from the World Health Organization. Recent reports have shown that many flavors, such as Gummy Bear, Tutti Fruitty, Bubble Gum, etc., were found to be especially appealing to adolescents and young adults.

The U.S. Food and Drug Administration (FDA) reports that 16-percent of high school and 5.3-percent of middle school students were current users of e-cigarettes in 2015, making e-cigarettes the most commonly used tobacco product among youth for the second consecutive year. In 2014, 12.6-percent of U.S. adults had ever tried an e-cigarette, and about 3.7-percent of adults used e-cigarettes daily or some days.

Khylstov and his colleagues measured concentrations of 12 aldehydes in aerosols produced by three common e-cigarette devices. To determine whether the flavoring additives affected aldehyde production during vaping, five flavored e-liquids were tested in each device. In addition, two unflavored e-liquids were also tested.

“To determine the specific role of the flavoring compounds we fixed all important parameters that could affect aldehyde production and varied only the type and concentration of flavors,” explained Vera Samburova, Ph.D., an assistant research professor of chemistry at DRI.

Samburova added that the devices used in the study represented three of the most common types of e-cigarettes — bottom and top coil clearomizers, and a cartomizer.

The study avoided any variation in puff topography (e.g., puff volume, puff velocity, interval between puffs) by utilizing a controlled sampling system that simulated the most common vaping conditions. E-cigarette vapor was produced from each device by a four-second, 40-ml controlled puff, with 30-second resting periods between puffs. The e-cigarette devices were manually operated to replicate real-life conditions and all samples were collected in triplicate to verify and confirm results. Specific care was taken to avoid “dry puff” conditions.

To provide further proof that the flavoring compounds, not the carrier e-liquid solvents (most commonly propylene glycol and/or vegetable glycerin) dominated production of aldehydes during vaping, the authors performed a series of experiments in which a test flavored e-liquid was diluted with different amounts of the unflavored e-liquid. Liquids with higher flavor content produced larger amounts of aldehydes due to pyrolysis of the flavoring compounds.

In all experiments, the amount of aldehydes produced by the flavored e-cigarette liquids exceeded the American Conference of Governmental Industrial Hygienists Threshold Limit Values (TLVs) for hazardous chemical exposure.

“One puff of any of the flavored e-liquids that we tested exposes the smoker to unacceptably dangerous levels of these aldehydes, most of which originates from thermal decomposition of the flavoring compounds,” said Khylstov. “These results demonstrate the need for further, thorough investigations of the effects of flavoring additives on the formation of aldehydes and other toxic compounds in e-cigarette vapors.”

HKU researchers call for total ban on e-cigarettes

Nov 10th, 2016
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http://news.rthk.hk/rthk/en/component/k2/1295926-20161110.htm

Researchers at the University of Hong Kong called for a total ban on the sale of electronic or e-cigarettes on Thursday, warning that they pose a very dangerous health risk, and may entice young children to start smoking.

They interviewed 469 smokers under 25 who had called the university’s smoking cessation hotline, and found children as young as 12 had tried e-cigarettes.

The researchers said e-cigarettes “tend to attract young people much more than adults, and there is actually strong evidence – not from Hong Kong yet, but from other countries – that many non-smoking young people started with e-cigarettes before becoming regular conventional cigarette smokers”.

Just ONE puff of flavoured e-cigarette vapour ‘contains dangerous levels of cancer-causing chemicals’

Nov 10th, 2016
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Flavoured liquids used in the devices exposes smokers to “unacceptably high” levels of aldehydes, produced when a compound decomposes

https://www.thesun.co.uk/living/2156130/just-one-puff-of-flavoured-e-cigarette-vapour-contains-dangerous-levels-of-cancer-causing-chemicals/

JUST one drag of a flavoured e-cigarette exposes a smoker to “unacceptably high” levels of cancer-causing chemicals, experts warned today.

They found aerosols – commonly called vapours – produced by the devices contain the dangerous substances.

These toxic aldehydes, including formaldehyde, are produced during the chemical breakdown of the flavoured e-liquid during the rapid heating process that happens inside e-cigs.

Dr Andrey Khylstov, of the Desert Research Institute, Las Vegas, said: “One puff of any of the flavoured e-liquids that we tested exposes the smoker to unacceptably dangerous levels of these aldehydes, most of which originates from thermal decomposition of the flavouring compounds.”

His team found the production of toxic aldehydes “is exponentially dependent on the concentration of flavouring compounds”.

E-cigarette liquids are marketed in nearly 8,000 different flavours, according to a 2014 report by the World Health Organisation.

Recent reports show many of these flavours, such as Gummy Bear, Tutti Fruity, and Bubble Gum, to name a few, are especially appealing to teens and kids – encouraging them to use the devices.

Around 2.8million adults use the devices in the UK and a 2014 study revealed more kids aged 11 to 15 experimented with e-cigs than traditional cigarettes.

In the US, 16 per cent of high school students regularly vape – making them the most commonly used tobacco product in teenagers.

To examine the dangers, Dr Khylstov and his team measured the levels of aldehydes in vapour produced by three common e-cigs.

To determine if flavourings were to blame for producing the cancer-causing chemicals, the researchers tested five flavoured liquids, as well as two control unflavoured liquids.

Researcher Dr Vera Samburov explained: “To determine the specific role of the flavouring compounds we fixed all important parameters that could affect aldehyde production and varied only the type and concentration of flavours.”

She said the devices used in the experiments were three of the most common types of e-cig.

Using a controlled system, the researchers were able to ensure the same level of “puff” each time, simulating common vaping conditions.

All tests revealed the level of cancer-causing chemicals produced by flavoured e-liquids exceeded limits set by American authorities, designed to protect against hazardous chemical exposure.

Dr Khylstov added: “These results demonstrate the need for further, thorough investigations of the effects of flavouring additives on the formation of aldehydes and other toxic compounds in e-cigarette vapours.”

The findings are published in the journal Environmental Science and Technology.

Vaping raises likelihood of teenagers starting to smoke, study suggests

Nov 8th, 2016
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Research based on teenagers in California tentatively proposes link but experts say it does not prove that one leads to the other

https://www.theguardian.com/society/2016/nov/08/vaping-raises-likelihood-teenagers-smoke-cigarettes-study-suggests

A study of teenagers in California has tentatively suggested a link between vaping and starting to smoke cigarettes, although experts say it does not prove that one leads to the other.

About 37% of teens in the US have tried vaping, and there is widespread anxiety that young people who use e-cigarettes may be more likely to start smoking as a result.

The study, published in the Journal of the American Medical Association (JAMA), looked at vaping and smoking in more than 3,000 teenagers, aged about 15, in the 10th grade of 10 public high schools in Los Angeles county, California.

The numbers who vaped or smoked at all were small – only 26 who had never smoked at the beginning of the study said at the end of the follow-up period, six months later, that they had used e-cigarettes and also smoked in the previous month. Others had previously smoked infrequently or frequently.

But the researchers did find a trend. The more the teenagers said they had vaped, the more likely they were to smoke cigarettes. The more frequent vapers were also likely to smoke more heavily.

The public health community is divided over the pros and cons of e-cigarettes. Some doctors believe they may be the best tool yet for helping established smokers quit the habit, but others are less convinced and warn they could be a means of hooking non-smokers into a tobacco habit.

The authors of the study – Adam Leventhal, of the University of Southern California Keck School of Medicine, and colleagues – acknowledge there are many unknowns but conclude that: “The transition from vaping to smoking may warrant particular attention in tobacco control policy.”

Why can’t scientists agree on e-cigarettes?

Other experts said although the study was well conducted, it could not explain the link. “This study could not tell us if it is something about the young people that vape that predisposes them to smoking or that vaping itself makes smoking more likely,” said Paul Aveyard, professor of behavioural medicine at the University of Oxford. It was well known that teenagers who tried one risky behaviour were more likely to be willing to try another.

“Smoking in young people has fallen in the UK and the US to record lows in the past few years, despite the rise in prevalence of young people experimenting with e-cigarettes,” he said.

“Very few young people who do not smoke cigarettes become regular users of e-cigarettes. In this context, we should not worry unduly about this study’s findings, but it is important to monitor smoking in young people and its relationship with e-cigarette use.”

Prof John Britton, director of the UK centre for tobacco and alcohol studies at the University of Nottingham, said the study “doesn’t tell us whether vaping caused these young people to start smoking, or whether they would have started smoking anyway; or whether vaping prevented some young people who would otherwise have become smokers from progressing to tobacco smoking.”

Children whose parents were smokers and trying to give up would be more likely to have access to e-cigarettes – and also more at risk of starting to smoke in the first place.

“The key question is whether vaping is increasing smoking uptake, over and above that underlying risk,” said Britton. “This study doesn’t answer that question; but it does show that if it does, the proportions of children affected are very small.”

Association of e-Cigarette Vaping and Progression to Heavier Patterns of Cigarette Smoking

Nov 8th, 2016
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http://jamanetwork.com/journals/jama/article-abstract/2579858

E-cigarette vaping is reported by 37% of US 10th-grade adolescents1 and is associated with subsequent initiation of combustible cigarette smoking.2 Whether individuals who vape and transition to combustible cigarettes are experimenting or progress to more frequent and heavy smoking is unknown. In addition, because some adolescents use e-cigarettes as a smoking cessation aid,3 adolescent smokers who vape could be more likely to reduce their smoking levels over time. Therefore, associations of vaping with subsequent smoking frequency and heaviness pattern among adolescents were examined.

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New evidence e-cigarettes are gateway to tobacco

Nov 7th, 2016
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http://6abc.com/health/new-evidence-e-cigarettes-are-gateway-to-tobacco/1594753/

There’s more evidence that electronic cigarettes may be enticing teens to try the tobacco ones.

A nationwide survey of teens who never smoked shows that nearly 60 per cent who tried the flavored electronic ones intend to start smoking tobacco.

And the majority of e-cigarette users started out with sweet, candy-like flavors.

“Due to a proliferation of e-cigarette flavors on the market, flavored e-cigarette use among youth in the U.S. has increased significantly,” study author Hongying Dai said.

The number of teens who use e-cigarette devices to “vape” has nearly quadrupled since 2013.

Flavored e-cigarettes aren’t prohibited in the United States.

Although the F-D-A has imposed new rules on electronic cigarettes, it doesn’t have legal authority to regulate the flavors.

Nearly 500 brand with more than 7-thousand flavors are currently on the market.

Dai’s team looked at the nearly 16,500 teens answering the survey who had never smoked cigarettes but used e-cigarettes.

The researchers also looked at more than 1,300 current smokers and assessed if they intended to quit. Finally, the investigators looked at nearly 21,500 teens to assess their perception of the dangers of tobacco.

The study found that just over 2,000 teens said they had used e-cigarettes in the last 30 days.

Among current tobacco smokers, 68 percent of those who also “vaped” said they had used flavored e-cigarettes.

Electronic-cigarette Use and Respiratory Symptoms in Adolescents

Nov 2nd, 2016
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Dr. Rob McConnell; Ms. Jessica L Barrington-Trimis; Ms. Kejia Wang; Mr. Robert Urman; Dr. Hanna Hong; Ms. Jennifer Unger; Dr. Jonathan Samet; Mr. Adam Leventhal; Dr. Kiros Berhane;

http://www.atsjournals.org/doi/abs/10.1164/rccm.201604-0804OC

Background: Rates of adolescent electronic (e-) cigarette use are increasing, but there has been little study of the chronic effects of use. Components of e-cigarette aerosol have known pulmonary toxicity.

Methods: Associations of self-reported use of e-cigarettes with chronic bronchitic symptoms (chronic cough, phlegm or bronchitis) and of wheeze in the previous 12 months were examined in 2086 Southern California Children’s Health Study participants completing questionnaires in 11th and 12th grade in 2014.

Results: Ever e-cigarette use was reported by 502 (24.0%), of whom 201 (9.6%) used e-cigarettes during the last 30 days (current users). Risk of bronchitic symptoms was increased by almost two-fold among past users (odds ratio (OR) 1.85 [95% confidence interval (CI) 1.37,2.49]), compared to never users, and by 2.02-fold (95%CI 1.42,2.88) among current users. Risk increased with frequency of current use (OR 1.66 (95%CI 1.02,2.68) for 1-2 days and 2.52 (95%CI 1.56,4.08) for 3 or more days in past 30 days) compared with never users. Associations were attenuated by adjustment for lifetime number of cigarettes smoked and secondhand smoke exposure. However, risk of bronchitic symptoms among past e-cigarette users remained elevated after adjustment for relevant potential confounders, and was also observed among never cigarette users (OR 1.70 [95%CI 1.11,2.59]). There were no statistically significant associations of e-cigarette use with wheeze after adjustment for cigarette use.

Conclusions: Adolescent e-cigarette users had increased rates of chronic bronchitic symptoms. Further investigation is needed to determine the long-term effects of e-cigarettes on respiratory health.

Flavoring Compounds Dominate Toxic Aldehyde Production during E‑Cigarette Vaping

Oct 27th, 2016
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