Japan to investigate e-cigarette safety after formaldehyde findings

[Aepsilons]

Japanese officials will evaluate the possible impact on health of smoking e-cigarettes after researchers found that devices bought in Japan contain up to 10 times more formaldehyde - a cancer-causing substance - than conventional cigarettes.

The findings, announced this week, have re-ignited the debate over whether e-cigarettes are a risk-free alternative to tobacco smoking, as more young people take up the vaping habit.

Researchers at Japan’s National Institute for Public Health said they had found two carcinogens - formaldehyde and acetaldehyde – in vapour produced by several types of e-cigarettes during a study commissioned by the country’s health ministry.

One brand of e-cigarette produced 10 times more formaldehyde – a substance used in embalming that has also been linked to sick building syndrome – than a regular cigarette, said Naoki Kunugita, who led the research.

“Especially when the wire (which vapourises the liquid) gets overheated, higher amounts of those harmful substances seemed to be produced,” he told AFP. He added: “We need to be aware that some makers are selling such products for dual use (with tobacco) or as a gateway for young people [to start smoking].”

The experts analysed several cartridges of e-cigarette fluid using a machine that “inhaled” 10 sets of 15 puffs. One new brand of e-cigarette, whose name has not been made public, showed a more than 10-fold increase in formaldehyde levels in nine out of every 10 sets. The device produced 1,600 micrograms of formaldehyde per 15 puffs.

Health ministry officials acknowledged that the elevated formaldehyde levels found in a single brand of e-cigarette was not proof in itself that vaping posed an increased cancer risk.

“The most important finding is that the vapour contained recognised carcinogens,” Hiroyuki Noda, of the health ministry’s tobacco-free initiative, told the Guardian. “Our panel of experts will now look into what possible effects those substances could have on the health of e-cigarette users.”

Some experts said the findings offered no proof that e-cigarettes could harm papers’ health.

Writing on the e-cigarette research website, the Greek cardiologist Konstantinos Farsalinos said the offending device tested by Kunugita was “a single extreme case out of the many products he tested,” adding that the high formaldehyde reading may have been caused by several factors, including a faulty e-cigarette.

“Obviously, we have to realise that focusing the discussion on one of the tens of carcinogens present in tobacco cigarette smoke is misleading,” Farsalinos said.

“Even if e-cigarettes contained similar, or higher, levels of formaldehyde, they do not contain the majority of other toxic and carcinogenic substances present in cigarette smoke. Overall, any residual risk from e-cigarette use is orders of magnitude lower than smoking. This is exactly what smokers need (and deserve) to know.”

Kunugita said officials would evaluate vaping’s possible impact on health before discussing whether or not to regulate the sale and use of e-cigarettes in Japan.

Vaping is quickly gaining popularity in Japan, where cigarette smoking is still tolerated in many enclosed and public spaces, even though the smoking rate among adults is at an all-time low. Like many other countries, Japan does not regulate e-cigarettes, but they have yet to become widely available in shops. Most Japanese users order e-cigarettes and flavoured liquids online.

Until recently, e-cigarettes were hailed around the world as a safer alternative to smoking, and have been credited with helping tobacco smokers quit their old habit.

The number of young people in the US who have tried e-cigarettes tripled from 2011 to 2013, the US Centers for Disease Control and Prevention said, adding that more than a quarter of a million young people who had never smoked a cigarette used e-cigarettes last year.

In August, the World Health Organisation called on governments to ban the sale of e-cigarettes to minors, warning that they posed a serious threat to the health of children and unborn babies. Authorities in the Australian state of Queensland, meanwhile, have announced restrictions on the sale and advertising of e-cigarettes from next January.

But some health professionals have criticised attempts to restrict the availability of e-cigarettes, citing evidence that they are an effective smoking cessation aid.

Writing in the British Journal of General Practice, Prof Robert West and Dr Jamie Brown from University College London said that for every million smokers who switch from tobacco to e-cigarettes, more than 6,000 premature deaths would be prevented in the UK every year.

If all 9 million smokers took up e-cigarettes instead, 54,000 lives could be saved, they said.

 

[SvenSvensonov]

Japanese officials will evaluate the possible impact on health of smoking e-cigarettes after researchers found that devices bought in Japan contain up to 10 times more formaldehyde - a cancer-causing substance - than conventional cigarettes.

The findings, announced this week, have re-ignited the debate over whether e-cigarettes are a risk-free alternative to tobacco smoking, as more young people take up the vaping habit.

Researchers at Japan’s National Institute for Public Health said they had found two carcinogens - formaldehyde and acetaldehyde – in vapour produced by several types of e-cigarettes during a study commissioned by the country’s health ministry.

One brand of e-cigarette produced 10 times more formaldehyde – a substance used in embalming that has also been linked to sick building syndrome – than a regular cigarette, said Naoki Kunugita, who led the research.

“Especially when the wire (which vapourises the liquid) gets overheated, higher amounts of those harmful substances seemed to be produced,” he told AFP. He added: “We need to be aware that some makers are selling such products for dual use (with tobacco) or as a gateway for young people [to start smoking].”

The experts analysed several cartridges of e-cigarette fluid using a machine that “inhaled” 10 sets of 15 puffs. One new brand of e-cigarette, whose name has not been made public, showed a more than 10-fold increase in formaldehyde levels in nine out of every 10 sets. The device produced 1,600 micrograms of formaldehyde per 15 puffs.

Health ministry officials acknowledged that the elevated formaldehyde levels found in a single brand of e-cigarette was not proof in itself that vaping posed an increased cancer risk.

“The most important finding is that the vapour contained recognised carcinogens,” Hiroyuki Noda, of the health ministry’s tobacco-free initiative, told the Guardian. “Our panel of experts will now look into what possible effects those substances could have on the health of e-cigarette users.”

Some experts said the findings offered no proof that e-cigarettes could harm papers’ health.

Writing on the e-cigarette research website, the Greek cardiologist Konstantinos Farsalinos said the offending device tested by Kunugita was “a single extreme case out of the many products he tested,” adding that the high formaldehyde reading may have been caused by several factors, including a faulty e-cigarette.

“Obviously, we have to realise that focusing the discussion on one of the tens of carcinogens present in tobacco cigarette smoke is misleading,” Farsalinos said.

“Even if e-cigarettes contained similar, or higher, levels of formaldehyde, they do not contain the majority of other toxic and carcinogenic substances present in cigarette smoke. Overall, any residual risk from e-cigarette use is orders of magnitude lower than smoking. This is exactly what smokers need (and deserve) to know.”

Kunugita said officials would evaluate vaping’s possible impact on health before discussing whether or not to regulate the sale and use of e-cigarettes in Japan.

Vaping is quickly gaining popularity in Japan, where cigarette smoking is still tolerated in many enclosed and public spaces, even though the smoking rate among adults is at an all-time low. Like many other countries, Japan does not regulate e-cigarettes, but they have yet to become widely available in shops. Most Japanese users order e-cigarettes and flavoured liquids online.

Until recently, e-cigarettes were hailed around the world as a safer alternative to smoking, and have been credited with helping tobacco smokers quit their old habit.

The number of young people in the US who have tried e-cigarettes tripled from 2011 to 2013, the US Centers for Disease Control and Prevention said, adding that more than a quarter of a million young people who had never smoked a cigarette used e-cigarettes last year.

In August, the World Health Organisation called on governments to ban the sale of e-cigarettes to minors, warning that they posed a serious threat to the health of children and unborn babies. Authorities in the Australian state of Queensland, meanwhile, have announced restrictions on the sale and advertising of e-cigarettes from next January.

But some health professionals have criticised attempts to restrict the availability of e-cigarettes, citing evidence that they are an effective smoking cessation aid.

Writing in the British Journal of General Practice, Prof Robert West and Dr Jamie Brown from University College London said that for every million smokers who switch from tobacco to e-cigarettes, more than 6,000 premature deaths would be prevented in the UK every year.

If all 9 million smokers took up e-cigarettes instead, 54,000 lives could be saved, they said.

Not a surprising finding, though the jury is still out on the over-all health effects of E-cigs. Once again, and since it hasn't failed me yet, Gizmodo has an interesting article on the dangers of E-cigs.

Why E-Cigarettes Might Not Be as Safe as You Think

It's little wonder why e-cigarettes' popularity has exploded into a $2 billion industry over the last few years; the promise of safe, harmless nicotine delivery without all the carcinogenic byproducts of looseleaf combustion is a hard offer to pass up. But are these devices and the nicotinated fluids they atomize really that safe? Stephen Dorf says so. Science, on the other hand, says it's complicated.

E-cigarettes are quite the media darling these days—despite the banishment of conventional smokers in television spots since the 1970s—appearing in everything from Super Bowl ads to the hands of late-night talk show guests. The CDC found that e-cig usage jumped from around 10 percent in 2010 to more than 21 percent in 2011 among adults who already smoked conventional cigarettes. Similarly, 10 percent of American high school seniors reported experimenting with e-cigarettes over the same period.

What exactly is an e-cigarette? US patent application No. 8,490,628 B2 defines an e-cigarette as "an electronic atomization cigarette that functions as substitutes [sic] for quitting smoking and cigarette substitutes." They were first invented in 2002 by a Chinese pharmacist as smoking cessation devices, and China remains the primary manufacturer of e-cigarettes globally today. The devices atomize a nicotinated propylene glycol solution, known as e-liquid, that may be doctored with additional additives, such as flavorings and colorings or variable nicotine concentrations. They can also be modified to vaporize cannabis derived products.

Smoke and Mirrors


Much of the e-cigarette's meteoric rise has been thanks to aggressive marketing campaigns by their manufacturers, touting the health "benefits" of vaping over smoking. A 2014 survey conducted by a team of researchers from the Center for Tobacco Control Research and Education at UC San Francisco looked at nearly 60 e-cigarette manufacturers websites and found that more than 90 percent of them cited e-cigs as healthier, cheaper, and cleaner than conventional cigarettes, 76 percent of them said that e-cigs do not produce secondhand smoke, and a quarter of them even used paid doctor endorsements to drive home those points—suggesting that some e-cig companies are only paying lip service to the FDA's stringent requirements about labeling.

What these websites fail to mention is that e-cigarettes also deliver a fraction of the nicotine that cigarettes do—roughly 20 percent (between 0 and 35 μg of nicotine per puff) of what a regular cigarette delivers. Which means the average vaper is more likely to be huffing on these devices longer and more often than conventional cigarettes. Or simply augmenting their current cigarette regimen with e-cigs (you know, for crowded bars and restaurants where smoking a real cigarette would get you thrown out for douchebaggery). It's the so-called "dual use effect."

"The e-cigarettes are rapidly penetrating the market, especially with kids. they're being heavily promoted largely by the cigarette companies that have purchased e-cigarette companies as a way to quit smoking, a way that's safe and doesn't pollute the air," Dr. Stanton Glantz, director of the Center for Tobacco Control Research and Education at UCSF, told me. "What the evidence to date shows is that while a puff on an e-cigarette isn't as dangerous as a puff on a regular cigarette, the main effect they seem to be having is to keep people smoking cigarettes," thanks again to the dual use effect. Sneaky, sneaky.

"You don't know what that is doing to your lungs," Ray Casciari, director of the thoracic oncology program and the chief medical officer at the OC's St. Joseph Hospital, told Forbes. "My experience over the past 35 years is that anything you put in the lungs has a chance of causing either lung damage or irritation."

Another recent practical study, published this year in the journal Reproductive Toxicology,similarly found that the vapors can damage the developing lungs of America's youth:

Bahl et al screened 41 e-cigarette refill fluids from 4 companies for cytotoxicity using 3 cell types: human pulmonary fibroblasts, human embryonic stem cells, and mouse neural stem cells. Cytotoxicity varied among products from highly toxic to low or no cytotoxicity.

The authors determined that nicotine did not cause cytotoxicity, that some products were noncytotoxic to pulmonary fibroblasts but cytotoxic to both types of stem cells, and that cytotoxicity was related to the concentration and number of flavorings used. The finding that the stem cells are more sensitive than the differentiated adult pulmonary fibroblasts cells suggests that adult lungs are probably not the most sensitive system to assess the effects of exposure to e-cigarette aerosol. These findings also raise concerns about pregnant women who use e-cigarettes or exposed to secondhand e-cigarette aerosol.

What's Really In Your Cig?

Another recent study published in the journal Toxicology and Applied Pharmacology showed that e-cigarette performance was virtually identical to that of regular cigarettes in terms of exhaled nitric oxide rates.

Nitric oxides cause the smooth muscles in the lungs and heart to relax, which can lead to reduced lung function and increased risk of heart attack. The more NO your body retains, the worse it is for you. And bear in mind, these are studies conducted using the products of top-shelf manufacturers. There's an entire other issue with harmful additives used by less scrupulous offshore firms that we're not even getting into.

What we do know is in e-cigs is not reassuring. Multiple studies have found chemicals like acetaldehyde, formaldehyde, and toluene, as well as heavy metals like cadmium, nickel, and lead, in both first and second-hand vapor. Again, these were present in concentrations a magnitude lower than conventional cigarettes but at high enough levels that they could arguably fall under California's Proposition 65 rules for mandatory labeling of their carcinogenic nature.

A recent meta-study by Dr. Priscilla Callahan-Lyon of the FDA's Center for Tobacco Products examining data from 18 previous studies on e-cig vapor found that most contained at least trace amounts of the solvents used to dissolve the nicotine and flavorings. These solvents are potent lung irritants and, upon heating, can be converted to carcinogenic compounds known as carboxyls.

What's more, since the first generation of e-cigs didn't produce the same nicotine kick that regular smoking did, manufacturers began incorporating voltage controls allowing users to up the power and increase the device's operating temperature—thereby increasing not just the rate of nicotine vaporization but that of carboxyl vaporization as well. According to Maciej Goniewicz of the Roswell Park Cancer Institute in Buffalo, using a current generation variable voltage vape on maximum can produce the same amount of formaldehyde as a regular cigarette. That's not good.

What's more, the atomization process generates ultrafine particles—which can instigate the same effects seen in tobacco smoke or industrial air pollution. A 2007 study published inEnvironmental Health Perspectives found that the size and chemical composition of these particles can vary greatly between products. This variability has a big effect on their individual cytotoxicities, but the study did conclude that their presence in the air has a similar effect to tobacco smoke in terms of your pulmonary health. Altogether, between 20 and 27 percent of e-cigarette vapor's ultrafine particles make their way into the circulatory system, compared to 25 to 35 percent for regular cigarettes. A recent report from Science News points out that these nanoparticles can trigger inflammation in the mucus membrane and have been linked to chronic diseases like asthma, stroke, heart disease, and diabetes.

We're In Unknown Territory

Even the supposedly inert chemical substrate of e-liquid, propylene glycol, can have some pretty nasty effects on your body when heated and inhaled. Propylene glycol (PG) is a ubiquitous synthetic liquid added to a variety of foods, cosmetics, and medicines as a humidifying agent. For these functions, the FDA has rated PG as GRAS, or Generally Recognized As Safe, the agency's general seal of approval basically.

However, none of those functions involve madly huffing hot PG into your lungs. "We have little information about what happens to propylene glycol in the air," the federal Agency for Toxic Substances and Disease Registry website declares.

We do know that habitual inhalation of aerosolized PG in industrial settings can lead to issues with the central nervous system, personality and behavior changes, and reduced spleen function. In fact, the Dow Chemical Company states that "inhalation exposure to [propylene glycol] mists should be avoided," and the American Chemistry Council has repeatedly issued warnings about inhaling theater fog as it may contribute to eye and respiratory infections.

"Propylene Glycol is a pulmonary irritant—it's used for theater fog," Glantz told me. "And if you look on the product packaging, there's a warning on there to avoid prolonged exposure. And there you're not even breathing it in hot."

Even better, when heated above a certain temperature, PG will convert to propylene oxide—a class 2B carcinogen as rated by the International Agency for Research.

We need More Data

In response to the potential health threats that these devices may instigate, the FDA has begun asking for more research into their effects on pulmonary health. And despite the FDA's rumblings about more strictly regulating the e-cig market, scientists simply haven't had time understand the long-term effects of vaping on human physiology or its effectiveness as a cessation device. "Some evidence suggests that e-cigarette use may facilitate smoking cessation, but definitive data are lacking," Callahan-Lyon recently wrote.

"Certainly, as the cigarette companies take over the e-cigarette market, there's no incentive for them to promote e-cigarettes as an alternative to regular cigarettes because the tobacco companies make a lot more money off of cigarettes," Glantz explained. $83 billion dollars more annually to be precise, and that's just in America. "The federal government and the FDA have to date been extremely flaccid in trying to deal with e-cigarettes," Glantz told me.

The solution is fairly simple, Glantz continued, only requiring more robust market regulation:

The first and, I think, most important thing to do is that e-cigarettes be included in existing clean indoor air laws which many, many cities are already doing. I believe there are already 150 to 200 cities around the country that have already done this including major cities like New York, Los Angeles, Chicago, and San Francisco.

Getting rid of the "smoke anywhere" claim and also protecting bystanders from breathing second-hand vapor, I think is very important. E-cigarettes should be subject to the exact same marketing restrictions as conventional cigarettes are—we shouldn't have them being advertised on television or the radio. The same kind of licensing requirements places have for selling cigarettes should be applied to stores selling e-cigarettes. And they should be prohibited from making these unsubstantiated claims that e-cigarettes are good for helping people quit smoking or that they are emitting only harmless water vapor.

So in the end, we still have more questions than answers when it comes to the long-term health effects of e-cigarettes. Sure, they're safer than conventional cigarettes—existing research bears that out—but they are far from truly "safe." They are not "harmless," and they do not generate "pure water vapor," or whatever Dorf was rambling on about. At the same time, there's an argument to be made that by even minimally reducing the harm caused by cigarettes is a positive thing.

Either way, the fact remains that e-cigs are synthetic chemical cocktails that we know precious little about. So maybe think twice before absentmindedly puffing away.


Why E-Cigarettes Might Not Be as Safe as You Think