Do E-Cigarettes Lead to Popcorn Lungs?
A Harvard study claiming most e-cigarette brands expose users to harmful chemicals omits critical information and exaggerates the risks of flavored e-cigarettes, according to tobacco control experts.
The study, published in the journal Environmental Health Perspectives, analyzes a host of e-liquid flavors to discover levels of potentially dangerous chemicals diacetyl, acetyl propionyl, and acetoin.
The researchers found one or more of the three chemicals in 92 percent of the 51 unique flavors of e-liquid. Diacetyl is identified in 39 of 51 flavors – 75 percent of the total.
Following the study, an array of media outlets focused on the presence of diacetyl, a chemical used for food flavoring that if inhaled in large amounts can lead to a severe respiratory disease – bronchiolitis obliterans.
Bronchiolitis obliterans is commonly known as “popcorn lung,” because it was identified in workers who inhaled the artificial butter flavor used to make microwavable popcorn. A number of cases of popcorn lung have been found to be so severe in some patients that they have required a full-blown lung transplant.
The Harvard study whipped up a storm of hyperbolic headlines including “Harvard study finds that E-cigarette flavors cause lung disease” and “Chemicals in Flavored E-Cigarettes Tied To ‘Popcorn Lung’ Disease.”
But the headlines may be shielding the truth about the potential risk of popcorn lung from using e-cigarettes. Dr. Konstantinos Farsalinos, an expert on e-cigarette research and an opponent of putting diacetyl in e-liquids, writes, “tobacco cigarette smoke contains high levels of diacetyl and acetyl propionyl, on average 100 and 10 times higher,” compared to average e-cigarette exposure.
Farsalinos draws the disparity between tobacco and e-cigarettes from research conducted by himself and colleagues published in the journal Nicotine and Tobacco Research in 2014.
Not only are levels of diacetyl far higher in tobacco smoke than e-cig vapor, but the levels of dangerous compounds found in many of the products studied “are absolutely minimal, and it is not expected to raise any concerns about human health effects,” according to Farsalinos.
Farsalinos adds that the researchers fail to mention the presence of these compounds in tobacco cigarette smoke. “This omission creates the impression that e-cigarettes are exposing users to a new chemical hazard while in reality their exposure will be much lower compared to smoking.” He concludes that the study is guilty of “creating false impressions and exaggerates the potential risk from diacetyl and acetyl propionyl exposure through e-cigarettes.”
But even more concerning for those who may want to exaggerate the risks of using e-cigarettes, is that even tobacco smoke has no identifiable link with any cases of popcorn lung.
According to Critical Reviews in Toxicology, “smoking has not been shown to be a risk factor for bronchiolitis (popcorn lung).“
Since tobacco smoke contains far higher levels of diacetyl than flavored e-cigarettes and there has not been a single confirmed case of a smoker contracting popcorn lung, the likelihood that vapers will contract this particular lung disease is minimal, to say the least.
Bill Godshall, executive director of Smokefree Pennsylvania and a long-time anti-smoking activist, is even more damning in his criticism of the Harvard study.
“This is yet another Department of Health and Human Services-funded study that is intended to deceive and scare the public about vaping to lobby for Food and Drug Administration’s deeming ban.
“While finding zero evidence of ‘Popcorn Lung,’ the authors are trying to create a public panic,” Godshall tells The Daily Caller News Foundation. Pro-vaping groups are also quick to point out that few people have claimed e-cigarettes are completely free of any health risk.
Greg Conley, president of the American Vaping Association tells TheDCNF, “in the debate over vaping, the concept of relative risk should not be ignored. Vapor products are a far safer alternative to smoking, but it has long been recognized that they are not 100 percent safe.
“Earlier this year, a dozen public health groups endorsed Public Health England’s briefing estimating vaping to be approximately 95 percent less hazardous than smoking. Their assessment left room for some unknown risk from ingredients like flavorings.”
Are E-Cigarettes Safer Alternative for Smoking?
Vaping is safer than smoking and could lead to the demise of the traditional cigarette, Public Health England (PHE) has said in the first official recognition that e-cigarettes are less damaging to health than smoking tobacco. The health body concluded that, on “the best estimate so far”, e-cigarettes are about 95% less harmful than tobacco cigarettes and could one day be dispensed as a licensed medicine in an alternative to anti-smoking products such as patches.
While stressing that e-cigarettes are not free from risk, PHE now believes that e-cigarettes “have the potential to make a significant contribution to the endgame for tobacco”.
The authors of the report also found that regular users of e-cigarettes are almost exclusively adults who are already smokers. In fact, the rate of youths and adults who smoke cigarettes has continued to decline in England, and there is no current evidence that e-cigarettes are "renormalizing smoking or increasing smoking uptake," they write.
In addition, there is no evidence that e-cigarettes are a "gateway" to tobacco products for teens and young adults. Despite some experimentation among never smokers, e-cigarettes are attracting very few people who have never smoked, the authors, led by Ann McNeill, PhD, professor of tobacco addiction at the National Addiction Centre, King's College, and Peter Hajek, PhD, CClinPsych, director of the tobacco dependence research unit at the Wolfson Institute of Preventive Medicine in London, United Kingdom.
Additional E-Cigarettes Benefit over Regular Cigarettes
Since you are “burning” tobacco, not to mention using an open flame to light it, traditional cigarettes by default pose serious fire hazards. Cigarettes are in fact the #1 cause of fire-related death in the United States and seven other countries. Worldwide, fires started by lit cigarettes constitute 10% of all fire-related deaths.
With e-cigarettes, you are not burning an open flame and do not have a hot cherry that can burn you, your clothes, your furniture, and so on.
There was an incident where an e-cigarette exploded in the user’s face in early 2012. It was determined though that the particular unit the person was using was a “mod,” which is a way vapers can alter their devices for more power that involves stacking the batteries. When used as intended, there have been no reports of an e-cigarette exploding.
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