E-cigarette News

A new study conducted by researchers from the University of California at San Diego found yet another health risk associated with smoking e-cigarettes. 

According to their findings, consumers who vape are increasingly more susceptible to a condition known as leaky gut. This happens when holes have developed in the gut lining that bacteria can leak through, which can ultimately cause inflammation throughout the entire body. 

“This is the first study that demonstrates how chronic exposure to e-cigarettes increases the gut’s susceptibility to bacterial infections, leading to chronic inflammation, and other health concerns,” said researcher Soumita Das, PhD. “Given the importance of the gut barrier in the maintenance of the body’s immune homeostasis, the findings provide valuable insight into the potential long-term harmful effects chronic use of e-cigarettes [has] on our health.” 

Risks to gut health

To better understand how gut health is impacted by e-cigarettes, the researchers created 3D models of the human intestinal system using stem cells. They then used the models to mimic the process of smoking an e-cigarette and analyzed the effects of smoking on the models’ gut reaction. 

The researchers found that chemical additives used in e-cigarettes -- specifically propylene glycol and vegetable glycerol -- are responsible for damage to the intestines. Ultimately, these chemicals damage the gut’s protective barrier, which is what initiates gut inflammation. 

While this is concerning for overall gut health, the researchers explained that it can also have greater complications for consumers’ immune systems. Once these chemicals break through the intestines, they have direct access to the immune system, which can make consumers more susceptible to infections. 

“The safety of e-cigarettes has been debated fiercely on both sides,” said researcher Dr. Pradipta Ghosh. “Nicotine content, and its addictive nature, has always been the major focus of those who argue against its safety, whereas lack of chemicals in the carcinogens that are present in the cigarette smoke has been touted by the makers of e-cigarettes when marketing these products as a ‘healthy alternative.’ In reality, it’s the chemicals making up the vapor liquid that we should be more concerned about as they are the cause of gut inflammation.” 

Though vaping rates have declined in recent months -- especially for young people -- the researchers hope that consumers understand the severity of the long-term risks associated with smoking e-cigarettes. 

“The gut lining is an amazing entity,” said researcher Dr. Ghosh. “It is comprised of a single layer of cells that are meant to seal the body from trillions of microbes, defend our immune system, and at the same time allow absorption of essential nutrients. Anything we eat or drink, our lifestyle choices in other words, has the ability to impact our gut microbes, the gut barrier, and overall health. Now we know that what we smoke, such as e-cigarettes, negatively impacts it as well.” 

As more and more studies highlight the health concerns associated with vaping -- which include serious lung damage and heart issues -- a new study conducted by researchers from the University of Rochester Medical Center is exploring how e-cigarettes can affect consumers’ mental function. 

According to their findings, vaping can have a negative effect on memory, thinking skills, and the ability to focus. The researchers say they are most worried about young people who vape. 

“Our studies add to growing evidence that vaping should not be considered a safe alternative to tobacco smoking,” said researcher Dongmei Li, PhD. 

Issues with cognitive function

The researchers conducted two studies to help them better understand what effect vaping has on consumers’ mental faculties. One study analyzed data from over 886,000 participants involved in the Behavioral Risk Factor Surveillance System Survey, and the other study looked at more than 18,000 responses to the National Youth Tobacco Survey. 

Ultimately, the researchers learned that participants who vaped or smoked cigarettes were more likely to struggle with cognitive function than those who had never smoked in any capacity. The study revealed that smoking -- whether e-cigarettes or traditional cigarettes -- was associated with three primary cognitive issues: decision-making, memory, and concentration. 

Additionally, the researchers explained that age played a large role in the participants’ cognitive abilities. They found that when participants were younger than 14 when they started vaping or smoking, they were even more likely to have cognitive struggles as adults. 

Though vaping rates for young people have declined in the last year, and many companies have put age restrictions on e-cigarettes to help prevent young people from picking up the habit, a great deal of e-cigarette advertising has previously been geared towards the younger demographic. The researchers are particularly concerned because high school age is a pivotal time in the brain’s development process. If young people have already picked up a smoking habit by this age, it could affect brain function long-term. 

“With the recent rise in teen vaping, this is very concerning and suggests that we need to intervene even earlier,” said Dr. Li. “Prevention programs that start in middle or high school might actually be too late.” 

There is no shortage of research highlighting the health risks associated with vaping -- especially when looking at the additives that are particularly popular among younger consumers. 

A new study conducted by researchers from the University of South Florida has explored the flavor additives even further, and it found that these chemicals can increase the risk of lasting heart damage.

“The flavored electronic nicotine delivery systems widely popular among teens and young adults are not harm-free,” said researcher Sami Noujaim, PhD. “Altogether, our findings in the cells and mice indicate that vaping does interfere with the normal functioning of the heart and can potentially lead to cardiac rhythm disturbances.”

Compromising heart health

The researchers conducted experiments on both young mice and human cardiac cells to better understand how flavor additives in e-cigarettes can compromise heart health. In all of the trials, both the mice and the human cells were exposed to several different flavor additives, as well as e-vapors that didn’t contain flavorings, to understand how the health risks change. 

While e-cigarettes pose a threat to consumers’ health without adding flavors, the researchers learned that the flavor additives only exacerbated those health risks in both mice and human cells. 

For the mice, the researchers observed several changes to their normal heart functioning. The primary disturbance was heart rate, as the mice exposed to e-cigarette flavor additives were more likely to develop ventricular tachycardia, which speeds up the natural heart rate. However, other mice were also more susceptible to a slowed heart rate variability, which means the time between heartbeats is slower; this typically happens when the body is under stress, and it can increase the risk for heart disease over time. 

The researchers noted similar effects to the human cardiac cells. Even before exposing the cells to the flavor additives, the e-cigarette vapor alone affected how fast the cells were able to beat. As the researchers added both nicotine and flavoring, the cells became even more compromised, though the worst outcomes came from the addition of the flavoring.  

“This experiment told us that the flavoring chemicals added to vaping devices can increase harm beyond what the nicotine alone can do,” Dr. Noujaim said. 

Tightening restrictions

Despite efforts to regulate e-cigarettes -- especially in recent months as experts warned about the risks associated with the COVID-19 pandemic -- many young people continue to seek out flavored vaping options. The researchers hope that these findings can help cut down on the use of e-cigarettes among this demographic.

“Our research matters because regulation of the vaping industry is a work in progress,” said Dr. Noujaim. “The FDA needs input from the scientific community about all the possible risks of vaping in order to effectively regulate electronic nicotine delivery systems and protect the public’s health. At USF Health, in particular, we will continue to examine how vaping may adversely affect cardiac health.”

Youth vaping rates plunged during the COVID-19 lockdown period, according to a new survey published Thursday in JAMA Network Online. 

Roughly two-thirds (35 percent) of teen and young adult e-cigarette users said they reduced their use of the products or stopped using them altogether (32 percent). The survey found that concerns about lung health were a key factor for 1 in 4 respondents who said they either cut back or quit. 

Concerns about COVID-19 (which affects the lungs) have combined with concerns stemming from last year’s nationwide outbreak of a condition dubbed “EVALI,” short for “e-cigarette- or vaping-associated lung injury.” 

"One of the main reasons they quit is that they were worried about lung health, and we think that's important, that they thought they could hurt their lungs," said lead researcher Bonnie Halpern-Felsher, a developmental psychologist and professor of pediatrics at Stanford University in California.

Kids adhered to stay-at-home orders were 50 percent more likely to quit or reduce their vaping, researchers found. However, only 15 percent of respondents said they were motivated to quit for fear of their parents finding out about their vaping.  

Emphasizing adverse health effects

Doctors and health officials say the study results suggest that emphasizing the health risks of vaping is an effective way to get younger users to stop using the products. Although teen vaping has become less of a concern in light of the COVID-19 pandemic, experts say it’s still a major problem. 

“Vaping is still an important issue just as I think smoking is still an important issue … We've sort of forgotten about it because we've had a bigger health concern to worry about,” Dr. Nancy Rigotti, director of the Tobacco Research and Treatment Center at Massachusetts General Hospital in Boston, told TODAY.

Experts say vaping use among teens could rise again after the pandemic is over and normal social events are cleared to resume. Halpern-Felsher said e-cigarette use among minors is largely socially driven, so the problem could resurface once kids can congregate safely.

"The concern is that as soon as youth are not having sheltering in place and they're all back in school, whether we're going to see more social use again and the uptick will happen," she said.

Highlighting research showing the health effects of vaping can be an effective way to get e-cigarette users to re-think their decision to start using the products in the first place. 

"If we can emphasize that vaping is not healthy and make it appear unattractive, we will win over this generation of e-cigarette users. We'll get them to stop,” said Dr. Panagis Galiatsatos, director of the Johns Hopkins Tobacco Treatment Clinic in Baltimore.

Signs of lung damage are common among people who vape, according to a new study. 

Researchers have found that one out of every three e-cigarette users (33 percent) reported having one or more of the following symptoms: cough, shortness of breath, nausea, stomach pain, and chest pain. 

All five of these symptoms are on the list of symptoms that the CDC has said are associated with e-cigarette- or vaping-associated lung injury -- a condition known as “EVALI.”

The symptoms were less prevalent among people who used disposable e-cigarettes, said lead researcher Dr. Thanh-Huyen Vu, a research associate professor of epidemiology at Northwestern University Feinberg School of Medicine in Chicago. 

That finding suggests that experimenting with unregulated ingredients and untested devices is “risky,” Vu said. The symptoms were 40 percent more common among vapers who mixed their own e-liquids and 71 percent more common among those who used flavored e-cigarettes. 

"We did not anticipate seeing such strong and consistent relationships between the users' product modifications and the use of flavored products with clinical symptoms, including EVALI-like symptoms," Vu said. "Clinical symptoms are common in [e-cigarette] users, and they are especially prevalent for users who modify products or consume flavored products."

Health concerns

Fifty-five percent of the more than 1,400 people involved in the study said they had one or more of the systems listed above. One third (33 percent) reported having one or more of the five e-cigarette- or vaping-associated lung injury (EVALI)-like symptoms. Cough and nausea were the most common.

People who reported EVALI-like symptoms were more likely to be younger than age 45, Hispanic, current cigarette smokers, or current users of other tobacco products such as pipes or smokeless tobacco.

"Our results indicate that e-cigarette- or vaping-associated lung injury symptoms were not an oddity, a brief occurrence or solely related to the use of THC (the psychoactive component of cannabis) or vitamin E acetate, both of which were pegged as possible contributors to EVALI outbreaks in the past year or so," Vu said. 

Vu and her team said the study suggests the need for health care professionals to “assist patients in better understanding the full risks and potential harms of using e-cigarettes and related products." 

People who do vape should be careful with the products they use and “not self-modify those products,” Vu said. Better yet, she says they should not vape at all. 

"Although further research is needed on the association of vaping with EVALI and the association of lung injury with COVID-19, the existing evidence indicates that there should be concern, and it is worth avoiding this risk by not vaping," Vu said.

With more and more consumers affected by vaping-related lung illness -- otherwise known as EVALI -- experts continue to look for risk factors associated with smoking e-cigarettes. While recent studies have pointed to both vitamin E and THC as the primary sources of EVALI, a new study found that the vaping devices themselves could be to blame. 

According to researchers from the University of California at Irvine, the results from the earliest stages of a new study found that the heating source on vaping devices has been linked with an increased risk of lung damage. 

“While further research is needed, these results indicate specific devices and power settings may play a key role in the development of EVALI as much as the additives do,” said researcher Dr. Robert A. Kloner. “The harms associated with e-cigarettes and vaping simply cannot be overstated.” 

Analyzing vaping devices

The researchers didn’t set out to uncover this link between vaping devices’ heating sources and subsequent lung damage; they were initially studying the effect of vaping on consumers’ heart health. However, after the e-cigarette they had been using in their study was discontinued and participants were forced to use a different model, they observed some key differences. 

While the new vaping device was essentially the same as the first one, the heating element was different. The first device used stainless steel as the heating source, and the second device used a nickel-chromium alloy as the heating source. Though that change may not seem like it would make a massive difference, the researchers observed drastic changes to the participants’ health in a short amount of time. 

“Within an hour of beginning an experiment, we observed evidence of severe respiratory distress, including labored breathing, wheezing, and panting,” said researcher Michael Kleinman, PhD. “After analyzing lung tissue from subjects in the study, we found them to be severely compromised and observed other serious changes such as lung lesions, red blood cell congestion, obliteration of alveolar spaces, and pneumonitis in some cases.”  

Despite several studies that have pointed to the additives in e-cigarettes as the primary source of lung damage, the researchers explained that the devices they used contained no nicotine, vitamin E, or THC. The participants had been involved in the study for more than a year when they received the new vaping devices, and none of them had shown any signs of lung illness or similar health concerns up to that point. 

The researchers plan to do more work in this area to better understand how the heating element on vaping devices can be a risk to consumers’ health. However, they hope that consumers take these findings seriously and take steps to prevent severe health concerns. 

“The results were so impactful, we felt it imperative to release the initial findings early so that electronic cigarette users could be cautioned sooner, especially considering e-cigarette users are at an increased risk of COVID-19,” said Dr. Kloner. 

The number of children and teenagers who use e-cigarettes is slightly down this year, but not enough for health officials to stop calling it an “epidemic.” 

The Centers for Disease Control and Prevention (CDC) said in a release that 3.6 million youths have used e-cigarettes this year. That’s down from 5.4 million in 2019. 

"Although the decline in e-cigarette use among our nation's youth is a notable public health achievement, our work is far from over," said CDC director Dr. Robert Redfield. "Youth e-cigarette use remains an epidemic, and [the] CDC is committed to supporting efforts to protect youth from this preventable health risk."

Vaping still common among youth

The CDC, which drew its findings from the National Youth Tobacco Survey, found that 8 in 10 middle and high school students who currently vape said they use flavored e-cigarettes. The use of mint and menthol flavored vaping products was also common among the demographic.

Health officials have been attempting to curb the rise in teen vaping for several years now. Efforts to drive down the rate of vaping among youth have focused on cracking down on sales of flavored products, which have been found to appeal to minors. 

Unfortunately, researchers have found that teenagers who use e-cigarettes may be more likely to continue vaping. 

“While many children try e-cigarettes, not all become regular users,” said researcher Adam Leventhal, who worked on a 2019 study out of the University of Southern California “Teens who use e-cigarettes may be more inclined to continue vaping rather than just temporarily experiment with e-cigs.” 

“The longer and more frequently you vape, the more you’re exposing yourself to toxins in e-cigarette aerosol and put yourself at risk of nicotine addiction,” Leventhal said. 

Working to drive down the numbers

In the latest analysis of data, the CDC found that 19.6 percent of high school students and 4.7 percent of middle school students used e-cigarettes in 2020 -- down from about 27 percent and 10 percent, respectively, in 2019.

"These findings reinforce the importance of continuing to focus on the strategies that work to reduce youth tobacco product use while keeping pace with emerging trends in tobacco products," said Dr. Karen Hacker, director of CDC's National Center for Chronic Disease Prevention and Health Promotion. "Implementing these strategies at the national, state and local levels is integral to preventing and reducing youth tobacco product use, including e-cigarettes.”

In a statement, FDA Commissioner Dr. Stephen Hahn said the agency “remains very concerned about the 3.6 million U.S. youth who currently use e-cigarettes” and that it “will do everything possible” to stop the health crisis. 

"The findings come as we mark today's premarket review submission deadline, a milestone for ensuring new tobacco products, including many already on the market, undergo a robust scientific evaluation by the FDA,” Hahn said. “Scientific review of new products is a critical part of how we carry out our mission to protect the public -- especially kids -- from the harms associated with tobacco use.”

On Monday, a flavored tobacco product ban (SB 793) was unanimously approved by the California Assembly. 

SB 793 will prohibit the retail sale of flavored tobacco products, flavored e-cigarettes, and flavored vaping products in the state. The legislation is part of a larger effort to curb rates of flavored tobacco use among children, to whom the products tend to appeal.

Supporters of the legislation said it would help reduce rates of smoking and vaping among children and teenagers who use them specifically because they come in flavors like menthol, cotton candy, and gummy bears. 

Health experts have raised concerns that the high rate of flavored tobacco use among minors threatens to derail progress in curbing overall smoking rates. 

“These flavors are marketed to kids and people of color to ensure tobacco companies have a clientele on the hook for life,” said Assembly Speaker Anthony Rendon (D-Lakewood).

Exemption for some products 

During the legislative process, the bill was modified to include an exemption for some premium cigars. The bill defines “premium” as “any cigar that is handmade, is not mass produced by use of mechanization, has a wrapper that is made entirely from whole tobacco leaf, and has a wholesale price of no less than twelve dollars ($12). A premium cigar does not have a filter, tip, or non-tobacco mouthpiece and is capped by hand.”

“It’s the most deadly consumer product ever created,” Assemblyman Jim Wood (D-Healdsburg) said during Monday’s floor debate. “In a perfect world, there would be no exemptions to this bill, but we all know we don’t live in a perfect world.”

Assemblyman Heath Flora (R-Ripon) said exempting cigars, hookah products, and cannabis threatens to leave open a loophole that could put kids at risk. 

“If we actually cared about the kids, we would deal with some of the other industries as well,” he said.

The measure -- which is supported by the American Lung Association in California, American Heart Association, and American Cancer Society -- now faces one more vote in the Senate before heading to Gov. Gavin Newsom’s desk.