Tobacco Use and Health Risks

If you want to vape, that's your business.

But exposing kids to nicotine-containing e-liquids -- the liquid used in “vape” products -- is another matter completely.

E-liquids, especially those containing even small amounts of nicotine, can be dangerous to children -- causing injury and even death -- if they touch or drink it.

Figures from the Food and Drug Administration (FDA) show that from April 2022 to March 2023, 7,043 e-cigarette or e-liquid exposure cases were reported, with approximately 88% of exposures occurring among children under five years old.

Why they are dangerous

Harmful effects from drinking e-liquids can include seizure, coma, respiratory arrest and death.

Accidental exposure to e-liquids and their contents -- including nicotine – can occur through contact in the mouth, on the skin, or by inhaling the e-liquid aerosol.

Moreover, containers for storing e-liquids can seem tempting to children of all ages for many reasons. But these products are not meant for children, teens, or young adults.

Safe Storage of e-liquids

As any parent knows, small kids are curious and put all sorts of things in their mouths. If you turn away even for a few seconds, they can get into things quickly that could harm them.

Here are a few tips from the FDA for storing these products:

• Always put your e-cigarettes and/or e-liquids in a safe and elevated location, in the original containers -- and out of the reach and view of children and pets -- every time you use them.
• Ask family members, house guests, and other visitors who vape to store their bags or coats that hold e-cigarettes or e-liquids in a safe and elevated location, out of the reach and view of children and pets.
• Explain to children old enough to understand that these products can be dangerous and should not be touched. Tell them that you or another adult are the only people who should handle these products.
• Know the poison control phone number. To be prepared in case of an emergency, also add the Poison Control HELP number (800-222-1222) to your phone contacts.
• When you remove products (adult-only) from their storage locations, handle them in a way that may help to prevent kids’ exposure to e-liquids.
• Store e-liquids in their original containers and lock product caps when you’re not using them. If a bottle has a cap that turns, twist it until you cannot twist it anymore.
• Clean up any spills or splashes immediately using soap and water.

A new study conducted by researchers from the American Cancer Society pinpointed two major risk factors for consumers when it comes to developing any kind of cancer: older age and smoking status. 

“Single cancer type-specific screening recommendations are based on risk factors for that specific type of cancer,” said researcher Dr. Alpa Patel. “Our findings are encouraging as we are working to define subgroups in the general population who could benefit from enhanced cancer screening and prevention.” 

Identifying those at the highest risk of cancer

The researchers analyzed data from nearly 430,000 participants enrolled in two studies – the Cancer Prevention Study-II Nutrition Cohort and the Cancer Prevention Study-3. They followed the participants over the course of five years, and none of them had a previous history of cancer. 

While several factors were taken into consideration, two came out as the biggest risks for developing any kind of cancer: older age and smoking status. The risk of developing cancer of any kind was higher for any current or former smokers (within 30 years of quitting) and participants over the age of 50; the risk was 25% higher for women and nearly 30% higher for men. 

The researchers also noted some risk factors that were specific to gender. For women, having a hysterectomy or tubal ligation, a high body mass index (BMI), high blood pressure, and type 2 diabetes all increase the risk of cancer. For men, red meat consumption and alcohol intake proved to be dangerous to long-term health outcomes. A family history of cancer and a lack of physical activity were likely to increase the risk of cancer among both men and women. 

The researchers hope their findings will help health care providers better identify those who may need preventative cancer care. 

“As we consider the possibility that future tests may be able to identify several types of cancer, we need to begin understanding who is most at risk for developing any type of cancer,” Dr. Patel said. “These types of data are not widely available, but necessary to inform future screening options, such as blood-based multi-cancer early detection tests that could help save lives.” 

While recent studies have explored consumers’ habits related to substance use during the COVID-19 pandemic, a new study conducted by researchers from the American Cancer Society looked closely at smokers. Their report showed that rates of consumers quitting smoking dropped over the course of the pandemic and remained low for over a year. 

“Smoking cessation is an urgent public health priority given that smoking is associated with an increased risk of severe COVID-19 outcomes and at least 12 cancers,” said researcher Dr. Priti Bandi. “It is essential to re-engage persons who smoke in serious attempts to quit smoking, considering a typical smoker tries to quit on average six times before being successful.” 

Consumers’ health is at stake

For the study, the researchers analyzed data from nearly 800,000 people enrolled in the Behavioral Risk Factor Surveillance System study from 2011 through 2020. They also looked at retail records from 2017 through 2020 that tracked purchases of nicotine replacement therapy (NRT) from over 30 states across the country. 

While the research spanned nearly a decade, 2020 marked the first year that attempts to quit smoking dropped. In 2011, 65.2% of American smokers attempted to quit; by 2020, that number dropped to 63.2%. These decreases remained steady throughout the pandemic. 

Similarly, NRT sales dropped over the course of the study. Experts found that purchases were as much as 13% lower in 31 states across the country when compared to national sales projections. 

The researchers also found that certain factors made it less likely for consumers to quit smoking. Consumers with lower education levels, those with comorbidities, middle-aged people, and Black consumers were all found to be the least likely to attempt to stop smoking over the course of the pandemic. The researchers believe the stressors related to COVID-19 may have come into play here. 

“These results remind us how critical it is for clinicians and health care systems to support persons who smoke with evidence-based quitting strategies,” said researcher Dr. William Dahut. 

Moving forward, the team hopes more work is done to encourage consumers across the country to quit smoking to promote the best health outcomes. 

“Tobacco is the number one, preventable cause of cancer and is responsible for up to one-third of all cancer deaths,” said researcher Lisa Lacasse. “We know quitting tobacco isn’t easy, so we must do everything in our power to ensure individuals trying to quit have access to the cessation services they need.” 

A new study conducted by researchers from the Johns Hopkins University Bloomberg School of Public Health explored the heart health risks associated with smoking cigarettes. According to their findings, consumers who currently smoke or have smoked cigarettes may be twice as likely to develop heart failure. 

“This reinforces the view that smoking casts a long shadow over heart health,” said researcher Dr. Kunihiro Matsushita. 

Long-term heart health risks

For the study, the researchers analyzed data from over 9,300 people enrolled in the Atherosclerosis Risk in Communities (ARIC) study. The participants were between the ages of 61 and 81, and none of them had a history of heart failure when the study began. The team tracked the participants’ health outcomes over the course of 13 years to better understand the link between heart health and cigarette smoking. 

The study showed that smoking cigarettes was linked with a higher risk of heart failure – even for those who had quit smoking. The researchers explained that there are two main types of heart failure – reduced ejection refraction and preserved ejection refraction. Compared to participants who never smoked, smokers were 2.16 times as likely to develop the former and 2.28 times as likely to develop the latter. 

There was also a link between the amount that the participants smoked and their heart health risks. The more cigarettes the participants smoked on a daily basis, and the more years that they smoked, the higher their risk of heart failure. 

Former smokers also weren’t exempt from heart failure risks. Only those who had stopped smoking for at least three decades had a lower risk of heart failure; all other former smokers remained at an elevated risk of heart failure. 

The team hopes these findings encourage stronger efforts to prevent smoking, particularly for younger consumers. 

“These findings underline the importance of preventing smoking in the first place, especially among children and young adults,” said Dr. Matsushita. “We hope our results encourage current smokers to quit sooner rather than later, since the harm of smoking can last for as many as three decades.”

A new study conducted by researchers from Cleveland Clinic explored how consumers’ weight may affect their cancer risk. According to their findings, losing weight following bariatric surgery may lower the risk of developing cancer. 

“According to the American Cancer Society, obesity is second only to tobacco as a preventable cause of cancer in the United States,” said researcher Dr. Steven Nissen. “This study provides the best possible evidence on the value of intentional weight loss to reduce cancer risk and mortality.” 

Long-term health benefits

For the study, the researchers analyzed data from participants enrolled in the Surgical Procedures and Long-term Effectiveness in Neoplastic Disease Incidence and Death (SPLENDID) study. There were over 5,000 adults with obesity who underwent bariatric surgery between 2004 and 2017. The researchers compared those participants' results to outcomes from 25,000 adults with obesity who didn't have the procedure.

The study showed that weight loss as a result of bariatric surgery was associated with a lower risk of cancer and cancer-related death. Under 3% of the participants who had the procedure and lost weight developed cancer, and less than 1% of the group died as a result of cancer. On the other hand, roughly 5% of the participants who didn’t have the surgery developed cancer, and 1.4% of that group died from cancer. 

“Patients can lose 20 to 40% of their body weight after surgery, and weight loss can be sustained over decades,” said researcher Dr. Ali Aminian. “The striking findings of this study indicate that the greater the weight loss, the lower the risk of cancer.” 

Overall, the study identified a nearly 50% lower risk of dying from cancer for participants who underwent bariatric surgery. The team hopes these findings highlight the importance of consumers following a healthy lifestyle in an effort to potentially lower their risk of cancer. 

“Based on the magnitude of benefit shown in our study, weight loss surgery can be considered in addition to other interventions that can help prevent cancer and reduce mortality,” said researcher Dr. Jame Abraham. “Further research needs to be done to understand the underlying mechanisms responsible for reduced cancer risk following bariatric surgery.” 

The U.S. government’s effort to curb cigarette consumption picked up speed on Thursday when the U.S. Food and Drug Administration (FDA) proposed rules prohibiting menthol cigarettes and flavored cigars.

The agency said its goals are to prevent youth initiation, significantly reduce tobacco-related disease and death, and increase the number of smokers who quit smoking altogether.

If enacted, the new standards the FDA is proposing will prohibit menthol as a “characterizing flavor” in cigarettes and prohibit all characterizing flavors (other than tobacco) in cigars. The move comes almost a year from an earlier move by the Biden administration to consider rules that would lower nicotine levels in cigarettes.

“The proposed rules would help prevent children from becoming the next generation of smokers and help adult smokers quit,” said Health and Human Services Secretary Xavier Becerra. “Additionally, the proposed rules represent an important step to advance health equity by significantly reducing tobacco-related health disparities.” 

According to Statista, the share of cigarettes in the U.S. that include menthol has been climbing steadily for years. In 2001, menthol cigarettes accounted for 26% of cigarette sales and grew to a 37% share in 2019. The company that will likely take the biggest hit from the FDA’s move is Reynolds American, which, with Newport leading the way, counts on menthol cigarettes for nearly 50% of its sales.

Reducing smoking rates

The FDA says its studies show that there would be a 15% reduction in smoking within 40 years if menthol cigarettes were no longer available. Those studies also estimate that 324,000 to 654,000 smoking-attributable deaths overall (92,000 to 238,000 among African Americans) would be avoided over the course of 40 years. The agency paid great attention to the youth market in its research.

“Characterizing flavors in cigars, such as strawberry, grape, cocoa and fruit punch, increase appeal and make cigars easier to use, particularly among youth and young adults,” the FDA said. “More than a half million youth in the U.S. use flavored cigars, and in recent years more young people tried a cigar every day than tried a cigarette.”

The agency said its proposal does not prohibit an individual consumer from possessing or using a menthol tobacco product. However, it said its enforcement would address any company that manufactures, distributes, or sells such products within the U.S. that are not in compliance with applicable requirements. 

Beginning May 4, 2022, the American public can comment on the proposed rules that the FDA will consider for future action.