On Tuesday November 4, 2014 Amy H. Smith of the Rowan County Health Department penned the following article for the Salsbury Post [published in Salsbury NC]: ‘Vaping’ the lesser of two evils? This is my reply to the article, text from the original article is quoted in italics.
“As of right now, the only information that we really have on e-cigarettes is coming from the big tobacco companies. Yes, e-products are less toxic than regular cigarettes, but less toxic definitely does not mean healthier.”
No. Big Tobacco is not the only source of information on e-cigarettes. In fact BT is a Johnny-Come-Lately to the e-cig party. E-cigs were invented by a physician in China after he lost his father to smoking related illness and he had seen too many failures with traditional stop smoking aids. As for sources of information, try doing some research in Nicotine and Tobacco Addiction or the British Medical Journal for starters. You’ll find plenty of science supporting the safety and effectiveness of e-cigs to begin a fact finding journey that will enlighten one to understand the power of this disruptive technology is an asset for a smoke-free world.
And No again: Less toxic is less toxic. When the dose makes the poison and the dose is reduced to non-poisonous levels it is a healthier alternative to the poisonously toxic levels. Caffeine is toxic but consumed everyday by millions around the world without toxic effect. Yet only recently a high-schooler consumed a toxic amount and died. Eliminating most of the toxic components in tobacco smoke while others are reduced below poisonous effect by creating an aerosol vapor is a healthier alternative to smoking.
Because it isn’t only the final paragraph but the development of the argument in-toto that must be addressed here is a point by point refutation of the “facts” presented:
“There are over 8,000 flavors for e-cigarettes and products being sold online and in stores, everything from cotton candy, watermelon, white chocolate, and brandy to Mountain Dew, and even Campbell Soup flavors.”
There are also supermarket aisles full of candy, cereal and soda in well over 8000 flavors. This means nothing. The notion, of course, is to rehash the old tripe about these being attractive to youth. In fact flavors are attractive to everyone. In 36 of the 50 states laws preventing the sale of electronic cigarettes have been enacted. In still others, folks like the American Lung Association have OPPOSED such laws. If it illegal to sell, possess or use under-age what difference does flavoring make? What difference would good parenting make?
“Flavored liquids for e-products are most likely not in a child-proof container which may lead to ingestion, hospitalization, and/or death, especially for younger children who perceive the liquid as a type of candy due to its scent, color and smell.”
While there are some eliquid makers that may not package their products in child-proof containers, we also don’t have child-proof containers for dishwasher gels and a host of other household chemicals, most of which have ‘enticing’ scents, colors and smells.
“Less than one tablespoon of many e-liquids on the market can kill an adult and as little as one teaspoon could kill a child.”
1 tablespoon is 15ml, 1 teaspoon is 5ml to get the measurement straight. 15ml of eliquid at a maximum 30mg/ml would yield 450mg of nicotine. If, and its contestable, the LD50 of 50mg/kg is accurate then we’re talking 3,500mg to kill 50% of those adults who ingest it. So NO, a tablespoon is NOT enough to kill an adult nor is a teaspoon likely to kill a child. In fact, as one of the most salient side effects of ingestion is nausea and vomiting it is highly unlikely anyone swallowing these amounts would absorb enough to cause anything more that discomfort. The poisoning events reported have proven this out. [Source: http://www.cdc.gov/niosh/idlh/54115.html]
“The side effects of e-liquid ingestion can include nausea, vomiting, increased heart rate, high blood pressure, agitation, coma, and/or death.”
These are legitimate potential side-effects from nicotine ingestion.
“In the United States, some poison control centers have seen their call volume increase as much 700 percent due to exposures to the e-liquid.”
Cherry picked for maximum shock value of course. There have been 3,014 calls to poison control centers for e-cigarette related exposures as of September 2014. That may be close to double the rate of calls from 2013. At the same time the e-cigarette user base has increased to 2.5 million. That puts the mis-handling events at less than 0.12% per user. Considering that over 1.1 million children were exposed to poisons in 2014 then eliquid accounted for only 0.27% of all poisoning cases reported [Source: http://www.aapcc.org].
“By the end of September, Carolina’s Poison Control had seen 114 human exposures to e-cigarettes and nicotine liquid in North Carolina in 2014, compared with eight similar exposures in all of 2011.”
By comparison it was far more likely that children in Carolina would be poisoned by dishwasher gels. [source 1=”<a” 2=”href="http://www.ncpoisoncenter.org">http://www.ncpoisoncenter.org</a>” language=”:”][/source]
“E-liquids can deposit high levels of nicotine into one’s skin if they are not handled properly. They can also be inhaled and/or cause eye irritation if mishandled.”
I return to the issue of LD50 described above. It is *extremely* unlikely that any adverse effect beyond localized irritation and possibly nausea/vomiting would result.
“The nicotine levels in e-products range from 26.8 to 43.2 micrograms per 100 milliliter puff. According to the FDA, tests also show that the consumer that purchases nicotine-free cartridges is still getting a low dose of nicotine, despite the claims.”
This is old and poorly gathered information. For better information see http://onlinelibrary.wiley.com/doi/10.1111/add.12410/abstract which shows that delivery is more likely in the range of 2 – 15mg per 300 puffs which is LOWER than the amount of nicotine delivered by conventional cigarettes.
“The FDA has found that some e-cigarettes contain diethylene glycol, an ingredient used in antifreeze, which is toxic to humans.”
The study which produced these results has been confounded by the method and the small sample size. For a better study see http://tobaccocontrol.bmj.com/content/early/2013/03/05/tobaccocontrol-2012-050859.abstract#aff-6 which is but one of many studies demonstrating a much lower risk of exposure to toxic chemicals from electronic cigarettes.
“Pregnant women can transfer nicotine to their developing fetus, which can be toxic.”
This is true regardless of route. The exact same thing is true for certified Nicotine Replacement Therapy (NRT) products such as gums and lozenges. It is not unique to electronic cigarettes.
“E-products cause inflammation of one’s lungs and they have the potential to cause asthma attacks and allergies.”
Many things will cause far more inflammation of the lungs and have far larger potential to cause asthma attacks (perfume is one very common irritant for example). The notion presented here is based on the concentration of vapor produced from Propylene Glycol a common carrier in albuterol inhalers and theatrical fog machines. Indeed too high a concentration may cause these symptoms in a very small number of people, but we already know it isn’t enough of a risk to ban these products or even regulate them very strictly.
“E-products can constrict one’s blood vessels.”
As this is the second use of ‘E-products’ I am assuming you mean e-cigarettes. Yes, they can temporarily cause vasoconstriction as that is also an effect of nicotine. The same effect will be realised regardless of route, indeed it is present in NRT products as well. Yet these are permitted to be marketed in the open.
“Prolonged exposure to nicotine may be linked to an increased risk of atherosclerosis, or the hardening of one’s arteries, which causes heart attacks.”
And it is possible that we are the product of interference by alien life forms acting on the biosphere of the planet. This is speculation at its worst. So far there are insufficient and contradictory findings regarding both of these assertions.
“Bystanders and the environment are exposed to some levels of nicotine and other additional toxins through vaping.”
But those exposures are not significant enough to warrant any special treatment. See http://www.ncbi.nlm.nih.gov/pubmed/23033998 which is, again, but one of many studies that there is “no apparent risk to human health from e-cigarette emissions”.
“E-products may re-normalize smoking and become a gateway to smoking tobacco products”
No, e-cigarettes de-normalize smoking in preference to using e-cigarettes. See this study http://www.nursinginpractice.com/article/study-e-cigarettes-%E2%80%98do-not-encourage-child-smoking%E2%80%99#.VBnP9r-51-k.twitter which, yet again, is one of many showing that e-cigarette use is not encouraging children to smoke. Even the CDC data shows that tobacco use is continuing to decline even though ever e-cigarette use is rising which would lead a rational person to consider that e-cigarettes may be a gateway out of smoking.
As a final note, I’ve cited sources, and careful inspection of the sources will reveal there are NO ties to any tobacco company, or e-cigarette company to the researchers performing the work. I’ve also provided links to the information which stands as primary source material. Where I’ve posited that there is more than one study, links in the publishing site will show the further citations.