The cocktail of chemical flavorings and additives in e-cigarettes can cause inflammation in the lungs, which in some instances may be worse than the damage caused by conventional cigarettes, a new medical investigation has found.
Writing in the current issue of the American Journal of Physiology, researchers discovered extensive inflammation triggered by inhalation of e-cigs’ heated chemical cocktail. There was no evidence in the laboratory-based study that the inflammation posed a cancer risk.
Although the research was conducted in mice, medical experts Friday said this is the kind of study that should have preceded e-cigs' launch years ago before they became widely marketed products. E-cigs were created to help wean smokers off conventional cigarettes, and the multibillion-dollar industry since has ushered in a new vaping habit that not only has attracted adults but is spreading among teens.
“We are behind in terms of research,” said Dr. Patricia Folan, director of the Center for Tobacco Control, a division of Northwell Health in Great Neck. Folan was not connected with the study.
In addition to the flavoring agents and colorants, e-cigs pack more nicotine than cigarettes, Folan said.
“They hit the market around 2006, 2007 before research could be conducted to determine what the potential problems would be. The manufacturers were the ones telling us that these products were safe to use,” Folan said.
Manufacturers based their safety claims about e-cig flavorings on approvals already in place by the U.S. Food and Drug Administration for a variety of food additives. The chocolate, bubble gum, cherry and other flavors are similar to the artificial flavors and colors in candies and other junk foods.
Juul Labs, makers of one of the most popular e-cig devices, has long vigorously defended the safety of its product and in a statement to the FDA last summer also defended its flavorings. “Appropriate flavors help adult smokers who do not want to be reminded of the tobacco-taste of a cigarette. We encourage FDA to allow for further scientific exploration on the role flavors play in helping adult smokers transition away from combustible cigarettes,” the company said.
Folan underscored Friday that compounds deemed safe to ingest as food were never approved by the agency to be inhaled into the lungs. Only now are medical analyses exploring these issues — and the problems they may cause, she said.
The battery-powered e-cigarette devices dispense a vapor generated from liquid, flavored chemicals. A so-called “e-liquid” contains a slurry of compounds, including propylene glycol, a colorless chemical with a faintly sweet taste. That compound is routinely used in the food and cosmetic industries. Also in the e-liquid mix are potent amounts of nicotine and fanciful flavorings.
Dr. Rachel Boykan, a pediatrician at Stony Brook Children’s Hospital, told Newsday that e-cig use, especially among teens, is understudied.
“We have concerns about the nicotine exposure, but we are also concerned about the propylene glycol. It’s not completely harmless,” Boykan said.
The research, which was conducted by medical investigators in Greece, found that even short-term use of e-cigs can induce significant inflammatory lung damage.
Folan noted that the study, led by Dr. Andreas Papapetropoulos of the University of Athens, has helped drive home the fact that food additives were never meant to be inhaled.
The medical community is already aware that a food additive can cause devastating lung damage based on the irreparable pulmonary problems endured by workers nearly two decades ago in factories that made microwaveable popcorn, she said.
Some inhaled large quantities of a chemical called diacetyl used in popcorn manufacturing to impart a buttery taste and wound up having to undergo lung transplants.
"The medical condition is called bronchiolitis obliterans, or popcorn lung," Folan said of the inflammatory disorder that caused scar tissue and was triggered by a food additive.