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As e-cigarette use increases, experts investigate health risks

Tests show e-cigarettes to be less harmful than tobacco, but minimal long-term research has been conducted

Despite widespread stigmatization of smoking cigarettes, the use of electronic cigarettes is on the rise nationwide. Electronic cigarettes, better known as e-cigarettes, simulate smoking by vaporizing a liquid solution containing nicotine and often added flavors.

“There’s emerging research that they’re much less risky than cigarettes,” said David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the Johns Hopkins Bloomberg School of Public Health. This is because e-cigarettes don’t burn the tobacco, and thus produce less of the major carcinogens present in conventional cigarettes, he said.

Both Abrams and Belinda Borrelli, professor of psychiatry and director of the Program in Nicotine and Tobacco at Alpert Medical School and the Miriam Hospital, stressed that there is not enough long-term research to determine exactly how safe e-cigarettes are.

“The fluid and the other chemicals (in e-cigarettes) are the problems (because of their toxicity), like the metals in the fluid, but right now we don’t really know,” Borrelli said.

“The jury is still out in terms of the long-term effects,” Borrelli said.

“While we don’t really know the long-term impact of inhalation, logic would suggest and some preliminary studies would suggest that it’s going to be less harmful than combusted tobacco in any form, mainly cigarettes or hookah,” Abrams said.

He added that there is almost no secondhand smoke from e-cigarettes, making them much safer for non-smokers.

Though he said that there is not much research on e-cigarettes, Abrams said the studies he has seen “put e-cigarettes in the category of somewhere between nicotine replacement therapy, which is pharmacy-grade nicotine from a pharmacy, and smokeless tobacco products, which are not harmless but are also much less harmful than cigarettes.” He said that in terms of risk, he would slot e-cigarettes between snus — a type of powdered tobacco — and dissolvable nicotine products.

Both Borrelli and Abrams discussed the rapid increase in popularity of e-cigarettes in recent years.

Abrams said it can be difficult to tell exactly how many people use them because “part of what we’re seeing is initial curiosity and experimentation rather than long-term use.”

“They’re getting pretty popular,” Borrelli said. “In 2009, it was 0.6 percent  of the U.S., in 2010 2.7 percent, and now it’s 6.2 percent, and the people who use e-cigarettes tend to be younger and in higher education.”

Abrams said potential for abuse is critical to understand, especially if people use them as a loophole for air restrictions and as a way to deal with cravings. E-cigarette use may make quitting traditional cigarettes more difficult, he added. If people exclusively used e-cigarettes and did not burn tobacco in any form, it could have “dramatic public health benefits because it’s clearly harm-reducing.”

“There is not a general consensus” on whether or not e-cigarettes may help in quitting smoking, Borrelli said. She added that though e-cigarettes are “probably safer than cigarettes,” the health risks are not entirely known.

They may contribute to a destigmatization of smoking conventional cigarettes and an increase in use by children “given the interesting flavors that are being marketed,” she wrote in an email to The Herald.

Because of the lack of long-term research on e-cigarettes, Abrams cautioned against aggressively regulating them.

He said he believes no product “containing nicotine in any form should be sold to kids under 18, and we should strictly enforce restrictions to minors in all places, like convenience stores and over the Internet.” But he added that he has mixed feelings on the regulation of e-cigarettes in public places.

“Given that I don’t think the data show that they have a whole lot of particulate matter in the air, there may not be a legal reason for banning them,” he said.

Because the number of carcinogenic substances can vary with the quality of the product, Abrams said he sees the situation as “more an issue of product regulation and quality control than heavily restricting them.”

He added there should be standards for manufacturing and the chemicals that compose the vaporized fluid.

The Food and Drug Administration is in the process of claiming jurisdiction over e-cigarettes, so producers and manufacturers are not permitted to “claim harm reduction or smoking cessation,” Abrams said.

Tomasz Komendzinski ’16 said he has used e-cigarettes before to see how they compare to traditional cigarettes but never purchased one himself.

He added that he knows e-cigarettes are healthier and said that he thinks people perceive e-cigarettes as less harmful than conventional cigarettes.

“They’re definitely less annoying, especially to non-smokers, because there’s no smoke,” he said.



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