*if the lines in text are not matching up to the specific comments please refresh this page or tap F5 on your keyboard.
A1 E-Cigarettes and Cancer: Not the Healthier Alternative Some Believe Them to Be
Smoking is a serious health problem that cannot be taken lightly. According to the Centers for Disease Control and Prevention A3 (CDC), cigarette are responsible for 480,000 deaths per year in the United States, and these deaths are not limited to smokers; 41,000 of those deaths are the result of secondhand smoke exposure (2014). This means that cigarettes are linked to about one in five deaths A4 (CDC, 2014). This makes tobacco usage the leading preventable cause of death, not only in the United States, but also around the world. Tobacco usage is linked to a variety of health problems, including: cancer, heart disease, stroke, lung disease, and diabetes (CDC, 2014). Moreover, nicotine, one of the addictive substances in tobacco products, is oftentimes considered the most addictive substance that human beings regularly ingest, and quitting smoking is often believed to be one of the most difficult addiction challenges a person can face.
Despite the overwhelming evidence that smoking causes severe health problems and even death, there has been tremendous resistance to attempts to make the sale of tobacco products illegal. In fact, many people in society continue to treat smoking as an undesirable habit, but one without the serious and negative health consequences linked to other addictions. As a result, many people begin smoking without fully comprehending how serious the potential health consequences are. Once they realize the negative impact that smoking can have on their lives, smokers frequently search for an effective means to stop smoking or to limit the impact that their addiction has on friends and family.
The e-cigarette was not introduced as a way to stop smoking, nor have its manufacturers suggested that it is a healthier alternative to traditional cigarettes. Despite that, many smokers have turned to e-cigarettes as a smoking cessation method. Unfortunately, e-cigarettes do not seem to reduce overall nicotine consumption. Even more alarming, they appear to have carcinogen levels that may make them even more dangerous than traditional cigarettes.
E-cigarettes and smoking cessation
While some nicotine replacement methods, such as nicotine gum and the nicotine patch, are effective, e-cigarettes appear to be missing an essential component for smoking cessation methods; they do not inhibit the behaviors that are linked to smoking. For many smokers, the ritual that surrounds smoking is a critical part of the addiction. Therefore, the use of an e-cigarette, which mimics the same behaviors used in smoking actual cigarettes, does nothing to deter the patterns of behavior associated with smoking, and, in fact, may actually reinforce those behaviors.
In fact, research suggests that the use of e-cigarettes not only does not help smokers stop smoking, but actually hinder those efforts. Smokers who use e-cigarettes as a smoking cessation effort actually appear to increase their nicotine consumption, as they simply augment regular smoking behaviors with the e-cigarette usage. When compared with a group of smokers who did not use e-cigarettes in efforts to stop smoking, the e-cigarette users had significantly lower rates of smoking cessation (Melville, 2015). Furthermore, they may actually get more nicotine through the use of the e-cigarettes, resulting in heightened tolerance levels that lead to more intense nicotine cravings and could result in smoking more cigarettes when they stop using the e-cigarettes.
E-cigarettes and carcinogens
What makes this particularly dangerous is the fact that e-cigarettes actually contain significantly higher levels of some carcinogens than regular cigarettes. E-cigarettes allow their users to manipulate their operation in order to increase or decrease the amount of nicotine delivered with each inhalation of the vapor they produce. To do this, the user manipulates the heat in the unit. However, as the heat increases, so does the production of formaldehyde-containing chemical that can release the formaldehyde to the user after the user inhales the vapor. The result can be formaldehyde exposure “at levels up to 15 times higher than regular cigarettes” A5 (Thompson, 2015).
Furthermore, this a problem that manufacturers seem to have increased, rather than decreased, over the course of e-cigarette production. Newer versions of the e-cigarettes operate at high temperatures that facilitate the production of formaldehyde-containing compounds. This can create tremendous variability in the toxicity of the vapor produced and consumed. When used at low-voltages and low-temperatures, the e-cigarettes do not appear to produce formaldehyde. However, when used at higher temperatures, they do. Moreover, the user controls the temperature of the e-cigarettes. “Users open up the devices, put their own fluid in and adjust the operating temperature as they like, allowing them to greatly alter the vapor generated by the e-cigarette” (Thompson, 2015). The result is such a dramatic increase in formaldehyde over a normal cigarette that e-cigarette users could see his or her lifetime risk of cancer increase by five to fifteen times compared to the smoking-related cancer risk (Thompson, 2015).
Some pro-vaping advocates suggest that the study is inherently flawed. They maintain that the temperatures used in the study would not be duplicated in real life scenarios. They suggest that users would only use the lower levels, avoiding the high levels of formaldehyde exposure linked to this hotter temperature usage (Thompson, 2015). This might be a valid argument if there were some mechanism to prevent users from using the devices at high voltages, however, the newer e-cigarettes have been specifically designed to allow for this higher voltage usage. However, even these critics suggest that e-cigarette users do not correct for this problem by lowering the voltage on their cigarettes, but by taking shorter puffs at the higher voltage. The result, therefore, would not be that they avoid exposure to these higher levels of formaldehyde, but it may result in less exposure than is documented in the research.
Moreover, it is no surprise that formaldehyde is dangerous. On the contrary, formaldehyde is a well-known and well-documented carcinogen. It has a number of industrial uses and is present, in low-levels, in many common household items. It is classified as a carcinogen by the International Agency for Research on Cancer and as a probable human carcinogen by the U.S. Environmental Protective Agency (National Cancer Institute, 2011). Formaldehyde undergoes rapid changes in the body once it is inhaled, so that its carcinogenic impact might be limited to the upper respiratory tract, but it has been linked in studies to nasal and lung cancers, as well as to a higher incidence of leukemia (National Cancer Institute, 2011).
One of the most significant health problems associated with the use of e-cigarettes is the fact that the products are largely unregulated. While the federal Food and Drug Administration (FDA) has been discussing regulating vapor cigarette products, it has yet to do so. Therefore, the ingredients in them are not subject to any type of regulation. What this means is that, while formaldehyde is currently identified as a health risk associated with these products, it may not be the only health risk, as the ingredients are subject to change without notice or oversight.
While e-cigarettes may seem like a healthier alternative than traditional cigarettes, the reality is that e-cigarettes present their own health hazards. They are not effective as a smoking cessation aid and may actually lead people to consume a greater number of traditional cigarettes. Moreover, they do not minimize the health risks associated with traditional cigarettes, and may actually put users at a greater risk of developing cancer. As a result, e-cigarettes should not be considered a safe alternative for people exploring nicotine replacement therapy options.
Centers for Disease Control and Prevention. (2014, November 20). Smoking and tobacco use:
A7 Fast facts. Retrieved April 5, 2015: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/
Mellville, N. (2015, March 2). E-cigarette use liked to lower success in smoking cessation:
Presented at SRNT. Retrieved April 5, 2015 from First Word Pharma website: A8 http://www.firstwordpharma.com/node/1266722?tsid=1#axzz3TRNKH1F2
National Cancer Institute. (2011, June 10). Formaldehyde and cancer risk. Retrieved April 5,
2015 from Cancer.gov website: http://www.cancer.gov/cancertopics/causes-prevention/risk/substances/formaldehyde/formaldehyde-fact-sheet
Thompson, D. (2015, January 21). High levels of formaldehyde in e-cig vapor. Retrieved April
5, 2015 from WebMD website: http://www.webmd.com/smoking-cessation/news/20150121/high-levels-of-cancer-linked-chemical-in-e-cigarette-vapor-study-finds