A group at East Carolina University is trying to fill in the gaps is trying to fill in some gaps in e-cigarette research.
Credit: Cape Cod Health
The researchers are taking a close look at what happens when people vape inside of their vehicles. Researchers say e-cigarette users told them they like vaping instead of smoking actual cigarettes because it doesn’t make their vehicle smell, according to WNCT.com.
E-cigarette users also don’t worry as much about the effects of second-hand smoke on others in their vehicles. The group is testing that theory with the help of a three-year grant from the National Institute of Health.
“People are now making a choice to vape inside of vehicles, to vape inside their homes and vape around children, so this is something we need to understand more about,” said Dr. Eric K. Soule with the ECU Department of Health Education.
Professors believe the project is a great opportunity for ECU undergraduates to get real-world research experience.
A new study suggests that vaping reduces inflammatory biomarkers when to compared to someone who smokes combustible cigarettes. “While vaping inflammatory biomarkers were elevated compared to nonusers, those differences were not statistically significant,” the study’s authors state.
“There was also no significant difference in the elevation of biomarkers between the exclusive smokers and dual smokers – the additive effect of e-cigarettes was low if present at all.”
The research, reported in the journal Circulation, used the U.S. For Disease Control and Prevention (CDC) and the U.S Food and Drug Administration’s (FDA) Population Assessment of Tobacco and Health (PATH) that has been released yearly since 2013.
The dataset is from this first cycle using data of participants’ smoking habits along with blood samples. The researchers looked specifically at metabolites, biomarkers, of inflammation and oxidative stress – the culprits felt to underlie tobacco’s harmful effects. In addition to the usual demographic data, there was specific information on the use or nonuse of tobacco, vaping, and cigarette smoking.
Results reflect findings for adults age 18 or older, where data on biomarkers and tobacco use were available, which was 7130 participants. This included 58.6 percent neither smoked nor used e-cigarettes (nonusers); 29.6 percent smoked exclusively; 1.9 percent vaped exclusively and 9.9 percent smoked and vaped (dual users).
“Exclusive and dual smokers had the highest inflammatory and oxidative stress biomarkers relative to nonusers,” the researchers note. “Exclusive vapers had ‘significantly lower levels’ except for C-reactive protein (than smokers).”
The research concluded that e-cigarettes appear to have little impact on inflammatory biomarkers, certainly not as great as smoking tobacco. This research “highlight(s) the importance of completely replacing cigarette smoking with e-cigarettes or quitting the use of both products for cigarette smokers to derive potential health benefits,” the report states.
Vaping can have a negative effect on memory, thinking skills and the ability to focus, particularly for young people, according to a recent study by researchers at the University of Rochester (New York) Medical Center.
“Our studies add to growing evidence that vaping should not be considered a safe alternative to tobacco smoking,” said Head researcher Dongmei Li.
The study is based on data analyzed from the over 886,000 participants involved in the Behavioral Risk Factor Surveillance System Survey and the more than 18,000 responses from the National Youth Tobacco Survey.
The researchers concluded that those who vaped or smoked cigarettes were more likely to struggle with cognitive function than those who had never smoked in any capacity. Also, the researchers noted that age played a large role in the participants’ cognitive abilities as they found that when participants were younger than 14 when they started vaping or smoking, they were even more likely to have cognitive struggles as adults.
“With the recent rise in teen vaping, this is very concerning and suggests that we need to intervene even earlier. Prevention programs that start in middle or high school might actually be too late,” Li added.
Three recent studies demonstrate the potential for improved health effects that can come from the use of e-cigarettes, when such vaping products are used on a permanent basis and the use of all tobacco products is halted.
Credit: TTI
The arguments used to promote the use of electronic cigarettes (e-cigarettes) and other vaping products is with a reduction in the risk of cardiovascular disease or cancer, and as a strategy to decrease the addiction to conventional cigarettes.
Other smoking related diseases include risk of lung disease, including lung cancer and emphysema. The research areas that support this have been provided by trade site Vapor Solo. In relation to the research, a review commissioned by Public Health England concluded that e-cigarettes were 95 percent less harmful than tobacco.
The first set of research is from the University of Dundee, U.K., drawing on an extensive clinical trial into the cardiovascular effect
CARDIOVASCULAR HEALTH The second area of research relates to a trial that found that patients (114 in total) who switched from smoking to vaping experience a 1.5 percentage point improvement with their blood vessel function, as demonstrated across a four week period. This improvement was as measured against conventional cigarette users. Heart health was assessed using a Fibromuscular Dysplasia (FMD) test, to assess how far a blood vessel opens.
Further studies from the research team are underway to measure the effects over a longer time period across which the broader effects of cardiovascular health can be assessed, including the risk of heart attacks. The results are supported by a second study from the Vanderbilt University Medical Center, U.S.
This research strand showed that heavy cigarette smokers with at least a 20 pack-year smoking history can reduce their risk of cardiovascular disease by 39 percent within five years if they switch to e-cigarettes or quit altogether. In a follow-up letter to The Lancet, the researchers “estimate that e-cigarettes are 95% less harmful to users than smoking. Or, as we prefer, smoking is estimated to be twenty times more harmful to users than vaping e-cigarettes.”
CANCER DEVELOPMENT A similar investigation, this time into the risk of developing cancers, was conducted between the U.S. Centers for Disease Control and Prevention (CDC), the Roswell Park Cancer Institute, U.S., and the University College London., U.K. This study was slightly larger, taking in 181 smokers in order to assess the long-term effects of vaping.
The smoker group included users of electronic cigarettes and conventional tobacco products. To determine the health variance, those involved in the study volunteered to provide saliva, breath, and urine samples. Qualitative questionnaires were also completed.
The data indicated that levels of carcinogens (including tobacco specific nitrosamines, which are one of the most important carcinogens in tobacco formed from nicotine) taken from former smokers who had switched to e-cigarettes were significantly lower compared with regular users of smoking tobacco products.
People who used both types of products, so-termed ‘combination smokers’ did not experience any significant health improvements. The third study was published in the peer-reviewed journal: Annals of Internal Medicine, titled “Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users: A Cross-sectional Study.”
The vapor industry continues to face several regulatory challenges. One of the most challenging of those is the seemingly never-ending battle against flavor bans for e-liquids. As most any vaper will tell you, flavors are instrumental in keeping former smokers from returning to combustible cigarettes. However, flavors are also what many industry regulators and anti-vapor advocates say lure youth to try vaping.
During Vape Live, a three-day virtual trade show and seminar hosted by Ireland-based Vapouround magazine, flavors and flavor bans in the United States, the world’s largest vapor market, were trending topics. Carlo Infurna Wangüemert, a vapor market analyst with ECigIntelligence, a regulatory research resource for the e-cigarette and tobacco alternatives industry, discussed recent market trends and the factors that are influencing the U.S. vapor market.
Wangüemert said that several factors are affecting the U.S. market: the e-cigarette or vaping use-associated lung injury (EVALI) scare, the Covid-19 pandemic and the U.S. Food and Drug Administration’s (FDA) premarket tobacco product applications (PMTAs). He said that Covid-19 didn’t impact market growth as much as it impacted consumer behavior.
Yael Ossowski / Credit: Consumer Choice Center
“We’ve seen a reduction of purchasing occasions and an increase of basket sizes [during the Covid-19 crisis],” he said. “We’ve also observed consumers buying a lot before the crisis in order to have enough stock in case of lockdowns, and it might also have affected the supply side as many independent shops had to close or have suffered an important drop of sales.”
Concerning supplies, Wangüemert sees the PMTAs drastically reducing the amount of variety on the market as many brands will try to keep their offerings as simple as possible. Before the FDA’s ban on prefilled flavored vape pods, those products represented half of the U.S. vapor market. Now, there is a rise in disposable e-cigarettes and refillable pod systems, according to Wangüemert. He said that this has led to several innovations in flavor output, such as better coils in open pod systems.
“Basically, hardware manufacturers are trying to develop new features and improving the functionality of their devices to make them small but complex enough to cover all vapers’ needs,” said Wangüemert, citing innovations that allow vapers to change temperature or change from mouth-to-lung to direct-to-lung with just one button as examples.
Refillable pod systems are the fastest-growing trend in the vapor industry, according to ECigIntelligence data. This is because they offer a larger selection of flavored e-liquids. Prefilled pods, however, are dropping because the only available flavors, tobacco and menthol, generate less complexity.
“Prefilled pods … show fairly well how regulation can have an impact on the market,” he said. “This ban is fully enforced online as only those two flavors are offered currently. We’ve observed an ongoing drop in the complexity of their flavors. Tobacco is [now] probably the most important flavor in prefilled pods.”
The U.S. market has also seen a surge in nicotine strengths, brought on mostly by the growing popularity of nicotine salts. Wangüemert said that nicotine salt-based e-liquids have been continually gaining ground during the last three years to the detriment of freebase liquids. “However, it is also interesting to point out that the average nicotine strength of nicotine salts is slowly going down,” he said.
Fruit flavors are also steadily rising in the U.S. market, according to Wangüemert. He said that fruit e-liquids, dessert and candy flavors all consume the Top 5 positions in flavors for e-liquid sales in 2020. “For the fruit category, which is mainly tropical fruits, mainly mango, are the ones helping the most in the growth of that category,” he said, adding that beverage flavors are also growing quickly, with lemonades experiencing a substantial amount of growth. “This might also be linked to the popularity of fruits, as lemonades are likely to contain them,” he explained.
Carlo Infurna Wanguemert / Credit: ECigIntelligence
Looking at tobacco and menthol flavors, Wangüemert explained that e-liquids containing tobacco generally have tobacco as the main flavor. However, menthol is much more popular as a complement to other flavors, such as fruit.
“Only 13 percent of the products that contain menthol have menthol as the main flavor. But [for] the other 87 percent, menthol is a complement or a cooling agent, being particularly popular in the fruit category,” he said. “Of course, these 87 percent of e-liquids that contain menthol that do not have it as the main flavor are more subject to potential bans than menthol-only flavors, which have been already excluded. However, our 2019 vape shop survey points out that menthol and tobacco represent just a small percentage of vape store revenues, meaning that flavor bans at the state level or even the consequences of the PMTA might strongly reduce their income and the vaping market in general as the offerings and variety of e-liquids were strongly reduced.”
Also speaking during Vape Live, Yael Ossowski, deputy director for the Consumer Choice Center (CCC), a consumer advocacy group, said that flavor bans in many U.S. states have had a major impact on the growth of the vapor market. States with strict flavor bans have seen major declines, with many vapers in those states returning to combustible products.
This prompted his organization to rank states by vaping regulations and the impact those regulations had on the vapor market. The group looked at how all 50 states confronted flavor restrictions, taxes and whether the state allowed for online sales. The CCC gave each state a number of points depending upon how much consumers were subject to the criteria. States that scored between 0–10 points received an F, 11–20 points received a C and 21–30 points received an A.
The states best suited for vaping were colored green on the corresponding chart while the worst states were colored red and middle-ground states were colored yellow. “For green states, we’ve got South Carolina, Georgia; we’ve got Iowa, Virginia, Florida, Texas and Oregon. You’ll notice, obviously, the red states, the places where we’re dealing with partial flavor bans, high taxes, shipping restrictions, there’s six of them.
Places like California, New York. You have New Jersey, Massachusetts, Rhode Island and Illinois,” said Ossowski. “Now we have our states in yellow. These are places that had a flavor ban in the past, and perhaps they’ve gotten rid of it, or it has not yet come into force. You have some taxation. It’s probably a bit more moderate than definitely those red states. And it has fewer shipping restrictions. People are able to order their vaping products online.”
One of the worst states, New York, has a tax rate of 20 percent of the retail price. Online sales are banned and all flavored products, except tobacco and menthol, are banned. These states, with low rankings, are also prone to other negatives for the vapor market, such as a growing black market, according to Ossowski.
California also has a statewide ban that is supposed to go into effect on Jan. 1, 2020. California also has several cities, such as San Francisco, that have banned vapor products entirely. It should be noted that, in California, flavor bans typically are only focused on nicotine vapor products, not marijuana vapor products. This is especially puzzling since the U.S. Centers for Disease Control and Prevention (CDC) has stated that the EVALI lung disease scare was caused by black market marijuana vapor products, not nicotine products.
“There is a lot of work that has been done by some very enterprising young journalists that kind of details everything with the black market when it comes to flavored vaping products. And that’s only just now burgeoning up in New York,” Ossowski explained. “There could be a lot more on this. We’re going to see. There’s not the biggest mainstream coverage on this.”
Credit: Consumer Choice Center
One of the main reasons that the CCC compiled the data and ranked the states is that the consumer group doesn’t want other states to follow behind states like California and Illinois by banning or restricting flavored vapor products. Ossowski said that these bans are detrimental to public health.
“It’s very dangerous. And in a way, by making it more expensive and pushing people often to the illegal market, not only are you seeing your price go higher, you’re also making it more difficult for people to acquire the products that they have transitioned away from tobacco to use. And we thought we’d actually be saving their lives and improving their lives. But what we see more often than not is that legislators make it harder,” he said. “They make it more difficult, and they actually put way more cumbersome barriers in the way so that you and I cannot access those products. We really do need to concentrate on laws, on policies, on studies, on figuring out who are the legislative champions that we can turn to in state legislatures or in the federal bureaucracy to be able to ensure that we have better laws that will enable harm reduction, that will enable us to continue to have vaping products for sale.”
California is the “worst state for vaping.” A new index ranks New York, California, New Jersey, Massachusetts and Rhode Island as the top states having the least consumer-friendly regulatory approach to vaping. The states of Virginia, Colorado, Texas and Maryland each received “A” scores.
The findings come from a report by the Consumer Choice Center, which ranks each state “based on its consumer-friendly regulatory approach to vaping products.”
David Clement and Yaël Ossowski, North American Affairs manager and deputy director of the Consumer Choice Center, the study’s authors, wrote in a press release that recent legislative actions on flavored vaping products including restrictions, taxation, and online sales prohibitions were key to each state’s score (graded A, C, or F).
“The worst states … are far behind all the other states because of flavor bans, exorbitant taxation on vaping products, and restrictions on online sales,” said Clement, North American Affairs Manager at the Consumer Choice Center. “Our research indicates these states go above and beyond to deter adult smokers from switching to vaping, which could vastly improve and prolong their lives.”
The U.S. Centers for Disease Control and Prevention is out with a false advertisement telling kids that “Nicotine in e-cigarettes can harm brain development.” The headline says, “It’s not like you can buy a new brain.” To make it accurate, I’ve added “…for your pet mouse,” writes Brad Rodu in his blog rodutobaccotruth.
Let me be crystal clear. The harm in brain development federal officials talk non-stop about only happens in laboratory torture of mice. Mouse studies are well known to be of questionable value in predicting human effects. There is absolutely no scientific evidence to support the claim that nicotine causes harm to human brain development, so it is astounding that federal officials traffic in this false narrative. This nonsense is an affront to 34 million adult current smokers and 55 million former smokers in the U.S., virtually all of whom started when they were teenagers. There is no evidence that their brain development was harmed, a fact that was specifically acknowledged by a prestigious nicotine researcher Dr. Neal Benowitz at an international tobacco meeting this week.
Credit: Brad Rodu
I have for years catalogued CDC misinformation campaigns regarding smokeless tobacco (examples here, here, here) and e-cigarettes (here, here, here, here).
Today, CDC’s bungling of Covid-19 facts and guidance is pulling back the curtain on that agency’s tragic shortcomings and its readiness to disregard or “warp” the truth. Educated tobacco users have known the CDC has been lying about and to them for years.
Increased rates of vaping nicotine and marijuana products in the U.S. did not result in more e-cigarette or vaping-related lung injuries (EVALI) cases, according to a new study from the Yale School of Public Health (YSPH).
“If e-cigarette or marijuana use per se drove this outbreak, areas with more engagement in those behaviors should show a higher EVALI prevalence,” said assistant professor Abigail Friedman, the study’s author. “This study finds the opposite result. Alongside geographic clusters of high EVALI prevalence states, these findings are more consistent with locally available e-liquids or additives driving the EVALI outbreak than a widely used, nationally-available product.”
Published in the Journal Addiction, the research estimates the relationship between a state’s total number of reported cases of EVALI per capita as of January 2020, and pre-outbreak rates of adult vaping and marijuana use, according to a release from the YSPH. Results show that higher rates of vaping and marijuana use are associated with fewer EVALI cases per capita.
The U.S. Centers for Disease Control and Prevention (CDC) announced in February that it had officially classified vitamin E acetate, an additive long linked to EVALI and most common in THC e-liquids that are informally-sourced—i.e., purchased off the street or home-mixed—as “a primary cause of EVALI.”
The EVALI outbreak has motivated a variety of state and federal legislation to restrict sales of nicotine e-cigarettes, including a temporary ban on all e-cigarette sales in Massachusetts in late-2019 and bans on flavored e-cigarette sales in several states and localities. However, if the goal was to reduce EVALI risks, the study suggests that those policies may have targeted the wrong behavior.
The study found that the five earliest states to legalize recreational marijuana—Alaska, California, Colorado, Oregon and Washington—all had less than one EVALI case per 100,000 residents aged 12 to 64, according to the release. None of the highest EVALI-prevalence states—Utah, North Dakota, Minnesota, Delaware and Indiana—allowed recreational marijuana use.
Despite the United States weathering the most severe healthcare crisis in generations, some elected officials are pushing policies that would push death rates even higher.
On August 11, Rep. Raja Krishnamoorthi (D-Ill.) the chairman of the Oversight Subcommittee on Economic and Consumer Policy, wrote to Food and Drug Administration Commissioner Stephen Hahn demanding a complete ban on the sale of reduced-risk tobacco alternatives such as e-cigarettes throughout the United States.
This is a misguided and dangerous move because these harm reduction products are proven to be 95 percent safer than combustible cigarettes, and twice as effective as conventional nicotine replacement therapies.
The key is the lack of smoke and corresponding carcinogens that lie in combustible tobacco. Since their inception 10 years ago, these products have provided a lifeline for smokers previously unable to quit their deadly habit.
According to the most comprehensive peer-reviewed research coordinated by the George Washington University Medical Center, if a majority of smokers in the United States quit smoking through the use of e-cigarettes over the next 10 years, there would be 6.6 million fewer premature deaths — one of the biggest public health breakthroughs in generations.
Despite the overwhelming scientific evidence on the benefits of smokers switching to vaping products, Krishnamoorthi has decided to use the COVID-19 pandemic as a pretext to support Big Tobacco and drive vapers back to smoking.
The lawmaker is using junk science to argue that vaping and smoking were somehow responsible for COVID-19 spread. Unfortunately for Krishnamoorthi, 763 studies published in the world’s most prestigious medical journals such as the European Respiratory Journal and Lancet have concluded otherwise.
These analyses have examined the medical records of millions of people in dozens of countries around the world and have completely and utterly debunked the representative’s spurious claims.
Not one to let “science” or “evidence” get in the way of his ideological agenda, Krishnamoorthi nevertheless was able to find one study he claimed supported his viewpoint. But the study presented is a study in itself on how not to analyze and interpret data.
The study conducted in May was limited to one online survey, with a relatively small number of respondents. Unlike the 763 credible studies that actually examined medical data, this particular analysis was limited to self-reporting by people who chose to engage in a survey on a website.
Even more important, the study does not even say what Krishnamoorthi claims it does. In fact, the study finds vapers — whether current or former — have no statistically significant higher rate of contracting COVID-19 than people who have never used this product.
The “spike” occurred only with dual users. But clearly, if neither smoking nor vaping increase your risk of developing symptoms, then there is no mechanism by which dual use would increase coronavirus risks, making the result a logical impossibility.
That is not the only bizarre thing about the results. The study contends that previous use of cigarettes increase risk, yet consumption over the last 30 days has no association whatsoever with COVID-19 incidence. Unfortunately, the empirical malpractice does not stop there.
The paper fails to adjust properly for the fact that more vapers chose to have a COVID-19 test than the population as a whole. This isn’t too surprising given most vapers are more health aware and health conscious, hence would be more like to opt for voluntary testing.
Clearly, this “study” — the only justification Krishnamoorthi has for his calls for prohibition — is worse than useless. The lawmaker leans heavily on an analysis that excludes all medical data and instead relies solely on a self-reporting online survey.
The results contradict 763 credible studies, rely on methodological pyrotechnics, and torture the data so brutally it would make a Bond villain blush. Yet it still doesn’t say what Krishnamoorthi wants it to say and has the unavoidable conclusion that e-cigarettes do not lead to higher rates of COVID-19.
For Krishnamoorthi to deny the science and condemn Americans to a preventable death just to fulfill a personal vendetta against reduced risk products is simply repulsive. There is absolutely no doubt that any ban on the sale of reduced risk tobacco alternatives would lead to countless easily preventable deaths as people once again take up the deadly habit of smoking.
The FDA must ignore this nakedly political letter, and instead act in accordance with the evidence. Millions of lives depend on it.
Tim Andrews is the executive director of the Taxpayers Protection Alliance. He wrote this for InsideSources.com.
Contrary to what its authors suggest, a recent study led by Stanford University fails to demonstrate a causative relationship between vaping and Covid-19 infection, according to the U.K. Vaping Industry Association (UKVIA).
Researchers at the Stanford University School of Medicine recently found that among young people who were tested for the coronavirus, those who vaped were five times to seven times more likely to be infected than those who did not use e-cigarettes.
“Whilst we welcome any research which can assist people in staying safe during the Covid-19 pandemic, the UKVIA is disappointed by the Stanford-led study which appears to dismiss the vital harm-reduction role of vaping for smokers. The study draws disproportionate conclusions, is fundamentally flawed and inconclusive,” said John Dunne, director of the UKVIA.
“While the leader of the study, Dr. Shivani Gaiha, has attempted to account for study participants ‘sheltering in place,’ this metric is self-reported and as such may be unreliable.
“Dr. Gaiha’s study also considers ‘ever-use’ to indicate that a person is a vaper. When this is corrected for those who were vaping within 30-days of a Covid-19 diagnosis, the connection between vaping and the virus is no longer significant. To suggest that any use of a vaping product dramatically increases the chances of contracting Covid-19 is therefore a gross exaggeration.”
“Furthermore, the UKVIA is concerned to see the researchers taking a partial approach to this research and calling upon regulation as a result of dubious findings. Putting such a call out on the back of the research seriously calls into question its purpose.”
Dunne also noted that the issue of youth vaping observed in some other countries is not representative of the situation in the U.K.
