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Ask the Doc: Secondhand 'Smoke' From e-Cigarettes

by Howard L. Scheiner, MD/AAHIVS
Thursday Jan 14, 2016

In this installment of Ask the Doc, Dr. Howard Scheiner takes a look at e-cigarettes, and the possible dangerous of secondhand 'smoke' from those who vape.

Quitting smoking is an excellent way to improve your overall health. And with the New Year, many people took steps to make that resolution happen -- among them, switching from cigarettes to e-cigs, or "vaping," in a move to quit.

But some wonder if vaping is actually any safer than smoking cigarettes. E-cigarettes are so new, few healthcare professionals know what chemicals are contained in them, not to mention the flavors that companies add to enhance the products for consumers.

And others question whether they can be harmed by others' vaping, much like secondhand smoke from cigarettes. Dr. Scheiner takes a cold, hard look at how things are heating up in the vaping industry.


Are e-Cigs a Healthier Option?

Q: Dear Doc, My roommate had been smoking e-cigarettes, initially as a way to stop smoking cigarettes. Recently, he has started smoking this huge vaporizer that produces enough fog for a club event or a Broadway show. Also the vapor has flavored aroma that I don't want to inhale. I don't think this is healthy but he says it's fine. What's the story?

A: The main component of e-cigarettes is the e-liquid contained in cartridges and now oftentimes tanks. To create an e-liquid, nicotine is extracted from tobacco and mixed with a base (usually propylene glycol), and may also include flavorings, colorings and other chemicals.

E-cigarettes are usually battery-operated and use a heating element to heat the e-liquid from a refillable cartridge (or tank) releasing a chemical-filled aerosol (vapor).

Roughly 500 brands and 7,700 flavors of e-cigarettes are on the market. The Food and Drug Administration (FDA) has no authority to regulate any of these products. So there is no way for anyone -- healthcare professionals or consumers -- to know what chemicals are contained in e-liquids, or how exactly e-cigarette use might affect health in the long run. (For the short run see the second question below)

But we do know that e-cigarettes contain nicotine and may have other harmful chemicals, including certain carcinogens.

The FDA did find detectable levels of toxic cancer-causing chemicals during early studies as far back as 2009 of an ingredient used in antifreeze. This appeared in two leading brands of e-cigarettes and 18 various cartridges. Levels of toxins in e-cigarette aerosols were also discovered to have varied considerably within and between brands.

We do know that nicotine is not safe. Newer e-cigarette devices, especially "tank" styles with higher voltage, also deliver a greater concentration of nicotine. This enhances the potential for addiction. Also, a 2014 study found that aerosol from e-cigarettes with these higher voltage levels contain more formaldehyde, another carcinogen with the potential to cause cancer.

Flavors in e-cigarettes may also be harmful. Flavorings that are safe to eat may not be safe to inhale, as shown by researchers at Portland State University in Oregon who demonstrated toxic degradation products that can be produced by reaction of the flavor chemicals at the high temperatures present during "vaping."

The American Lung Association finds all of this "alarming" and has urgently called for FDA oversight of these products.


Is Secondhand 'Vape' Harmful?

Q: I used to like having a cigarette after sex. Since I stopped smoking I've switched to e-cigarettes, but my boyfriend is upset with the secondhand "smoke." What are his risks from secondhand "vaping?"

A: The vapor or aerosol or "flavored fog" is the secondhand emission of the e-cigarette or "tank." As there are not many studies to date, there's not a lot that can be stated with certainty about the potential harm they may cause. But there are also no studies that show these secondhand emissions are safe. Two initial studies have found formaldehyde, benzene and tobacco-specific nitrosamines (all carcinogens) coming from those secondhand emissions.

Other studies have shown that chemicals exhaled by users also contain formaldehyde, acetaldehyde and other potential toxins. According to a study published in the journal PLOS this year, the inhalation of e-cigarette vapors damage the epithelial cells in the lungs, which leave them at risk for infection.

My preference, as a non-user, would be to avoid the potential risk.

The American Lung Association supports prohibiting the use of e-cigarettes in worksites and public places, and including e-cigarettes under smokefree laws with other tobacco products.

How you work that out with your boyfriend, I'm not sure.


Image of e-cigarette from www.vaping360.com


Called "more than a doctor, a trusted friend" by his patients, Dr. Howard Scheiner is a true native New Yorker. He was born in the Bronx, he attended the esteemed Bronx High School of Science and City University of New York before receiving his medical education at The Mount Sinai School of Medicine. Truly a Renaissance man, in addition to his lifelong service to the medical profession, Dr. Scheiner is a published author, playwright and musical composer. Combining all his loves, he is perhaps most proud of founding "The Brent Varner Project, Inc." a charity that provides free HIV services to those in need through the Actors Fund of America.


Ask the Doc

This story is part of our special report titled "Ask the Doc." Want to read more? Here's the full list.


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