Feb 25, 2018 | Updated: 09:54 AM EDT

Clearing Up the Smoke—Editorial On E-Cigarettes Study & Public Opinion

Jan 28, 2015 08:03 PM EST

In a recent article published by our writers entitled "Just a Bunch of Hot Air? The Truth About Vaping" our journalist investigated new research published by the New England Journal of Medicine regarding e-cigarettes and health implications associated with vaping. Readers have said that the article propagated fear tactics to decidedly speak against vaping, and with so many questions having recently arisen in response to the article, the editorial staff has decided that it is best to clear up the subject here. 

Firstly we would like to say that while new research is often criticized or even questioned in its efficacy at pinpointing applicable problems in practice, rather than in theory, we as science journalists share a wide breadth in our combined knowledge and specifically report on studies published in reliable, well-established journals to bring news to our readers. Though our readers may at times find that some information is merely highlighted in our articles, we try our best to present new findings but ultimately leave the final interpretation of the studies to be done by our readers. We could feasibly include important statistics like p-values and ANOVA tests that are performed by researchers to ultimately relay the importance of their findings, however, as reputable journals significantly investigate these findings and have them peer-reviewed, that is not necessary in most cases.

The new study in question is entitled "Hidden Formaldehyde in E-Cigarette Aerosols" and was published last week in the New England Journal of Medicine after extensive review. Looking to investigate the health-related implications of electronic cigarettes, researchers from Portland State University in Oregon tested liquids and flavorant chemicals used in e-cigarettes, finding that under certain conditions the liquids degraded into formaldehyde-releasing agents that are potentially carcinogenic to consumers. While the study admittedly does not apply to all vaping liquids, neither to all smokers of e-cigarettes, the purpose of the study was to reveal certain conditions that reportedly can increase risks of cancer as much as 15 times that of long-term cigarette smoking.

"E-cigarette liquids are typically solutions of propylene glycol, glycerol, or both, plus nicotine and flavorant chemicals. We have observed that formaldehyde-containing hemiacetals, shown by others to be entities that are detectable by means of nuclear magnetic resonance (NMR) spectroscopy, can be formed during the e-cigarette 'vaping' process" lead author of the study, David H. Peyton says. "Formaldehyde is a known degradation product of propylene glycol that reacts with propylene glycol and glycerol during vaporization to produce hemiacetals." 

"This happens when propylene glycol and glycerol are heated in the presence of oxygen to temperatures reached by commercially available e-cigarettes operating at high voltage. How formaldehyde-releasing agents behave in the respiratory tract is unknown, but formaldehyde is an International Agency for Research on Cancer group 1 carcinogen."

Utilizing 10 successive aerosolized samples to create their model, the researchers found significant enough concentrations to warrant health-related warnings for readers, though the study author does acknowledge that further research is likely necessary to further conclude the exact behavior of the chemicals and implications of these hemiacetals.

Not conducted with human test subjects, as is often the case in these types of studies, researchers utilized a tank system to measure each puff. The chemicals released were calculated at varying voltages, which while they may not necessarily be common for all consumers are plausible smoking voltages, given recent modifications in the vaping industry as consumers look for more customizable smoking devices to suite their needs.

Ironically enough, while consumers may be outraged with what they believe to be exorbitantly large values and estimations made on behalf of the researchers, the study authors note that their estimates are conservative, as they did not collect all aerosolized liquid throughout the course of their studies.

Furthermore, researchers at the moment are unaware of how these chemicals react in reality within biological systems, which is why the study authors warn against such extremes, since "formaldehyde-releasing agents may deposit more efficiently in the respiratory tract than gaseous formaldehyde, and so they could carry a higher slope factor for cancer."

The study in question has caused quite a bit of controversy, as it further expands on growing literature against electronic cigarettes, however, while the data remains conservative in its application to actual consumers other health professionals not involved in the study are speaking out against the particularly rare conditions that are not often the norm with smokers of electronic cigarettes.

"The study went searching for formaldehyde, one of carcinogens that are also present in cigarette smoke. It found it when e-liquid was heated to maximum and drawn via long puffs by a machine" Director of the Tobacco Dependence Research Unit at the London School of Medicine and Dentistry, Professor Peter Hajek says. "In e-cigarette use by humans, overheating the liquid generates acrid tasting 'dry puff' which is unpleasant and avoided rather than slowly inhaled. When a chicken is burned, the resulting black crisp will contain carcinogens but that does not mean that chicken are carcinogenic. Without overheating the e-liquid, no formaldehyde was detected."

As is the case with any research or controversial issue, readers and researchers can find supporting information on either sides of an argument, however, we as science journalists rather take an objective role and present credible information as it is published within the science community. And ultimately, while we try our best to present all of the important facts to our readers, we always suggest that inquiring minds follow links within our articles to the primary sources where the efficacy of the study and supporting information may be found. 

We appreciate your continued interest and you sharing your opinions on the news that we present.

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