Cleaveland: Too early to say that e-cigarettes are safe

Cleaveland: Too early to say that e-cigarettes are safe

January 8th, 2015 by By Dr. Clif Cleaveland in Life Entertainment

Dr. Clif Cleaveland

Dr. Clif Cleaveland

Electronic nicotine delivery devices -- better known as e-cigarettes -- were introduced several years ago as a harmless substitute for cigarettes, cigars and pipes. The devices permit use of nicotine without exposure to the cancer-causing chemicals contained in tobacco. Sales of e-cigarettes have subsequently boomed for both tobacco users and those who have never smoked, chewed or dipped.

Some who use e-cigarettes insist that, by using them, they were able to wean themselves off tobacco, a positive development. But it's far too early in the testing to say that e-cigarettes are truly safe.

The device employs a battery to heat a cartridge which contains a solution of nicotine and other chemicals. The resulting vapor is inhaled in a process dubbed "vaping."

Many different devices are available with widely varying designs. The dose of nicotine delivered per inhalation differs from brand to brand. Some e-cigarettes may be altered for use with other drugs such as marijuana.

There is even greater variability among the hundreds of vaping solutions that may be used in a device. Glycerol and propylene glycol are often used as carriers of nicotine, along with such synthetic flavoring agents as menthol, tobacco, chocolate, various desserts and fruits. The identity of many chemicals is not disclosed by manufacturers.

Nicotine is rapidly absorbed from the lining of the mouth and transported to the brain, where it attaches to neural receptors. Once activated, these receptors trigger the release of dopamine and other neurochemicals that generate a sensation of pleasure. Cocaine, heroin and marijuana produce a similar response.

Nicotine activates the sympathetic nervous system, the body's emergency response system. The resulting release of epinephrine increases both pulse rate and blood pressure. So when taken in puffs, nicotine may act as a stimulant, but when deeply inhaled, nicotine also may have a sedative effect. Because the effects are short-lived and the body rapidly adapts to them, larger and more frequent doses of nicotine are required to sustain the drug's actions. This is true whether the nicotine comes from a regular or an e-cigarette.

The various flavoring agents are added to nicotine to give the solution the appeal of candy or a dessert. These chemicals raise a number of questions. Many have been tested for safety but only in the ingested form. The effect of these agents on the lungs' respiratory lining is unknown. No one knows exactly what new chemicals are generated by combustion of these chemicals. There is no information on fetal risk if pregnant women choose to use e-cigarettes.

Some who use e-cigarettes insist that, by using them, they were able to wean themselves off tobacco, a positive development. But it's far too early in the testing to say that e-cigarettes are truly safe.

And aggressive promotion of the devices has led to a rapid rise in their use by teens. A recent study from the University of Michigan showed that, in 2014, more teens used e-cigarettes than tobacco-containing cigarettes. Among eighth graders, 9 percent had tried the devices within the previous 30 days compared with 4 percent who had smoked traditional cigarettes. Seventeen percent of 12th graders had used e-cigarettes versus 14 percent who had used tobacco in the same interval.

The brain of a teenager is undergoing vital changes, especially in the complex connections related to the organization and control of emotional responses, a process that continues until the early 20s. There is no data available to determine the effects of increasing doses of nicotine at this stage of development.

Tennessee and its neighboring states have banned the use of e-cigarettes in minors. Ten states and the District of Columbia do not limit their use. So millions of children can buy e-cigarettes.

We live in a time of suspicion of governmental regulations. Because of the many uncertainties regarding the safety of e-cigarettes, the U.S. Food and Drug Administration needs to push aggressively for a nationwide ban on the use of the devices and their related substances by minors and pregnant women. Until full testing of the safety of the countless chemicals used in e-cigarettes is completed, the FDA should raise red flags about their use by anyone.

At present, e-cigarettes serve mainly the profit motives of their manufacturers and distributers.

Contact Clif Cleaveland at cleaveland1000@comcast.net.