Used steam is dangerous for young people

Under steam

More than 120,000 people die every year in Germany from tobacco smoke. The e-cigarette seems to be the lesser of two evils: No smoke is inhaled, but rather a liquid evaporates that you inhale or puff. The ingredients are considered less harmful, vaping as less addictive.

The UK health authorities and the Royal College of Physicians medical association estimate that e-cigarettes are around 95 percent safer than tobacco smoke. Against the background that with the smoke of a cigarette, among other things, condensate, benzene, hydrogen cyanide or formaldehyde are inhaled - a total of 12,000 different substances, most of which are toxic or carcinogenic - and 15 to 40 milligrams of biologically active pollutants are in the main flow of a filterless find, e-cigarettes could actually be considered harmless.

Even so, the UK is left alone with its extremely positive assessment of vaping. A US team led by David Eaton from the University of Washington has come to the conclusion after a large-scale analysis of more than 800 studies on behalf of Parliament: E-cigarettes are far less harmful than conventional glow sticks. But the researchers emphasize that there are also health risks here that cannot yet be properly assessed.

For example, there is no doubt that nicotine is addicting. How high the dependency potential is cannot yet be classified because the vaporizers have only been on the market for a few years. There is moderate evidence that the risk and severity of addiction are less pronounced with e-cigarettes, but this depends on the amount of nicotine in the liquid used - the e-liquid - and the device used.

E-liquids don't always contain nicotine, but they do contain many other substances that are inhaled when vaping and that can be toxic. This was recently confirmed by a study by the University of North Carolina, published in the journal Plos Biology. Robert Tarran's scientists exposed human cell cultures to 7700 different e-liquids, all of which are flavors that are available for sale. The more a liquid disrupted cell growth when it evaporated, the more toxic the experts rated it.

"It turns out that the ingredients in e-liquids are extremely different. Some of them are more toxic than nicotine alone and more harmful than the standard ingredients in e-cigarettes, namely propylene glycol and vegetable glycerin," says Tarran. Both substances are used as humectants. They are considered harmless when swallowed, but are inhaled in the e-cigarette, as the American researchers point out.

In their experiments, propylene glycol and glycerine significantly disrupted cell growth, even in small doses - pure, without aromas and nicotine. In general, the more ingredients the liquid contains, the more toxic its effect, warn Tarran and his colleagues.

According to the University of Washington, it is currently not possible to assess whether e-cigarettes increase the consumer's risk of cancer in the long term. However, it has been proven that vaping in closed rooms increases nicotine and fine dust pollution for non-smokers - even if not quite as strongly as tobacco smoke. E-cigarettes could cause coughing and wheezing in adolescents and increase the number of seizures in asthma patients, the US researchers emphasize.

Studies by the State Health Office of Bavaria, among others, indicate that the ultra-fine particles from oversaturated propylene glycol vapor penetrate deep into the lungs, impair breathing and cause inflammatory processes. The fine dust particles also had effects, which is particularly problematic for children and pregnant women who are exposed to the steam for a long time as passive smokers.

Apart from that, the risk of addiction is not off the table. Experts fear that e-cigarettes will make it easier for young people to start smoking. A study by the Mannheim Institute for Public Health at the University of Heidelberg in 2015 came to the conclusion that e-cigarettes are widespread among young people.

16 percent of the 840 seventh and eighth graders surveyed had tried an e-cigarette at least once. Above all, secondary school students are apparently susceptible: for them it was around a third. For the total schoolchildren, 17 percent had steamed, for the high school students only nine percent.

The Mannheim researchers have observed that the young people are instigated primarily by their social environment. Most of those who use e-cigarettes do not belong to the class of tobacco smokers. The inhibition threshold to take up the e-cigarette is lower than with tobacco. The University of Washington evaluation also sees substantial evidence that vaping can later induce adolescents and young adults to smoke.

In any case, business is booming. In Germany alone, the sales of e-cigarette manufacturers rose from 2010 to 2015 from five million to 275 million euros. The e-cigarette trade association believes this trend will continue. Market observers consider growth of a third within a year to be realistic. "E-cigarettes have now become a supposedly cool trend product for young people, too, which can be connected to a PC to tune the steam," says Sven Schneider, head of the child health research department at the Mannheim Institute for Public Health.

The young people would be lured by their curiosity. The industry is likely to further optimize the potential for dependency through technical changes and the chemical composition of liquid and steam, Schneider fears. The claim of the manufacturers that mainly smokers who want to quit are switching to e-cigarettes is not confirmed by research.

For example, a recent study by Massachusetts General Hospital of 1,357 adults, published in the Annals of Internal Medicine, shows that vaping can even discourage people from giving up tobacco. The medics interviewed patients who had decided to quit smoking after hospitalization, one and three months after discharge. Six months later, the researchers combined the interviews with laboratory tests.

Result: Those who had switched to e-cigarettes in some cases after their discharge smoked more than those who did not vape. However, this was especially true for nicotine addicts who did not have access to a smoking cessation program, the researchers say. Perhaps that smooths out the contradiction that arises here between the work from Massachusetts and the Washington evaluation: David Eaton and team come to the conclusion that vaping helps adults to leave out tobacco.


Smoking is also bad for the liver

Most people know that smoking is not good for the lungs and heart. But the smoke also damages the liver - and that probably also applies to e-steam. As a central detoxification organ, the liver is stressed primarily by nicotine, which it filters out of the blood. More than ten million people in Germany now have fatty liver disease - nicotine consumption can accelerate the progression of the disease.

An animal study by the Charles R. Drew University of Medicine and Science in Los Angeles shows that e-cigarettes may also have an influence on liver diseases. The researchers exposed mice to the vapor from e-cigarettes. The nicotine concentrations in the blood corresponded to those of human vapers, according to the researchers led by Theodore Friedman. The laboratory mice lacked the gene for apolipoprotein E; they were thus prone to a lipid metabolism disorder, which is associated with an increased risk of cardiovascular diseases and blood vessel constriction. There is a similar rare hereditary disease in humans, familial dysbetalipoproteinemia. As the US experiments showed, after twelve weeks 433 genes were altered in the steamed mice, which are related to the development of fatty liver. In addition, the rodents' internal clock had changed, which can accelerate the development of fatty liver. The researchers believe their results are transferable to humans.