Toxic Effects of Electronic Cigarettes vs. Combustible Cigarettes

by | Jul 15, 2019 | 2018, Environmental Health, Tobacco

Written by Halima Phelps, Staff Writer. Use of e-cigarettes appears to be associated with exposure to known tobacco-related toxicants, but the exposure is reduced compared with cigarette smoking.

Since their induction into the US market in 2003, e-cigarettes have greatly risen in consumerism for various reasons. Among these reasons are the idea that they might support smoking cessation, the belief that they entail less risk than combustible cigarettes, and their role as a smoking fancy with youth.1,2  However, studies have shown that there are still health risks associated with smoking e-cigarettes, and questions have been raised concerning the negative effects of these items in the marketplace: such as them posing as a gateway into other teen-smoking habits and prolongation of the process for quitting in adults; although these have not yet been statistically evident to date.1 In this population-based longitudinal cohort study, the health effects of toxicant consumption in cigarette-smokers (n=2411), e-cigarette smokers (n=247), dual combination smokers (n=792), and never users of any tobacco item (n=1655: reference group) were evaluated using 5105 male and female participants between the ages of 35-54.3

The method of testing included an evaluation of 50 biomarkers associated with tobacco toxicity. Among these biomarker categories were urinary nicotine metabolites, tobacco-specific nitrosamines (TSNAs), metals, polycyclic aromatic hydrocarbons (PAH) and volatile organic compounds (VOC).3  Urine samples were self-collected from participants and shipped in appropriate conditions overnight for processing of biomarkers via highly selective mass spectrometry using Stata, version 14.0 at the Center for Disease Control and Prevention’s Division of Laboratory Sciences.3 Statistical analyses were assessed from November 4, 2016-October 5, 2017 using the Population Assessment of Tobacco and Health (PATH).3 Results revealed that between never users and e-cigarette-only users, there was a significant difference in all major nicotine metabolites and nicotine equivalents; and the difference between e-cigarette-only users and cigarette-only smokers were similar for most metals and 3 VOC’s (toluene, benzene and carbon disulfide), but all major nicotine metabolites were significantly lower with e-cigarette only users. “Geometric mean concentrations of total nicotine equivalents (e-cigarette only users: 2.000; 95% CI, 1.100-3.500 nmol/mg creatinine; cigarette-only smokers: 27.90, 95% CI, 23.80-32.70 nmol/mg creatinine; t = 8.53, P < .001) and NNAL (e-cigarette–only users: 4.887; 95% CI, 3.817-6.257 pg/mg creatinine; cigarette-only smokers: 203.5; 95% CI, 181.7-227.9 pg/mg creatinine; t = 27.96, P < .001) were approximately 93% and 98% lower in e-cigarette–only users compared with cigarette-only smokers, respectively.” 3 And “cigarette-only smokers exhibited biomarker concentrations that were approximately 36% lower for total nicotine equivalents (dual users: 43.70; 95% CI, 39.80-48.10 nmol/mg creatinine; cigarette-only smokers: 27.90; 95% CI, 23.80-32.70 nmol/mg creatinine; t = 4.78, P < .001); and 23% lower for NNAL (dual users: 262.6; 95% CI, 240.0-287.3 pg/mg; cigarette-only smokers: 203.5; 95% CI, 181.7-227.9 pg/mg creatinine; t = 4.39, P < .001) than dual users.” 3

In conclusion, this study reveals that there is still risk of toxicant ingestion with the use of e-cigarettes, though lower than with combustible cigarettes. There is, however, a significantly-increased toxicant load with dual use. This information should be used to educate the public on the toxic load, lung effects (COPD), carcinogenic nature and other genetic harms of e-cigarettes; especially used in tandem with other tobacco sources.2

Source: Goniewicz ML, Smith DM, Edwards KC, et al. Comparison of nicotine and toxicant exposure in users of electronic cigarettes and combustible cigarettes. JAMA network open. 2018;1(8):e185937-e185937.

Open Access. This is an open access article distributed under the terms of the CC-BY License. 2018;1(8):e185937. doi:10.1001/jamanetworkopen.2018.5937

Click here to read the full text study.

Posted July 15, 2019.

Halima Phelps, BA, AA, PBT, is a graduate of the University of Wisconsin Parkside. She graduated in 2014 with a bachelor of arts in Spanish and a biology minor. She is currently a student staff member in the department of postgraduate education and completing a medical degree at the National University of Health Sciences in Lombard, IL.

References:

  1. Cummings KM, Morris PB, Benowitz NL. Another Article About E‐Cigarettes: Why Should I Care? : Am Heart Assoc; 2018.
  2. Korfei M. The underestimated danger of E-cigarettes-also in the absence of nicotine. BioMed Central; 2018.
  3. Goniewicz ML, Smith DM, Edwards KC, et al. Comparison of nicotine and toxicant exposure in users of electronic cigarettes and combustible cigarettes. JAMA network open. 2018;1(8):e185937-e185937.