E-CIGS: THE INCENDIARY TRUTH

Just 10 puffs increase your risk of heart disease They make blood pressure soar like tobacco They make smokers LESS likely to quit

ADECADE ago, e-cigarettes were nothing more than a novelty. The battery-powered devices, which heat up a liquid containing nicotine and flavouring, so that it can be inhaled as a vapour, were dismissed by many as little more than a passing fad. Now, however, they are everywhere. Thousands of people in Ireland today use ecigarettes, drawn in by the seductive proposition that they can happily puff away without damaging their health. The legion of users here is growing daily.

So-called ‘vaping’ is also gaining popularity across the globe, encouraged by doctors who believe that it is far safer than smoking real cigarettes. Not surprisingly, tobacco giants, keen to defend their profits, are buying up brands and creating their own products.

Now, however, a growing number of studies have cast serious doubt on the rosy assumption that e-cigarettes are an almost harmless alternative to smoking. The latest research is deeply worrying. Scientists at the world-renowned Karolinska Institute in Stockholm have discovered that just 10 puffs on an e-cig are enough to trigger physiological changes that, in the words of one leading expert, ‘start the heart disease ball rolling’.

This study follows others which have found that – just like ‘real’ cigarettes – ecigs raise blood pressure and promote a hardening of the arteries. Separate research indicates that the food additives used to flavour the vapour could be dangerous when heated and inhaled.

And another hotly disputed study, published earlier this year, even suggested that those who vape are 28% less likely to quit tobacco than those who do not.

Despite all this, there remains a widespread view, not least among policy-makThey ers, that smokers should be encouraged to switch from tobacco to e-cigarettes.

However, critics of this approach remain unconvinced.

Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, said: ‘We simply can’t know what their effect will be on health if used over the long term, because they have not been around long enough. To me, it would be sensible to take a precautionary approach and regulate them.’

And Dr Filippos Filippidis, lecturer in public health at Imperial College, London, said: ‘We don’t know whether we may start to see diseases emerge in 10 or 20 years’ time associated with some of the ingredients. We urgently need more research into the devices.’

His warning is particularly chilling because it took decades for the link between tobacco and lung cancer to emerge.

In the Karolinska study, published in the journal Atherosclerosis, Swedish researchers took 16 occasional smokers of cigarettes and asked them to each take 10 puffs on an e-cigarette. Within the first hour, there was a ‘rapid rise’ in levels of a type of cell indicating damage to the inner lining of blood vessels, called endothelial progenitor cells or EPCs, the scientists found.

This increase, they wrote ‘was of the same magnitude as following smoking of one cigarette’.

added that this ‘very short exposure to e-cigarette vapour… may indicate an impact on vascular integrity leading to future atherosclerosis’ – better known as hardening of the arteries.

Professor Joep Perk, a heart specialist and spokesman for the European Society of Cardiology, said: ‘It really surprises me that so little vapour from an e-cigarette is needed to start the heart disease ball rolling. It’s worrying that one e-cigarette can trigger such a response.’

So will long-term use of e-cigs cause heart disease? That remains to be seen. But the Swedish study is not alone in raising concerns.

In August, a team at the University of Athens Medical School claimed that puffing on an e-cigarette for half-an-hour led to similar levels of stiffness in the aorta – the main artery – as smoking a traditional tobacco cigarette. Both activities also raised blood pressure.

Study leader Professor Charalambos Vlachopulos said: ‘E-cigarettes are less harmful (than smoking tobacco) but they are not harmless. I wouldn’t recommend them now as a method of giving up smoking.’

New research is coming thick and fast. But it is a study in the journal Lancet Respiratory Medicine – which found that e-cig users were 28% less likely to quit tobacco than those who didn’t vape – that has caused the most dispute. This finding matters because the vast majority of e-cig users are trying to quit tobacco.

Co-author Stanton Glantz wrote: ‘While there is no question that an e-cigarette is less dangerous than a cigarette, the most dangerous thing about e-cigarettes is that they keep people smoking cigarettes.’

His findings have been leapt on by e-cig sceptics. But e-cig advocates have dismissed it as unscientific and ‘grossly misleading’.

Peter Hajek, of the Tobacco Dependency Research Unit at Queen Mary University of London, said it only looked at current smokers who had used e-cigarettes in the past – ignoring ex-smokers who had given up tobacco thanks to the devices.

Advocates of getting smokers to

Very little vapour is needed to start heart disease ball rolling. It’s a worry

Switching is really a no-brainer, as nothing is worse than smoking

swap tobacco for e-cigarettes now fear their simple message – that switching saves lives – is getting lost in a cloud of confusion.

Professor John Britton, director of the Centre for Tobacco and Alcohol Studies at Nottingham University, said: ‘The decision to switch should be a no-brainer. There’s nothing worse for health than smoking.’

And e-cigarettes did help 18,000 people quit smoking last year, according to research by University College London and Cancer Research UK.

Scientists such as Dr Britton believe that despite the lurking dangers of e-cigarettes, they could deliver huge benefits to health.

To that end, a group of 13 health bodies in Britain issued an unprecedented ‘consensus statement’ in July, supporting the principle that smokers should be encouraged to switch.

However, Dr Filippidis said: ‘Only time will tell who is right; but my personal opinion is that some more caution would be prudent until the evidence is clearer.’