VAPING, E-CIGARETTES CAN BE ADDICTIVE
New study has evidence that vaping can be addictive, and exposure to nicotine in e-cigarettes is highly variable, writes SHEILA KAPLAN
ANATIONAL panel of public health experts concluded in a report released Tuesday that vaping with e-cigarettes that contain nicotine can be addictive and that teenagers who use the devices may be at higher risk of smoking.
Whether teenage use of e-cigarettes leads to conventional smoking has been intensely debated in the United States and elsewhere. While the industry argues that vaping is not a stepping stone to conventional cigarettes or addiction, some anti-smoking advocates contend that young people become hooked on nicotine, and are enticed to cancercausing tobacco-based cigarettes over time.
The new report by the National Academies of Sciences, Engineering and Medicine is the most comprehensive analysis of existing research on e-cigarettes. The report also cited conclusive proof that the devices are safer than traditional smoking products and may help smokers quit, citing conclusive proof that switching can reduce smokers’ exposure to deadly tar, dangerous chemicals and other carcinogens.
But, it stopped short of declaring that e-cigarettes are safe, noting that there are no long-term scientific studies of the devices’ addictive potential or their effects on the heart, lungs or on reproduction.
The panel found evidence among studies it reviewed that vaping may prompt teenagers or young adults to try regular cigarettes, putting them at higher risk for addiction, but that any significant linkage between e-cigarettes and long-term smoking has not been established. It said it was unable to determine whether young people were just trying cigarettes or becoming habitual smokers.
“When it got down to answering the questions about what the impacts on health are, there is still a lot to be learned,” said David Eaton, of the University of Washington, who led the committee that reviewed existing research and issued the report. “E-cigarettes cannot be simply categorised as either beneficial or harmful.”
The report was commissioned in 2016, after the Food and Drug Administration gained the authority to regulate tobacco products that had previously been outside its jurisdiction, such as ecigarettes and cigars.
Mitch Zeller, head of the agency’s tobacco division, said the committee was assigned to assess the existing science, and to point out gaps in research. The report will aid the agency in its review of applications for lowerrisk tobacco products and the potential harm or benefits those pose to individuals and the public.
Cessation was one area where the report did give the booming e-cigarette industry some good news. It pointed out the benefits for smokers trying to quit. But people who continue to smoke cigarettes, alternating with ecigarettes, do not gain the same health benefits, the committee said. That is especially important given that most adults who vape also still smoke or use other tobacco products. The report also said the evidence was limited on whether e-cigarettes were effective for quitting smoking.
While there is no evidence at this time that e-cigarettes or their components cause cancer, the committee recommended more long-term research. Some e-cigarettes do contain chemicals and metals whose long-term effects — including on pregnancy — also need further study, the committee said.
The authors of the new report cite conclusive evidence that vaping can be addictive, and that exposure to nicotine from ecigarettes is highly variable, depending on the characteristics of the device, as well as how it is used. They also cited conclusive proof that in addition to nicotine, most e-cigarettes also contain and emit numerous potentially toxic substances. In terms of secondhand vapour, the committee said there was conclusive evidence that e-cigarette use increases airborne concentrations of particulate matter and nicotine indoors.
It concluded that much of the current research on e-cigarettes is flawed, either in methodology or because of industry-financed bias. In addition, the levels of nicotine and other chemicals, including metals, vary in e-cigarettes from brand to brand, which has complicated some research findings.
In July, the FDA delayed the deadline at least four years for e-cigarette companies to apply for approval to keep their products on the market, largely by showing some public health benefit. The agency did not postpone other aspects of its tobacco control programme, including requirements for mandatory age and photo-ID checks to prevent illegal sales to minors and the banning of free samples.
Several major tobacco companies that produce e-cigarettes declined to comment on the report. A law firm that represents some businesses and trade groups in the industry said the report’s main conclusions were positive and that there are substantial benefits for smokers to switch to vaping completely. But, public health advocates who objected to the July delay said this report gave them further concern.
“What the report demonstrates is that despite the popularity of e-cigarettes, little is known about the overall health effects, and there is wide variability from product to product,” said Matthew L. Myers, president of Campaign for Tobacco-Free Kids. “That makes the case stronger for FDA regulation.”
The panel found evidence among studies it reviewed that vaping may prompt teenagers or young adults to try regular cigarettes, putting them at higher risk for addiction, but that any significant linkage between e-cigarettes and long-term smoking has not been established.