E-Cigarettes – Behind the Smoke and Mirrors

Using e-cigarettes, or “vaping”, is among the hottest new trends. Due to a lack of regulation, a variety of flavors (7700), and aggressive marketing, e-cigarette use has skyrocketed in recent years. This is particularly true in the youth demographic, where use tripled from 4.5% in 2013 to 13.4% in 2014. As a result, youth e-cigarette use has surpassed youth cigarette smoking. The $1.7 billion e-cigarette industry is also on track to outsell tobacco products within a decade. Yet, little and conflicting information exists about the safety of this new product. What’s behind the smoke and mirrors?

E-cigarettes are a type of Electronic Nicotine Delivery Systems (like e-pens, e-pipes, e-hookah and e-cigars). They contain a cartridge filled with nicotine, other liquids like propylene glycol, and flavorings. During vaping, a battery-powered heating element heats the cartridge, releasing a chemical filled aerosol. The end of the e-cigarette glows, just like a real cigarette. The user then exhales a cloud of vapor, resembling smoke.

Because no tobacco burning occurs during this process, evidence suggests that e-cigarettes “may be safer than regular cigarettes”. When used as instructed, the levels of dangerous chemicals inhaled are a “fraction” of those from their tobacco counterpart. Thus, according to Dr. Siegel at Boston University, e-cigarettes are preferable to cigarettes. Some also believe that vaping can assist people in quitting smoking, much like nicotine gum.

But don’t light up just yet. Tests reveal that most e-cigarettes contain at least traces of solvents. In addition to irritating lungs, solvents can “transform into something more worrisome: carbonyls”. Carbonyls include known or suspected carcinogens (cancer causing chemicals) such as formaldehyde and acetaldehyde.

Another dangerous chemical in e-cigarettes is nicotine. For adults, nicotine consumption is associated with cardiovascular disease and poisoning. For kids and teens (often drawn to e-cigarettes by the candy flavors and ease of purchase), nicotine can affect brain development. Finally, for fetuses, nicotine can cause lasting consequences for brain and lung function, pre-term delivery, low birth weight, and stillbirth.

Unfortunately, these nicotine concentrations have not caused e-cigarettes to replace tobacco (which also contains the highly addictive chemical). In 2013, 76.8% of those who recently vaped also smoked cigarettes. Some even believe that e-cigarettes could be a “gateway drug” to tobacco by creating nicotine addictions and “making smoking popular again”. Hence, the Center for Drug Evaluation and Research has not approved e-cigarettes as a safe or effective method to quit smoking.

That is what we know – but there is still so much we don’t know about vaping. Because the Food and Drug Administration (FDA) does not yet regulate the 500 brands of e-cigarettes, their exact ingredients are unclear. Initial tests hint that the toxins and nicotine levels in e-cigarettes vary considerably within and between brands. The levels also differ from what packages indicate.

Knowledge of vaping effects is also incomplete. In the words of R. Morgan Griffin, “research into the effects of e-cigarettes lags behind their popularity”. Plus, it will be years before we can discern the effects of long-term use or second-hand exposure.

Through all this haze, a few key take-aways emerge. First and foremost, if you don’t smoke, do not start vaping – there are risks and no health benefits. Secondly, if you smoke cigarettes and wish to quit, don’t rely on e-cigarettes to ease the transition. Rather, opt for an FDA-approved method. Finally, if you plan to continue smoking, talk to your doctor about safer alternatives. Such alternatives may ultimately include e-cigarettes, but further research and regulation is necessary.

To learn more about e-cigarettes and vaping, please contact Action on Smoking and Health, the Foundation for a Smokefree America, or our partners, the American Lung Association and Healthy Lifestyle Choices.




The Skinny on Weight Loss: How Much is too Much?

Every January, millions of Americans vow to lose weight. This year, 40% of Americans have made such a New Year’s resolution. For many, the motivation is to “get fit” or “be healthy”. Others want the figures of celebrities like Taylor Swift or Jennifer Lawrence. But how thin is too thin?

According to the Center for Disease Control, the Body Mass Index (BMI) is the standard tool for classifying weight. It equates to the body mass divided by the square of the body height. A BMI under 18.5 is considered “underweight”, while a BMI of 25+ is “overweight”. Thus, a healthy 5’9” person would weigh between 125 and168 pounds.

In recent years, however, popular culture has severely distorted this concept of healthy weight. Magazines and runways are among the worst culprits, often glamorizing skeletal models. In fact, an editorial/fashion model today ranges from 5’6” and 90 pounds to 5’11” and120 pounds. With these dimensions, models weigh ~23% less than the average US woman. Moreover, “most runway models meet the Body Mass Index criteria for anorexia”.

Psychiatrists say there is no definitive causal link between exposure to such models and eating disorders in women. But in a survey of Grades 5 to 12 girls, 70% indicated that “magazine images influence their ideals of a perfect body”. This cohort suffers disproportionately from anorexia (at a rate of 2.7% versus 0.6% for the adult population).

Thus, governments are beginning to take action. Last month, in France, parliamentarians passed a bill requiring models to secure a doctor’s certificate confirming their health. Employer penalties include up to 6 months in jail and a $81,000 fine. Furthermore, all images that digitally alter a model’s silhouette must be labelled as “touched up”.

And France is not the only country to act. In 2006, Spain banned models with a BMI of under 18 from participating in Madrid’s fashion week. Shortly thereafter, Italy’s fashion industry agreed to follow a voluntary code to keep unhealthy models off the catwalk. Finally, in 2012, Israel required models to prove a BMI of at least 18.5.

Sadly, these efforts were too late for some. In recent years, models like Isabelle Caro, Ana Carolina Reston, Luisel Ramos, Eliana Ramos, and Hila Elmalich all succumbed to anorexia. So too have thousands of Americans, as an estimated 4% of anorexic individuals die from complications related to the disease. In fact, anorexia is said to have the highest mortality rate of any psychiatric disorder.

To learn more about healthy eating, please contact our partner, Healthy Lifestyle Choices. To combat anorexia, contact the National Eating Disorders Association, the National Eating Disorder Information Centre, the Joy Project and the Alliance for Eating Disorder Awareness.