Cigarette smoking is the leading cause of preventable death. Smoking contributes to about 30 percent of all U.S. cancer deaths and nearly 90 percent of lung cancer deaths. In the U.S. alone, nearly half a million people die each year due to smoking-related causes. “This is equivalent to three 747s crashing every day for a year,” says Amy V. Lukowski, clinical director of Health Initiatives Programs at National Jewish Health.
Fortunately, cigarette smoking has declined from 42 percent of adults in 1965 to 17 percent in 2014. There are now more former smokers than current smokers. Even better, the rate of cigarette smoking among teens is at its lowest level since 1991 ( 16 percent in 2014). Against this backdrop of good news, however, is the increasing use of electronic cigarettes, or e-cigarettes.
Electronic cigarettes are an electronic nicotine delivery system, or ENDS. Although there are many e-cigarette products on the market, they essentially all consist of a battery, a heating element and a storage tank for liquids. When you smoke an electronic cigarette, it produces an aerosol with tiny airborne particles. Since e-cigarettes don’t produce smoke, users are not exposed to dangerous tars and carbon dioxide.
[See: 7 Things You Didn’t Know About Lung Cancer.]
Are E-Cigarettes Safer Than Traditional Cigarettes?
The short answer is that we just don’t know, Lukowski says. According to the National Cancer Institute, the tiny particles in the aerosol can penetrate deep into the lungs, making the presence of toxic chemicals potentially hazardous. “The data does not clearly support that [e-cigarettes are] safer,” Lukowski says. “It’s just an assumption. Because the products have not been around for long, we don’t know the long-term health effects yet.”
Experts are in the very early stages of trying to understand the health effects of e-cigarettes, says Dr. Steven Dubinett, professor in the Department of Pathology and Laboratory Medicine at the David Geffen School of Medicine at UCLA and a member of UCLA’s Jonsson Comprehensive Cancer Center. “We do know from studies in the lab that e-cigarettes can cause normal cells to take on characteristics of cancer cells. The aerosol can cause gene changes that share characteristics of changes that tobacco causes.”
While e-cigarettes may be a safer alternative for people who already smoke, Lukowski and Dubinett worry these products may encourage smoking in individuals who otherwise would not — especially teens. In fact, the U.S. Surgeon General reports that the flavorings in e-cigarettes are one of the main reason youth use them. For this reason, e-cigarettes are often referred to as a gateway product. “This is quite concerning,” Dubinett says. “Younger kids whose brains are still forming are quite susceptible to nicotine addiction. E-cigarettes are marketed with flavorings appealing to kids. There’s a whole new generation becoming addicted.”
Although traditional cigarette smoking in teens is down significantly, the use of e-cigarettes increased 800 percent among high school students between 2011 and 2014. (E-cigs were introduced in the U.S. about a decade ago.) Lukowski is concerned that e-cigarettes are going to undo progress in reducing smoking rates and renormalize smoking behaviors. “Ninety percent of smokers try tobacco before age 18,” she says. “We want to push this back, delay initiation, so their chances of dependency are greatly reduced.”
[See: 8 Questions to Ask Your Pharmacist.]
Furthermore, half of students who report using tobacco are using two or more products, such as hookah or combustible cigarettes and smokeless tobacco, Lukowski says. This means that even if e-cigarettes are safer, if a user is also smoking a combustible product, he or she is not getting any benefit.
It’s hard to study e-cigarettes because they’re not regulated, Dubinett says. Manufacturers don’t have to use product labels, so we don’t actually know what’s in them. Some brands advertise no nicotine, but if you test them in a lab, Dubinett says, you find they actually do contain nicotine.
Because e-cigarettes are marketed to youth, not adults, Lukowski says parents lack information about them. E-cigarettes don’t have the same telltale smell of cigarettes, so parents may not even know their kids are using them. “We are conducting a human experiment in the real world,” Lukowski says. “This is a public health problem.”
[See: 10 of the Biggest Health Threats Facing Your Kids This School Year.]
A Bridge to Quitting Smoking?
Some tobacco users switch to electronic cigarettes as a tool to quit smoking. However, Dubinett says, research is inconclusive as to whether this is actually an effective means for quitting.
“There are evidence-based smoking cessation strategies,” Lukowski says. “We know what works well. We’re trying to fit electronic cigarettes into these programs without data and without them being regulated. We don’t know what is in the products. We don’t know if they are safe for quitting.”
Regardless of what tools you use to help you, the best way to reduce your risk of lung cancer at any stage of your smoking history is to quit, Dubinett says. Your risk of developing lung cancer decreases over time after you stop. “Quitting smoking dwarfs every other intervention in medicine.”
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Electronic Cigarettes and Cancer: a Safer Choice? originally appeared on usnews.com
