Long-Term Effects of E-Cigarettes Unclear

You might be seeing more patients in your practice who’ve ditched traditional cigarettes in favor of electronic cigarettes (e-cigarettes). Companies making e-cigarettes have touted them as less harmful than other forms of tobacco, and some argue that e-cigarettes can actually help smokers quit smoking. But recent research is showing these devices might not be as safe as people think.

E-cigarettes are made up of a battery-powered heating element that vaporizes a liquid containing nicotine, propylene glycol or glycerin and flavorings. The user then inhales this vaporized liquid through the device.

It’s no secret that experts can’t agree on whether e-cigarettes do more harm than good. The debate continues in part because public health agencies around the world have promoted these products as a healthier way of consuming tobacco than traditional cigarettes. In fact, one independent review board in the United Kingdom determined that e-cigarettes were around 95% less harmful than smoking.

It should be noted that e-cigarettes are also viewed as an alternative product to help consumers stop smoking traditional cigarettes, but the FDA has not approved them for this use.

A recent study from the University of California suggests that the long-term health effects that come from using these products are anything but harmless. In lab studies performed by Diana Messadi, DDS, and her colleagues tested the aerosols in e-cigarettes and their effects on normal human oral keratinocytes. They compared the results observed in cells exposed to aerosols with cells that were not exposed.

The results were clear. Significantly fewer cells exposed to aerosols from e-cigarettes were viable compared to cells that were not exposed. The researchers also observed that in exposed cells, intracellular glutathione levels were decreased — this molecule helps to protect cells from oxidative stress that may cause cancer in traditional tobacco smokers. Also, the aerosolized cells expressed higher levels of heme oxygenase, an enzyme that might be associated with the inflammatory response. The findings seem to indicate that using e-cigarettes may increase the risk for periodontal disease and cancer.

Researchers involved in the study plan to test their results in animal studies, and other scientists at the University of Minnesota are performing similar studies with similar results. Messadi cautioned clinicians to educate their patients on the potential harmful effects of using e-cigarettes, just as they would caution them against smoking tobacco. She recommends discouraging young adults form ever starting to use these products, and says if adults are using these devices to stop smoking traditional cigarettes, they should only use e-cigarettes for a brief period of time.