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"Lungs diagram detailed" by Patrick J. Lynch, medical illustrator - Patrick J. Lynch, medical illustrator. Licensed under CC BY 2.5 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Lungs_diagram_detailed.svg#/media/File:Lungs_diagram_detailed.svg

“Lungs diagram detailed” by Patrick J. Lynch, medical illustrator

Scientists studying the effect of  e-cigarettes on lung tissue have discovered that e-cigarette vapor damages lung cells – whether or not the vaping compounds contain nicotine. The damage to lung endothelial cells – the cells lining the blood vessels of the lung – was greater when the e-cigarettes contained nicotine, but damage was still seen even when the e-cigarettes were nicotine-free. This confirmation of the physical lung damage caused by e-cigarettes is of great concern given the recent data from the Centers for Disease Control showing that e-cigarette use among middle school and high school students tripled from 2013 to 2014.  High school and middle school students are more likely to have tried e-cigarettes in the last 30 days than any other tobacco product, according to the CDC’s 2014 National Youth Tobacco Survey. Seen by some as an alternative to traditional tobacco cigarettes, traditional tobacco heavyweights have joined the ecig market in recent years: Altria, the maker of Marlboro, sells MarkTen e-cigs, RJR, the maker of Camel, Kool, and Winston, sells the Vuse brand e-cig, while Lorillard, the maker of Newports and Kents, is behind the Blu brand of e-cigs.

This most recent study, “Endothelial disruptive pro-inflammatory effects of nicotine and e-cigarette vapor exposures”, published in the American Journal of Physiology—Lung Cellular and Molecular Physiology, investigated whether “[N]icotine, one of the hundreds of molecules present in [cigarette smoke] extracts, is sufficient to alter lung endothelial barrier function by affecting cytoskeletal regulation” (the internal design for cell shape and function). The researchers exposed human and mouse cells to e-cigarette vapor, using both nicotine and nicotine-free e-cigarettes. They found that nicotine e-cigarette vapor resulted in a loss of function of the endothelial cells in the lungs, acute lung inflammation and decreased lung endothelial cell proliferation.

Significantly he researchers also found that nicotine-free e-cigarettes contained substances that physically damage the lungs. One of the lung-harming substances, acrolein, is also known to damage lung endothelial cells. Acrolein was found in both nicotine and nicotine-free e-cigarettes.

Lead researcher Irinia Petrache, a professor at Indiana University, said of their findings:

“The increased use of inhaled nicotine via e-cigarettes, especially among the youth, prompts increased research into the effects on health. This research reports that components found in commercially available e-cigarette solutions and vapors generated by heating them may cause lung inflammation. The effects described characterize short-term effects of e-cig exposures. Whereas studies of long-term effects await further investigations, these results caution that e-cigarette inhalation may be associated with adverse effects on lung health.”

Two million high school students used e-cigarettes in 2014 according to the CDC. Yet currently there is no regulation of the contents of e-cigarettes, or of how they are marketed to children or adults, unless they are being prescribed for a therapeutic purpose. While some states bar sales to minors, kids buy their ecigs online to avoid these prohibitions. Several U.S. Senators have asked the FDA to stop the marketing and sale of  e-cigarettes to children. Experts are particularly concerned that the many candy-like flavors, such as bubble gum and cotton candy, are produced primarily to appeal to children.

The FDA is holding public hearings to decide whether to regulate e-cigarettes as a tobacco product, with the final hearings set for Monday and Tuesday of next week, June 1-2, 2015.  This study of the lung damage caused by ecigarettes underscores the importance of recognizing the health effects of e-cigarettes as a public health problem. Children and other users are being exposed to these harmful substances, possibly believing they are harmless.

Thornton Law Firm represented the Commonwealth of Massachusetts in the state’s landmark $8 billion settlement with the tobacco industry.  Currently, the firm is fighting to provide low-dose CT scans to a class of Marlboro smokers to screen for lung cancer. The firm is also closely monitoring the developing marketing, production, and health effects related to the newest “tobacco” products, e-cigarettes.