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Vaping may help pneumonia-causing bacteria invade airways

by UNTV News   |   Posted on Friday, March 2nd, 2018

FILE PHOTO: An exhibitor staff member uses an electronic cigarette at Beijing International Vapor Distribution Alliance Expo (VAPE CHINA EXPO) in Beijing, July 24, 2015. REUTERS/Jason Lee

(Reuters Health) – People who smoke e-cigarettes might have an increased risk of developing pneumonia because the vapor could help bacteria stick to cells lining the airways, a small experiment suggests.

Traditional cigarettes have long been linked to an increased risk of pneumonia, but it’s been less clear whether e-cigarettes might have the same effect.

To find out, researchers did a series of laboratory experiments to see whether exposure to e-cigarette vapor might increase levels of a molecule produced by airway lining cells, called platelet-activating factor receptor (PAFR).

Pneumococcal bacteria use PAFR to help them adhere to airway cells.

First, the researchers exposed some human airway epithelial cells in culture dishes to e-cigarette vapor. Compared to cells that weren’t exposed, those that were had PAFR levels three times higher.

Then, they exposed mice to e-cigarette vapor and found higher PAFR production in the rodents who inhaled the fumes.

Finally, the researchers asked 17 people who were regular vapers to come smoke an e-cigarette in the lab. Compared with these participants’ PAFR levels measured before the vaping session, there was a three-fold increase in PAFR levels an hour after people smoked e-cigarettes.

“The take-home message is that it is over-optimistic to assume that all of the adverse effects of cigarette smoking are reduced by switching to vaping,” said senior study author Jonathan Grigg of Queen Mary University of London.

“It also raises the question that, even if we have not proved that vaping increases the risk of pneumonia, for young people taking up vaping for the first time, a precautionary approach would suggest that the risk should be assumed to exist until proved otherwise,” Grigg said by email.

Big U.S. tobacco companies are all developing e-cigarettes. The battery-powered gadgets feature a glowing tip and a heating element that turns liquid nicotine and flavorings into a cloud of vapor that users inhale.

Even when e-liquids don’t contain nicotine, the lungs are still exposed to flavoring chemicals when the e-liquids are heated and the vapors are inhaled.

Some previous research, mostly in lab experiments, has linked exposure to these flavorings to an increase in biomarkers for inflammation and tissue damage. This type of cell damage can lead to lung problems including fibrosis, chronic obstructive pulmonary disorder and asthma.

In the current lab experiment, PAFR levels surged in human nose lining cells in culture dishes exposed to e-liquids with nicotine and in cells exposed to nicotine-free vapor. This was accompanied by increased adhesion by pneumonia-causing bacteria.

Even though the study is small and the results must be verified in larger human trials, the findings still suggest that e-cigarettes aren’t risk-free and shouldn’t necessarily be considered a safe way for people to try to curb use of traditional cigarettes, the researchers conclude in the European Respiratory Journal.

At least when it comes to pneumonia, nicotine patches or gum may be a safer option for smoking cessation, the researchers note.

“PAFR expression is enhanced in cigarette smokers and patients with chronic obstructive pulmonary disorder and has been hypothesized to be mediating enhanced adhesion of bacteria to epithelial cells and subsequent development of pneumonia,” said Ilona Jaspers, deputy director of the Center for Environmental Medicine, Asthma & Lung Biology at the University of North Carolina at Chapel Hill.

“The data shown here suggest that vaping e-cigarettes could also increase expression of PAFR in relevant epithelial cells,” Jaspers, who wasn’t involved in the study, said by email. “In general, I would refrain from calling e-cigarettes ‘safer’ than cigarettes, but would suggest calling them causing ‘different’ effects than cigarettes.”

SOURCE: bit.ly/2nV3Ts7 European Respiratory Journal, online February 7, 2018.

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Even without nicotine, e-cigarettes can still damage lungs

by UNTV News   |   Posted on Monday, February 12th, 2018

FILE PHOTO: Jerred Marsh (R) samples flavored vape juice from Nancy Reyes at the Vape Summit 3 in Las Vegas, Nevada May 2, 2015. REUTERS/David Becker/File Photo

(Reuters Health) – E-cigarette liquids sweetened with flavorings like vanilla and cinnamon may harm the lungs even when they don’t contain nicotine, a U.S. study suggests.

Researchers examined what happened to monocytes, a type of white blood cell, upon exposure to flavoring chemicals used in popular e-cigarette liquids. None of the liquids contained nicotine, but the flavoring chemicals still appeared to increase biomarkers for inflammation and tissue damage, and many of them also caused cells to die.

Over time, this type of cell damage can lead to wide range of lung problems including fibrosis, chronic obstructive pulmonary disorder, and asthma, said senior study author Irfan Rahman, an environmental health researcher at the University of Rochester Medical Center in upstate New York.

“Nicotine-free e-liquids have generally been considered safe; however, the impact of flavoring chemicals, especially on immune cells, has not been widely researched,” Rahman said by email. “This study shows that even though flavoring compounds are considered safe for ingestion, it is not safe for inhalation.”

Big U.S. tobacco companies are all developing e-cigarettes. The battery-powered gadgets feature a glowing tip and a heating element that turns liquid nicotine and flavorings into a cloud of vapor that users inhale.

Even when e-liquids don’t contain nicotine, the lungs are still exposed to flavoring chemicals when the e-liquids are heated and the vapors are inhaled. Since the flavoring chemicals are considered safe to eat, e-cigarettes are often promoted as a alternative to traditional cigarettes, researchers note in Frontiers in Physiology.

When researchers exposed human lung cells to e-liquids in the laboratory, the cells increased their output of inflammation-related chemicals that can eventually lead to damage in the lungs.

Exposing cells to mixtures containing a variety of flavors appeared to cause a worse reaction than using a single flavor, the study found.

Among the single flavors, cinnamon and vanilla appeared the most toxic to the lung cells.

One limitation of the study is that the experiment didn’t involve people actually vaping and breathing in the e-liquids, the authors note. The study also doesn’t offer a complete picture of e-cigarette safety or address the potential for health problems to emerge after long-term use.

While more research is needed to better understand what happens to lung cells when people smoke e-cigarettes, the results suggest that e-liquids should be regulated and clearly labeled to list the mix of flavors used, the researchers conclude.

“It is expected that more complex mixtures or exposure at higher doses will have more adverse effects on isolated cells in the laboratory,” said Dr. Konstantinos Farsalinos, a researcher at the University of Patras-Greece and the National School of Public Health-Greece who wasn’t involved in the study.

While evidence to date suggests that e-cigarettes may be less harmful than smoking traditional cigarettes, it still make sense for users to pay attention to what’s in the e-liquids they’re inhaling, Farsalinos said by email.

“Whether pre-mixed or do-it-yourself liquids, it is the amount of flavorings that would determine the level of potential adverse effects,” Farsalinos added. “I expect simpler mixtures to be safer compared to more complex blends.”

SOURCE: bit.ly/2Bkvc7p Frontiers in Physiology, online January 11, 2018.

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Occasional smokers who vape smoke more cigarettes

by UNTV News   |   Posted on Thursday, June 22nd, 2017

A man smokes an electronic cigarette vaporizer, also known as an e-cigarette, in Toronto, August 7, 2015. REUTERS/Mark Blinch

(Reuters Health) – Tobacco companies have been selling electronic cigarettes as a way to wean smokers off paper cigarettes, but a new study suggests the strategy could backfire.

The report in Preventive Medicine found that young adults who occasionally smoked conventional cigarettes smoked more of them if they also used e-cigarettes – battery-powered gadgets that heat liquid nicotine into vapor.

“The participants who were vaping ended up using more cigarettes. It’s actually a risk factor for increasing their cigarette use,” lead author Neal Doran said in a phone interview.

“They’re not using e-cigarettes to try to stop smoking,” said Doran, a psychologist and psychiatry professor at the University of California, San Diego School of Medicine.

Though smokers have been turning to e-cigarettes since they came on the market in 2007 as a healthier alternative to smoking tobacco, little is known about the long-term effects of the practice known as “vaping.”

E-cigarette use grew 900 percent among high school students from 2011 through 2015, according to a report from U.S. Surgeon General Vivek Murthy. The 2016 report declares e-cigarettes “unsafe” for youth and young adults (bit.ly/2sKHv9P).

The new study’s findings are “consistent with the worry that, regardless of whether vaping is itself unsafe, vaping causes worse outcomes because it leads to more consumption of cigarettes,” Doran said.

Stanton Glantz, who directs the Center for Tobacco Control Research and Education at the University of California, San Francisco, said the study “has tremendous policy implications.”

“What this study shows very convincingly is that if they’re using e-cigarettes it’s actually leading them to smoke more conventional cigarettes, not less,” he said.

Glantz was not involved with the new study, but the findings are consistent with those of previous research he conducted on adolescents.

“The e-cigarettes are having the effect of stimulating conventional cigarette smoking,” he said in a phone interview. “They’re propping up and reinforcing the conventional cigarette market.”

Doran and his team studied 319 Californians, ages 18 to 24. At the start, participants did not smoke daily but had smoked at least one cigarette in the prior six months. During the study, they reported their frequency of cigarette and e-cigarette use five times at three-month intervals.

Those who vaped more also reported smoking 18 percent more cigarettes, the study found.

“In the larger scheme of things, e-cigarettes could be good, bad or neutral,” Doran said. “I don’t think we know the answers yet. This is one of the ways in which they could be bad – by people increasing their cigarette use if they’re using both.”

Dual users may be exposed to more nicotine and wind up at risk for chronic tobacco use and dependence, the authors write. Previous studies have shown that e-cigarette use increases the risk of smoking tobacco-filled cigarettes.

Some prior studies suggest that e-cigarette vapor may be less toxic than traditional cigarette smoke. But electronic alternatives nonetheless release potentially hazardous chemicals.

Sales of vaping products are expected to reach $4.4 billion this year, according to Wells Fargo Securities analysts.

With flavors like bubble gum and chocolate peanut butter cup, e-cigarettes or vape pens are often packaged to appeal to youth, who experts believe are more vulnerable to becoming dependent on nicotine.

The San Francisco Board of Supervisors is considering banning flavored tobacco products. Residents opposed to the legislation recently argued that e-cigarettes help them smoke less.

But, Glantz said, “This paper shows exactly the opposite is true.”

Numbers released this month from the U.S. Centers for Disease Control and Prevention showing declines in youth use of both cigarettes and e-cigarettes have led some to claim that as proof of the benefits of vaping.

But Doran and Glantz don’t see it that way.

Instead, Glantz said he views the smoking decreases as evidence of efforts to educate youth about the potential harms of e-cigarettes as well as the results of efforts to regulate e-cigarettes with clean-indoor air laws and minimum-age requirements.

States and local jurisdictions have imposed a patchwork of laws pertaining to the use of electronic cigarettes, and some states, including California, now tax vape products.

“There’s this Wild West atmosphere with e-cigarettes, and there’s a lot of controversy and disagreement about whether they’re good or bad,” Doran said.

“If they’re harmless, and they help people quit, then they’re great. If they make it harder to quit and also encourage people to smoke cigarettes who would not have smoked otherwise, then they’re terrible,” he said. “The truth probably lies in the middle, but where exactly is the key question.”

SOURCE: bit.ly/2tscS56 and bit.ly/2rBKmg8 Preventive Medicine, online June 3, 2017.

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E-cigarette ads’ wide reach among U.S. youth alarming: CDC

by UNTV News   |   Posted on Thursday, January 7th, 2016

A man smokes an electronic cigarette vaporizer, also known as an e-cigarette, in Toronto, in this August 7, 2015, file photo. REUTERS/Mark Blinch/Files

A man smokes an electronic cigarette vaporizer, also known as an e-cigarette, in Toronto, in this August 7, 2015, file photo. REUTERS/Mark Blinch/Files

E-cigarette companies are reaching about seven in 10 U.S. middle- and high-school students with advertisements employing themes of sex, independence and rebellion that hooked previous generations on regular cigarettes, a government study released on Tuesday said.

The marketing strategy could reverse decades of progress in preventing tobacco use among youth, warned the U.S. Centers for Disease Control and Prevention, which suggested tighter controls on e-cigarette sales to reduce minors’ access.

“The e-cigarette advertising we’re seeing is like the old-time Wild West,” CDC Director Tom Frieden told reporters. “No rules, no regulations and heavy spending advertising the products.”

E-cigarette use among middle- and high-school students soared over the past five years, surpassing use of regular cigarettes in 2014, according to CDC statistics. Spending on e-cigarette advertising also jumped, increasing to an estimated $115 million in 2014 from $6.4 million in 2011.

The CDC’s National Youth Tobacco Survey found that 68.9 percent of this age group saw e-cigarette ads from one or more media sources in 2014, most commonly in stores but also online, on television and in movies or magazines.

E-cigarettes contain cartridges that typically hold nicotine as well as other liquids and flavorings, and a heating element to create a vapor that the user inhales.

Many researchers believe e-cigarettes are less harmful than regular cigarettes, but the risks are still being studied.

Frieden said any tobacco use by young people could lead to brain damage, addiction and higher risk of becoming regular cigarette smokers.

“The use of e-cigarettes in kids appears increasingly likely to result in an increased risk of using regular cigarettes,” Frieden said.

Most states have passed laws banning the sale of e-cigarettes to minors, and the U.S. Food and Drug Administration’s proposal to regulate the products is under federal review.

Altria Group (MO.N), which owns three U.S. tobacco companies, is among e-cigarette sellers that have said they favor laws that prevent minors purchasing their products.

(Reporting by Barbara Liston in Orlando, Fla.; Editing by Colleen Jenkins, Lisa Von Ahn and Andrew Hay)

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