E-Cigarette Studies Continue to Smoke out Concerns about These Products
LewisFirst, MD, MA, Editor in Chief, Pediatrics
We have published so many electronic cigarette (e-cigarette) articles over the past
three years in our journal that there is now even a “Pediatric Collection” of these articles which can be found on the Gateway portal for AAP publications.
Yet as soon as we publish one new study, more keep being submitted. That is why this
week we are releasing two new e-cigarette studies this week, well worth your attention.
The first by Rubinstein et al. (10.1542/peds.2017-3557) examined whether toxic volatile organic chemicals were associated with adolescent
e-cigarettes smoked in the past month or over their lifetime of smoking. The study
was based on gathering saliva samples collected within 24 hours of e-cigarette use
for 8 volatile compounds as well as cotinine if conventional cigarettes were also
smoked. While toxic volatile compounds were higher in prevalence in the saliva samples
when teens smoked both conventional and e-cigarettes, they were still prevalent in
e-cigarette users alone when compared to controls, although in less hazardous amounts
than when combined with tobacco smoke. Since we don’t know just how much of these
carcinogenic compounds need to accumulate in the lungs to cause deleterious results,
this study suggests that we at least alert our teen patients to the potential risks
of such exposure despite their belief that e-cigarettes are “healthier” than conventional
tobacco products. Neither is good when it comes to exposure to toxic volatile organic
If the Rubinstein et.al study is not sufficient to raise further concerns about e-cigarettes,
there is a second study being released this week by Chaffee et al (10.1542/peds.2017-3594) on the progression of conventional tobacco smoking in those who also try e-cigarettes.
While teens may think use of e-cigarettes will slow or eliminate the usage of conventional
tobacco smoking, the authors of this study used results from a national survey to
show that dual smokers increase their established cigarettes smoking, meaning their
achieving at an earlier age ≥ 100 cigarettes in their lifetime. Thus this study myth-busts
the perception that established smoking will diminish given the increases seen in
this study. If you’re looking for more evidence of why e-cigarettes are not in the
best interest of adolescents trying to quit tobacco smoking, you’ll light up with
the findings in both of these studies. Link to them and see what we mean.