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The vaping can be more dangerous than we have realized

When electronic cigarettes appear for the first time on shelves some years ago, they are marketed as a shiny, discreet technology that can help older smokers to shoot a potentially deadly habit.

Flash ahead of 2018, the year in which the Juul device took three quarters of the US electronic cigarette market. Instead of taking care of older smokers, the electronic cigarette industry appears to be predominantly aimed at young people without smoking.

Maciej Goniewicz, one of the leading e-cigarette researchers based at the Roswell Park Comprehensive Cancer Center in Buffalo, looks at developments close: Volunteers who go out for his research on electronic cigarettes seem to be getting younger. "[These are] People who have long been breathing fresh air ̵

1; and have never smoked cigarettes with tobacco – have now started using electronic cigarettes," Gonevic said.

He and other researchers around the world are now trying to figure out what impact this new habit can have on brain and organ development in the long run. And they find that electronic cigarettes can be more dangerous than we appreciated, especially for hearts and lungs. There is also an increasing number of studies suggesting that evaporation can lead to smoking.

But before we dive into the latest health problems, we have several warnings. New evidence does not mean that cigarettes are safer than electronic cigarettes . In fact, medical experts agree that vaping is much better for health than smoking, one of the most deadly habits known to man. (And this message about relative risk seems to be lost as more and more people mistakenly think that electronic cigarettes are more dangerous or more dangerous than tobacco.)

Moreover, as people are not in a hurry for a long time, the science of its effects on health is still preliminary – and it is far from convincing. It can take decades for all diseases caused by electronic cigarettes to come out entirely, especially among young, healthy people who use them. There is also the problem of generalizing electronic cigarettes: There are hundreds of devices on the market, and each one delivers different levels of nicotine (or no nicotine) and a slightly different cocktail of chemicals.

In view of these objections, I asked the researchers to share what bothered them most. Here's what they told me.

Nicotine in electronic cigarettes can burden the cardiovascular system

When you plug in an electronic cigarette, you heat up a liquid that contains flavors and other chemicals, and often nicotine.

Some devices, in particular Juul, deliver effectively high doses of nicotine. (Yuull says one of his e-liquid capsules is equal to a nicotine pack of cigarettes.)

"Nicotine [in e-cigarettes] does the same thing as [combustible] cigarettes," says Neil Benovic, a professor of medicine. at the University of California at San Francisco, who studies the relationship between electronic cigarettes and heart health. He can increase the adrenaline circulating in our bodies and activate sympathetic nervous system (our "fight or flight" reaction), increase. blood pressure, accelerating heart rate, and causing arteries – the blood vessels – to narrow down.

In January last year, the National Academy of Sciences, Engineering Sciences and Medicine, in its assessment of evidence of the impact of vaping on health, found that there is "insufficient" evidence that the use of electronic cigarettes leads to long-term changes in heart rate and blood pressure.

But Gonevich told Vox that he was quickly changing. The impact of electronic cigarettes on the body's cardiovascular system is an emerging field of research – with more research being done to suppose that evaporation can actually be bad for the heart.

In a review of the journal Nature Review Cardiology Benowitz and his co-authors have made the case that while we still do not know what this means for long-term health outcomes, nicotine in electronic cigarettes may contribute to heart- vascular events, "especially in people with cardiovascular disease."

Several recent observational studies have found a link between regular sweating and increased risk of heart attacks, strokes and coronary arteries. disease. Studies do not prove that electronic cigarettes cause these conditions, but given the known cardiovascular effects of nicotine, it is likely to learn much more about burning and its effect on these diseases. Heart Attacks, High Blood Pressure, and Coronary Heart Disease

Even when the vapors do not contain nicotine, it can bring other health risks to the heart. The heating element in electronic cigarettes emits small particles, sometimes involving metals, and they can be fed deep into the lungs and absorbed into the body's circulatory system. "This is where we see potential cardiovascular toxicity," Gonevic said.

Recent studies have shown that blowing of electronic cigarettes increases the concentration of these microscopic pollutants – particularly PM2.5 and ultra-fine particles – in closed environments.

Researchers still do not know what the aerosol particles of electronic cigarettes are, but these small particles have been studied extensively in the context of air pollution and smoking. In these studies, researchers have linked exposure to small particles with a number of bad cardiovascular outcomes – including heart attacks, high blood pressure and coronary artery disease.

The thought is that when we are exposed to large particles – like dust – our bodies protect against them. Namely, cough, we throw away these foreign pollutants from our respiratory tract. But with fine dust particles, this protective mechanism is not triggered – and again, these micro-pollutants can penetrate our lungs and the cardiovascular system.

The same applies to other toxic chemicals that produce electronic cigarettes when heated, such as acetaldehyde, formaldehyde and acrolein.

"We already have enough evidence from hundreds of studies that link exposure to these chemicals with disease outcomes," Gonevic said. "We know that formaldehyde can cause cancer and that acrolein can cause certain cardiovascular diseases." So there is no convincing evidence directly linking this aspect of the use of electronic cigarettes to long-term cardiovascular outcomes. But on the basis of these studies, the researchers believe that such a link is plausible. Electronic cigarette vapors can irritate the lungs

Much of the damage caused by smoking comes from the burning process – smoke wears the cells that cover the lungs, damage them and make them more permeable to the annoying and causing cancer chemicals in cigarettes. Since electronic cigarettes do not burn tobacco, it is believed that the money they produce is far less harmful than ordinary cigarette smoke. But this does not mean that the vapors are harmless.

Breathing of the steam into the lungs can irritate them – and this is proven in recent wheezy studies. Wheezing – the tall sound caused by narrowed and unusual airways – is more than an irritation: This may be a sign of emphysema, heart failure and lung cancer. cigarettes exacerbate wheezing. Some people in the study were current people who only used electronic cigarettes; others are just smokers; others are dual users (smokers and vapors); and finally there were people who did not smoke or drink at all.

Compared to the last group – non-users – the risk of wheezing among adolescents doubled.

When researchers examined the story of the participants in the roasting or smoking study, they came to even more interesting discoveries: The risk of wheezing is higher in current students who are also former smokers than in former smokers who are not were smokers. In other words, not only the potential history of smoking is the driving career in the whispering of the vapors. "That's why," the authors conclude, "encouraging the complete cessation of both smoking and fumes will be beneficial in maximizing the risk of wheezing and other associated respiratory symptoms."

for the Development of Chronic Obstructive Pulmonary Disease (COPD), a set of pulmonary complications that make breathing difficult. Studies in mice and human airway cells have shown that the nicotine-containing e-cigarette money causes "effects normally associated with the development of COPD."

In preliminary human studies, the researchers also established a link between regular nutrition and COPD. But again, this human study has been observed – not experimentally – so it is not yet clear whether vaping causes COPD. (For example, it is possible for people who have COPD to use the bulk of electronic cigarettes, such as ex-smokers looking for a harm reduction method.)

However, Benovitz says, "you do not want to put things in lungs that can cause inflammation of the lungs. My biggest concern for electronic cigarettes is that if you are not a smoker, they could worsen asthma, cause cough, and increase the risk of respiratory tract infection such as cold, flu and bronchitis. "

to help people stop smoking or lead to more smoking?

We still do not know for sure whether the increase in evaporation leads to fewer adults who smoke tobacco. The best available research on this issue was published earlier this year in the New England Medical Journal . The randomized study of electronic cigarettes has shown that people who have been randomly assigned to use electronic cigarettes have stopped cigarettes with almost twice the frequency of people who have been randomized to nicotine replacement therapy.

But while electronic cigarettes perform better than nicotine replacement therapy in the study, they only help a small group of participants in the group to come out.

On the other hand, there is convincing evidence that electronic cigarettes can act as a gateway to traditional cigarette smoking among young people. The report of the National Academy of Sciences, Engineering and Medicine on the Health Implications of Electronic Cigarettes has evaluated 10 high-quality studies on this portal issue and they all point to the same effect.

"The evidence base is sufficiently large and sufficiently consistent and strong enough to conclude that there is a link between the use of electronic cigarettes and the use of flammable tobacco [cigarettes]," said Adam Levental, a member of the reporting committee last January . But what is less clear is whether young people are more likely to try out cigarettes after the money runs out, or then continue to become long-term smokers.

However, this is a very important finding because another key issue for the introduction of electronic cigarettes on the market is what effect they will have on youth smoking levels that have fallen sharply in recent years. Right now, like many other health-related issues of electronic cigarettes, we do not know the results for sure. But we are likely to begin to pay attention to opportunities.

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