1. Jan Czogala, PhD1,
2. Maciej L. Goniewicz, PharmD, PhD1,2,
3. Bartlomiej Fidelus, PharmD1,
4. Wioleta Zielinska Danch, PhD1,
5. Mark J. Travers, PhD2 and
6. Andrzej Sobczak, PhD1,3

1. 1 Department of General and Analytical Chemistry, School of Pharmacy and Laboratory Medicine, Medical University of Silesia, Sosnowiec, Poland
2. 2 Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY
3. 3 Department of Chemical Hazards, Institute of Occupational and Environmental Health, Sosnowiec, Poland

1. Corresponding Author Maciej L. Goniewicz, PhD, Department of Health Behavior, Division of Cancer Prevention and Population Science, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA. Telephone 716 845 8541 Fax 716 845 1265 E mail at

• Received July 5, 2013.
• Accepted November 10, 2013.

Abstract

Introduction Electronic cigarettes (commonly referred as e cigarettes) are designed to generate inhalable nicotine aerosol (vapor). When an e cigarette user takes a puff, the nicotine solution is heated and the vapor taken into lungs. Although no sidestream vapor is generated between puffs, some of the mainstream vapor is exhaled by e cigarette user. The aim of the study was to evaluate the secondhand exposure to nicotine and other tobacco related toxicants from e cigarettes.

Materials and Methods We measured selected airborne markers of secondhand exposure nicotine, aerosol particles (PM2.5), carbon monoxide, and volatile organic compounds (VOCs) in an exposure chamber. We generated e cigarette vapor from 3 various brands of e cigarette using a smoking machine and controlled exposure conditions. We also compared secondhand exposure with e cigarette vapor and tobacco smoke generated by 5 dual users.

Results The study showed that e cigarettes are a source of secondhand exposure to nicotine but not to combustion toxicants. The air concentrations of nicotine emitted by various brands of e cigarettes ranged from 0.82 to 6.23 g/m3. The average concentration of nicotine resulting from smoking tobacco cigarettes was 10 times higher than from e cigarettes (31.60 6.91 vs. 3.32 2.49 g/m3, respectively p .0081).

Conclusions Using an e cigarette in indoor environments may involuntarily expose nonusers to nicotine but not to toxic tobacco specific combustion products. More research is needed to evaluate health consequences of secondhand exposure to nicotine, especially among vulnerable populations, including children, pregnant women, and people with cardiovascular conditions.

• The Author 2013. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e mail

Scientist raises a red flag about e-cigarettes and heart attack risk

Cvs to stop selling cigarettes – wsj.com

A scientist from Brown University is claiming that prolonged exposure to nicotine, even delivered by methods other than cigarettes, may increase the risk of developing a potentially fatal heart condition.

It’s the latest research to question the safety of e cigarettes, a popular substitute for smoking tobacco cigarettes, which are known to be harmful.

Chi Ming Hai unveiled his findings at the American Society for Cell Biology’s annual meeting in New Orleans. The presentation stems from work published last year in the journal Vascular Pharmacology.

Hai studied how nicotine and cigarette smoke extract stimulate the formation of rosettes on the surface of cells. The rosettes act like drills to bore through a scaffolding that protects vascular cells in the heart.

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The result can be atherosclerosis, or hardening of the arteries, a common cause of heart attacks. The newly reported research, for which Hai only provided an abstract, shows that the process occurs during nicotine administration, even without cigarette smoke.

‘Cancer of Blood Vessels’

Hai subjected rat and human vascular smooth muscle cells to nicotine for six hours. He said that the nicotine stimulated the rosettes to bore through the cells’ defenses.

Hai described atherosclerosis as a sort of cancer of blood vessels which leads to plaque build up and clogged arteries.

Cigarette smoke contains thousands of chemicals, but nicotine is the major chemical that causes cigarette addiction, Hai said in a statement to Healthline.

In my opinion, if taking nicotine for a short time can lead to complete cessation of smoking, e cigarette included, then it will be beneficial to take nicotine for a short time as a bridge to smoking cessation,” he added. “However, our data suggest that long term consumption of nicotine by e cigarette smoking is likely to increase the risk of developing atherosclerosis by stimulating invasion of vascular smooth muscle cells.

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Laboratory ‘Nonsense’?

Carl Phillips, scientific director for the Consumer Advocates for Smoke Free Alternatives Association (CASAA), dismissed the research as nonsense.

There is some pretty good research going on about why exactly cigarette smoke causes heart disease, which was substantially not understood, he told Healthline. But any such research that reaches the conclusion that the nicotine without smoke causes such disease is clearly wrong.

Elaine Keller, president of the CASAA, pointed to other recently published research that she said shows outcomes in the real world as opposed to a laboratory. One study showed that smokers put on nicotine replacement therapy after suffering an acute coronary event like a heart attack or stroke had no greater risk of a second incident within one year than those who were not.

Another study, conducted in Sweden, showed no greater risk of heart attack among men who chewed tobacco than among those who didn’t.

Jed Rose, a Duke University professor of psychiatry and behavioral science, told Healthline that the levels of nicotine administered in Hai’s 2012 study were about 10 times higher than what an average cigarette smoker would inhale.

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Vaping in the ‘Wild West’

Dorothy Hatsukami, a psychiatry professor at the University of Minnesota, is currently recruiting volunteers to study the effects of e cigarettes. She plans to study 25 people who smoke with the new devices and 25 people who smoke them in addition to tobacco cigarettes.

For starters, she wants to know the effects of the chemicals inhaled in the e cigarette vapor. The main ingredient propylene glycol is already used in some food products and toiletries in the U.S. In a 2006 review of the substance, the FDA found no research to suggest a public health hazard when used at its current levels or in the future.

But with the burning popularity of e cigarettes, the FDA had been expected to issue new guidelines this year. They have not, possibly as a result of the government shutdown.

The devices are so new there is virtually no regulation at all. We’re really at the beginning stages of understanding what the potential health impact might be, Hatsukami told Healthline. There could be public health benefits, certainly they are less toxic than cigarettes, but they may lead to other public health harms.

She likened the current e cigarette environment to the ‘Wild West.’

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Vapers Want to Be Cut a Break

Vapers, as e cigarette smokers call themselves, find the fuss over their new fix frustrating. Todd Smith owns a vaping supply store in Davenport, Iowa called the Vaporosity Shop. He has franchised his business, which began with one location, to four stores in two states in just five months.

The vapor in the e cigarettes at Vaporosity stores comes from a juice made by the husband of a franchisee who is a high school science teacher, Smith said. The flavored liquid includes nicotine and propylene glycol, as with most e cigarettes.

He told Healthline he is among the millions of Americans who have quit smoking tobacco cigarettes, proven to be deadly, by switching to vaping. He scoffs at efforts to demonize the products and at new initiatives to ban these devices in public.

We don’t lose our taste buds when we become adults, he said, referring to e cigarette flavors like bubble gum and cotton candy. And if they’re going to ban e cigarettes, then they’d better ban fog machines at Halloween.

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