Electronic cigarettes, the plastic, light-up, 21st-century version of traditional smokes, have been marketed as the safe alternative to smoking, despite no studies on how they affect the human body — until now.
The University of Miami was awarded a $1.95 million grant this week from the Florida Department of Health to conduct the study, which UM said is the first of its kind, to determine whether e-cigarettes create any potential pulmonary health risks and are as safe as they are marketed to be.
Matthias Salathe, professor of medicine and molecular and cellular pharmacology at UM, will conduct the study over the next five years to determine the effect of e-cigarettes on human airways. The battery-operated cigarettes burn liquid chemical compounds and release vapor — instead of smoke. Some variations come without nicotine, the addictive stimulant in regular cigarettes.
“Some people think e-cigarettes are a good way to stop smoking because they can get the nicotine but not the other dangers, but the problem with that is that we have no idea whether e-cigarettes are harmless,” Salathe said. “While we have a lot of studies on other things that you inhale, there is really no study on whether this is causing trouble or not.”
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The UM study aims to provide data that could help determine whether there should be e-cigarette regulation.
Research on the contents and effects of e-cigarettes has been limited.
A 2009 FDA study found traces of cancer-causing chemicals, including an ingredient used in anti-freeze, inside two leading brands of e-cigarettes and a 2014 British Medical Journal study found that nicotine levels ranged in e-cigarettes, with particular variability in the actual and advertised level of nicotine on e-cigarette packages.
The contents of e-cigarettes vary, Salathe said, because they are not regulated by the U.S. Food and Drug Administration, though other nicotine products are, such as nicotine patches and gum.
The UM study will start with, of all things, a smoking robot.
The robot will inhale the battery-powered cigarettes, both with nicotine and without, and release the vapor over a culture of human airway cells.
Two human groups will also be used to track the effect e-cigarettes have on human airways over a longer period of time. A group of non-smoking volunteers will be asked to smoke e-cigarettes without nicotine to test the changes to their airways. Another group of 120 traditional smokers who would like to transition to e-cigarettes will be used to test whether e-cigs are a healthier alternative to traditional cigarettes by measuring whether there is a decrease in the inflammation in their airways caused by smoking regular cigarettes.
The popularity of e-cigarettes has skyrocketed thanks to intensive marketing efforts focused on liquid flavors ranging from fire-and-ice gum to condensed milk, making the devices more attractive to younger generations.
According to the Centers for Disease Control and Prevention’s most recent Morbidity and Mortality Weekly Report, e-cigarette use among middle and high school students tripled from 2013 to 2014.
Use among high school students rose from 4.5 percent in 2013 to 13.4 percent in 2014, raising the number of vaping high schoolers from little over a half million to 2 million. About 3.9 percent, or 450,000 middle school students, used e-cigarettes in 2014, up from 1.1 percent in 2013, or about 120,000.
“It’s a dangerous enterprise,” said Michael Campos, the lead investigator on the study and an associate professor at the University of Miami Miller School of Medicine. “The market is growing faster than the research. They [e-cigarette companies] are using the momentum to keep marketing and making their millions while we will catch up in maybe a few years to tell them, ‘Hey, this is bad. Don’t do it.’”
E-cigarette stores and bars have popped up in malls across Miami-Dade County and in TV and magazine advertisements. Tobacco companies have jumped in the ring, too, selling their own e-cigarette products, a practice Campos said makes him suspicious.
Campos, who is also the pulmonary section chief in the Department of Medicine at the Miami Veterans Affairs hospital, said he has seen more and more of his patients, who are usually heavy smokers, transition from smoke to vapor.
The answers have changed recently when he asks the standard question: Have you been smoking?
“It’s not unusual to hear, ‘Not as much but I have this,’” Campos said. “And they show me an electronic cigarette.”
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This story was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation