Tobacco Asia

Volume 19, Number 2

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22 tobaccoasia / Issue 2, 2015 (May/June) Test participants in this study tested two atom- izers, one with a single wick and the other with a double wick. They then were asked to test the atomizers at different wattage levels, the levels be- ing 6.5, 7.5, 9, and 10 watts and inform the re- searchers when dry puffs, an unpleasant burning taste that happens when e-liquids get overheated, started. Participants reported that the single wick atomizer produced dry puffs at 9 and 10 watts, while the double wick atomizer was normal at all wattage levels. The researchers also found that in the double wick atomizer there were minimal levels of aldehydes at all wattage levels. For the single wick atomizer, there were minimal levels of aldehydes at 6.5 and 7.5 watts but higher levels of aldehydes at 9 and 10 watts. In other words, it was found that aldehydes are produced at high levels only under dry puff conditions. According to Dr. Farsalinos, this in itself serves as a defense mechanism that protects the vaper from exposure to high levels of aldehyde as vapers usually avoid dry puffs anyway. The study also showed that if vapers use better atomizers, such as double wick rather than single wick, wattage levels are not an issue and vapers can vape at higher wattage with- out the problem of exposure to the production of aldehydes. Passive Vaping Another issue that regulators are concerned about is the effects of passive vaping – what happens to a non-vaping person who is near a vaper. A study by Dr. Farsalinos and team presented in 2012 had five vapers and five smokers vape or smoke in a hotel room on different days. The study found that after a five-hour period, the level of organic carbons found in the room from e-cigarettes was 0.73 milligrams per cubic meter (mg/m3) and 6.66 mg/m3 from tobacco cigarettes. Or, in simpler terms, as Dr. Farsalinos mentioned, "You got the same amount of organic carbon in 11 minutes of smoking as you would get from 5 hours of vap- ing. That's a huge gap and it shows that the level of chemicals that are released in the environment inside the room when someone [is] vaping are extremely low compared to smoking. "Chemical studies have found that exposure to toxic chemicals from electronic cigarettes is by Nitrosamines, a main carcinogen found in tobacco cigarette smoke. Study says conventional cigarettes deliver 1,800 times more nitrosamines than e-cigarettes. far lower compared to tobacco cigarettes. There's no doubt about it. However, besides comparing the level of specific chemicals, we have to under- stand that most of the 6,000 chemicals that are present in tobacco cigarette smoke are totally ab- sent from e-cigarettes. So, you don't get exposed to all these chemicals." Glycerin Other research findings Dr. Farsalinos presented included toxicological results showing that live cells exposed to e-cigarette vapor have a survival rate of up to 1,500% higher than in cells exposed to tobacco cigarettes, results from a study of car- diovascular function in which it was shown that there are no adverse effects in heart function and no effects on oxygen delivery to the heart after us- ing e-cigarettes, as well as debunking the claims of a previous study that said e-cigarette vapor causes lipoid pneumonia because of the glycerin in e- liquids, which, as Dr. Farsalinos explained, is not possible as glycerin or glycerol is an alcohol and lipoid pneumonia can only be caused by the pres- ence of lipid substances in the lungs. Throughout his presentation at the Forum Dr. Farsalinos stressed that e-cigarettes should be for smokers who are looking to quit smoking. "We don't recommend to start using e-cigarettes to a non-smoker," he said. "Basically it should be marketed as a smoking substitute for smokers only and that's how studies should be performed. This is the information that we need – how would a smoker react if he switched from tobacco to electronic cigarettes?" The safety of using e-cigarettes is also a major concern for regulators; however, as Dr. Farsali- nos pointed out, long-term studies on safety can- not be performed because, in contrast to smok- ing, which is known to cause diseases after 15 or 20 years of exposure, there currently are no e-cigarette users who have been vaping for that long who can be studied. "Vapers will eventually look for safety and quality and will choose the products which have been tested," said Dr. Farsalinos. "So, it's not only that the regulators are asking for proof of safety but the vapers are going to start asking for proof of safety and quality of the products. To do all this we need the industry to participate actively. The industry needs to recruit experts and fund studies, consult experts, develop well-designed protocols. "The e-cigarette is a public health revolution," concluded Dr. Farsalinos. "There is no doubt that they are less harmful by big margins compared to tobacco cigarettes. Of course we need more evi- dence and proof about the safety and quality in or- der to convince [not only] the regulators but also the scientists and the doctors."

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