Tag Archive for: smoking

Vaping: The Spit Test

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The use of e-cigarettes, also known as vaping, is gaining in popularity, especially among young adults. I wouldn’t recommend it because the research is incomplete; here’s the latest study.

Researchers recruited subjects for three groups: 15 non-smokers, 14 e-cigarette users, and 15 cigarette smokers. The researchers had the subjects spit into sterile containers. Then they examined the sputum for abnormalities between the groups.

E-cigarette users had increases in stress proteins usually associated with cigarette smoking. Defense proteins that are generally associated with chronic obstructive pulmonary disease (COPD) were elevated in e-cigarette uses as well. Vapers also had an increase in sputum components associated with an immune response typically found in cigarette smokers. Finally, proteins generally associated with thicker sputum similar to that found in cigarette smokers were also found in e-cigarette users.

Reduced antioxidant levels. COPD. Alterations in immune function. Thicker spit. Yes, this was a small study. Yes, these are only factors associated with serious lung disorders, not the disorders themselves. But do you see anything that seems to indicate vaping doesn’t have serious risks? You can wait until the research shows the hazards or you can quit vaping now. Your lungs. Your body. Your choice.

What are you prepared to do today?

Dr. Chet

P.S. Get all the info on vaping in one place on the Health Info page under Basic Health Info: “Should You Vape?”

 

Reference: https://doi.org/10.1164/rccm.201708-1590OC.

 

The Bottom Line on E-Cigarettes

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Vaping e-cigarettes is supposed to be better than smoking cigarettes because the toxic chemicals will be gone. That may be true for the chemicals released from tobacco and paper, but the third area of concern is the e-liquids that make up the flavor component of e-cigarettes. The marketing tactic often focuses on the variety of flavors available. The question is this: are they safe or do they contain chemicals that could negatively impact the lungs?

Researchers obtained a random sample of e-cigarette liquids from the most popular brands on sale in Greece, Spain, Germany, the Netherlands, the UK, Hungary, Romania, Poland, and France. The samples included a variety of different flavors and nicotine strengths. They analyzed each sample to find out exactly which chemicals were present and in what quantities.

Every liquid container that they tested contained at least one substance that has some level of health risk according to the United Nations classification system. The chemicals, with long complex names, can cause respiratory irritation, allergy or asthma symptoms, or breathing difficulties if inhaled. What they might do when heated is still to be determined.

There were several more research papers presented that also illustrated that e-cigarettes are not problem free. The belief is that they are not as harmful as conventional cigarettes, but the fact is we really don’t know because the components haven’t been tested.
 

Meanwhile There’s the FDA

And they probably never will be tested, at least in the U.S. This past July, the new head of the FDA Dr. Scott Gottlieb announced that he was suspending laws that govern e-cigarettes for five years. In the last administration, the governance over e-cigarettes was turned over to the FDA where they enacted restrictions that insisted the products be tested for safety before being brought to market. Those rules have been suspended so the industry could have time to set standards and comply with tobacco regulations.

I read Dr. Gottlieb’s ruling. As a physician who has treated cancer patients, he has seen what cigarettes do first hand. His belief is that nicotine addiction is the primary issue and that vaping, while not as good as not smoking, may help people quit smoking by using these products to help reduce reliance on nicotine. Gottlieb seems to believe that nicotine, while still addictive, does not kill people; it’s the 5,000 other chemicals in cigarettes that do.

I simply do not understand his reasoning. There are hazards to nicotine, as the research this week has shown. There are chemicals in the e-liquids that have not been identified, have not been tested, and we have no history with their use to investigate. How do we know what health issues we’re facing without finding answers to those questions?

One more thing. Dr. Gottlieb is an investor in a vaping products company called Kure. He has said that he will divest his interest and recuse himself from decisions on vaping for one year. I guess physician years are like dog years; he seems to have made a big decision on vaping after being in office just a few months.
 

The Bottom Line

As a former smoker, I understand the addiction. If vaping products had been available when I quit, maybe I would have used them. As a healthcare professional today, there is not a chance. We’re talking about inhaling substances that have never been subjected to any form of safety or toxicity testing. It’s unreasonable to do that. The studies I reviewed this week clearly show there is doubt. We know how long it took the tobacco industry to finally admit that tobacco was addictive when they had the data all along. The e-cigarette industry has no data at all.

You are a free-living human being. It’s your body, and what you choose to put in it is your choice. I just hope none of it comes from tobacco or e-cigarette products.

What are you prepared to do today?

Dr. Chet

 

Reference: European Respiratory Society. 2017. Abstract OA1978.

 

Update: E-Cigarettes Put Lungs at Risk

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The second study presented at the European Respiratory Conference on e-cigarettes that caught my attention was a study done in Sweden. Researchers questioned over 30,000 people, randomly selected from the Swedish population. The purpose was to ask the subjects about smoking: did they smoke, what did they smoke, and what type of respiratory symptoms did they have? Here’s what they found.

Only 12.6% of those surveyed said they smoked, and the numbers broke down this way: 11% smoked only conventional cigarettes, 0.6% vaped only, and 1.2% said they used both. Researchers speculated they smoked cigarettes when allowed and vaped in public or other settings.

What about respiratory conditions? As you might expect, the highest percentage of respiratory issues came from those subjects who smoked both conventional and e-cigarettes at 56%; 46% of those who smoked only cigarettes had respiratory issues, and 34% of those who exclusively used e-cigarettes. How many non-smokers had respiratory conditions? Only 24%. The results clearly show that vaping causes the same respiratory issues such as wheezing or productive coughs as might be found in tobacco cigarettes.

What might be contributing to the issues with e-cigarettes? I’ll cover that on Saturday. One thing is clear so far: vaping is not innocuous as has been sold to consumers.

What are you prepared to do today?

Dr. Chet

 

Reference: ERS 2017. Abstract PA4485

 

Update: E-Cigarette Safety

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As the European Respiratory Society held their annual convention, several research studies made the health news, including e-cigarettes and vaping. The appeal of e-cigarettes is that they seem to be safe–you’re not actually burning tobacco with its associated chemicals and inhaling that into your lungs. E-cigarettes remove all that bad stuff and associated negative health effects. Or do they?

In the first study, researchers recruited 15 subjects who had smoked cigarettes occasionally, fewer then 10 per month; subjects had also never used e-cigarettes. They were asked to smoke e-cigarettes for 30 minutes in a random order on different days; once with nicotine, the other without. The researchers measured blood pressure, heart rate, and arterial stiffness immediately after smoking the e-cigarettes and then two and four hours later.

In the first 30 minutes after smoking e-cigarettes with nicotine, there was a significant increase in blood pressure, heart rate, and arterial stiffness. That didn’t happen after the e-cigarettes without nicotine. While this is a small pilot study, it seems that vaping nicotine can impact the cardiovascular system in the same way regular cigarettes do.

What are you prepared to do today?

Dr. Chet

 

Reference: ERS 2017; Abstract OA1979.

 

How to Live to Your 90s

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Today’s message is based on my father-in-law, Don Jones, or Joner as most of us knew him. As I said Wednesday, he passed away last Sunday. He lived to 94 years and six months; Peggy, the sister he was closest to, died at the exact same age. How was he able to live that long? I’ll give you my observations based on his life.

  • Genetics: it pays to have the right genes and Dad certainly did. Several of his siblings lived into their 90s.
  • Quit smoking: he quit smoking before he turned 21 years old. That’s probably the single most important thing he did. His father and siblings who smoked all died much younger. He never drank alcohol after that either.
  • Love: he loved his wife of over 70 years deeply, and as I said Wednesday, he longed to be with Ruth again. That’s a love that transcends life itself.
  • Humor: he had a great sense of humor. He gave it and was able to take it as well. My big ears were a frequent target. Once after we came in from a run together on a cold day, he said, “I know why you wear that headband: reduce wind resistance.”
  • Demeanor: he was almost always calm and pleasant and rarely showed any anger. Paula said when she was a kid and acted up, he’d just hang his head and sigh, and that hurt worse than any spanking. Once when he was mad at me, he showed it by leaving the newspaper at the top of the steps instead of putting it on the counter. He never stayed mad long.
  • Faith: he believed in God and lived his faith.
  • Exercise: he worked physical jobs most of his life. Then he began running when he was 70 and continued until he was in his mid-80s, hitting 700 miles for 2002. No doubt that helped him live longer than he might have with a genetic tendency toward stroke. He was never very fast but once you’re over 70, there’s not a lot of competition and he enjoyed picking up trophies at many of his 5Ks. I’m sure that competitive spirit added zest to his life.
  • Body weight: he was never fat for his height. That reduced any additional stress on his joints.

Those are my observations on how Joner lived into his 90s. While you can’t change your genes, you can certainly make the most of what you’ve got; his lifestyle and approach to life certainly helped my father-in-law.

What are you prepared to do today?

Dr. Chet

 

The Genetics of Smoking

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The study I’m examining this week is profound for a number of reasons. Identifying the genes that are affected by direct contact with the toxins in cigarette smoke provides one piece of a very complex puzzle. For example, they showed the difference in genetic mutations in the same type of tumors between smokers and non-smokers. The smokers had the genetic mutations while the non-smokers didn’t. So why did they get that type of cancer? That’s why I said it’s one piece of a puzzle. There are undoubtedly other factors involved.

With the information that . . .

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Smoking and Cancer Update

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A fascinating research paper was recently published in which researchers compared the genetic mutations found in 14 different types of tumors from chronic cigarette smokers and those who never smoked. They were attempting to see the differences in the genetic damage that occurred in tumors from the same organs between people who smoked and those who had never smoked. While they occur less frequently in non-smokers, some types of lung cancers still occur in those who never smoke.

This was complicated research to say the least. The research group had developed an algorithm that would look at over 90 . . .

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How Long Can Third-Hand Smoke Last?

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Researchers were interested in finding out how long the residual particulates and substances last in people who quit smoking and in their environment. They recruited 90 smokers to participate in the study and tested the verified quitters for third-hand smoke pollutants at baseline, one week, and one, three, and six months after they quit.

The subjects were tested in two ways: their fingers and their urine were checked for metabolites of third-hand smoke. They also tested the dust in their environment. As you might expect, the bodies of the ex-smokers saw a dramatic decline in smoking metabolites . . .

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The Tenacity of Third-Hand Smoke

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Recently I found a moving box full of my mother’s recipes. When I opened the box, I was hit with the smell of stale, old, cigarette smoke. My mother was a smoker for over 45 years, so the smell makes sense. What you should also know is that she died over 20 years ago. That’s how long the smells can linger from the residual parts of cigarette smoke.

Cleaning her home after she died, I had to use a full strength cleaner without diluting it in water, then rinse. One pail of water would last for a section . . .

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Smoking and Exercise

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What are we doing well when it comes to health habits? Based on the study published in the Mayo Clinic Proceedings, we seem to be getting the message that we shouldn’t smoke tobacco: 71% of all Americans don’t smoke based on the data from the NHANES data set. This wasn’t just a questionnaire; the participants had their blood tested as part of their participation in the study. You can lie on a questionnaire, but you can’t fool a blood test for metabolites found in cigarette smoke.

Better doesn’t mean good enough in my opinion. I . . .

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