What do we know about the health effects of vaping?More than nine million adults in the United States use e-cigarettes regularly, according to the Centers for Disease Control and Prevention. A few years ago, Professor of Biology Karen Bernd found herself on the leading edge of a trend when a student decided to explore what remains, to this day, somewhat uncharted research territory. In this Q&A: what consumers should know, and what researchers have yet to find out about vaping.
What is vaping, and how is it done?
Vaping is the act of using an electronic nicotine delivery system, or e-cigarette. The liquid that becomes vapor is glycerol-based, and sometimes flavorings are added. The liquid can come with or without nicotine. The liquid is vaporized as it is pulled through the coil system in the e-cigarette, and the vaporous particles, flavoring and, possibly, nicotine are delivered into the individual. If nicotine is present, it creates a physiological response; but users also react to the flavors, which range from tobacco flavor, which is made without tobacco, to Piña Colada to triple chocolate. Within the United States, it’s a growing social activity among youths.
Public health professionals are interested in whether vaping can be used for smoking cessation, and are concerned about it as an entry system; they want to know whether people are likely to transition from using ‘mods,’ or e-cigarettes, to tobacco cigarettes.
Vaping is perceived by most to be healthier than smoking cigarettes because you are not burning tobacco, and it’s the tobacco combustion products that contain the 3,000-plus carcinogenic components. If you can get rid of the nasty part of burning tobacco and retain the nicotine, well that would seem to be a safer alternative.
The average person who has started to vape is probably not thinking about all of these things. Research has shown that middle- and high-schoolers are among the fastest growing populations of new users. While I believe in the youth of our country, I don’t think they are consciously saying, “I want to reduce my exposure to combustion products of tobacco.”
Why is this trend a concern for you and your lab?
My lab is focused on the effect of environmental pollutants on lung cells, and I’m very interested in working with students on projects that they are invested in, and that fit within the context in which they live. College students vape.
A few years ago, Kaki Bennett ’15 was new to the lab and wanted to study tobacco cigarettes. I pointed out to her that tobacco has been well studied, and we know it is harmful. E-cigarettes were brand new in the United States at the time, so we both started reading about them. At about the same time, the first vape shop opened up in the area. We predicted the trend, and she became really interested in it.
My current students, Rosie Major ’18 and Davied Sanchez ’17, are looking at different flavorings and whether the presence of the flavoring causes a different effect on the health of the lung cells.
The e-cigarette technology has been around since 2000, but it’s only really become popular in the past five years in the United States. There aren’t any FDA regulations focused on what you can put in an e-liquid. The guidelines the e-liquid manufacturers follow ensure that all of the chemicals they are using are safe to eat, which is wonderful. But you do not ingest these liquids—you breathe them, and the particles go into your lungs. The effect they have on the lining of your lungs might be different than the effect they would have on your esophagus, stomach and intestinal tract were you to eat them. Something that is harmless in one condition might be an irritant under different conditions.
What do we currently know about how vaping affects lung cells?
It’s a new field, and it’s wide open. We don’t have a definitive answer, we have bits and pieces. And by “we,” I mean the whole field, not just my lab; my lab has bits of the bits and pieces.
As Kaki explained in her thesis defense, if you put something that is healthy on one end of a scale and something that kills you on the other end, smoking cigarettes is one extreme, and vaping is closer to the middle. But if you’re breathing in particles, it’s going to have an effect on lung cells. Would the lung cells prefer that you not breathe in particles? Probably. So I don’t think you could consider vaping a health tonic by any stretch of the imagination; but if the choice is vaping vs. smoking, vaping would seem to be a safer alternative. Maybe not safe, but safer.
The brain doesn’t fully develop until around age 24; is there analogous development with the lungs?
That’s a good question. My impression would be that vaping at a very early age, early on in development, would probably be more detrimental. The whole concept of second-hand vapor is a completely different field. What I’m talking about is when you are actually drawing on the e-cig yourself.
Would the lung damage from vaping have more of an effect in a young adult than it would on an older adult? That would depend on the person and what else they have been exposed to. Older adults have been exposed to more things that can damage their cells, so if they add in something that has a detrimental or irritant effect, it could be the straw that breaks the camel’s back. In younger adults, it may be the thing that starts the damage. Now which one of those is worse? Starting the damage, or escalating it? I don’t know. What we really need to find out first is whether it causes damage.
What is the current state of the research in your lab?
Maggie Furlong ’16, who worked with me last semester, was looking at the flavor-free, glycerin-based substances. Rosie is looking at cinnamon-flavored liquids, and Davied is looking at French vanilla. These flavorings were chosen because they are quite popular. Additionally, cinnamaldehyde is the chemical constituent that makes cinnamon flavor, and it’s known to be reactive and able to cause damage, so we are researching whether the amounts you are exposed to when you vape cause damage to cells. There has been some research to indicate that chemicals in the vanilla flavoring can cause irritation or damage to some cell types, but they haven’t been tested on these lung cells.
To get accurate results, we hook up an e-cigarette to a vaping machine, and the cells “vape.” It’s not an actual lung, but the machine draws in the vapor and the cells are exposed in much the same way the cells would be exposed in the lung.
Have there been definite findings?
Everything we are doing is building a picture, and so if you think of the picture as a mosaic, we are still looking at it way up close, and we are placing the little tiles. We are not at the stage yet where we can back up and see the tiles starting to form a picture.
Are the students you work with as excited about this work as you are?
Yeah, I think they are, but they may be excited for different reasons. Part of what gets me excited about this is working with them and watching them develop different skills in the lab. I will say that out of the research I have done throughout my career, this is an area of research that holds the attention of people in the general public—when I talk about it, they are interested and ask questions, rather than rolling their eyes and changing the topic. I understand that. Talking about protein translocation in algae doesn’t get the same sort of public response.
Do you have plans to explore new areas of inquiry?
I have lots of plans. The e-cigarette/vapor work will continue this summer and into the fall. I will be expanding collaboration with Professor Cindy Hauser in the chemistry department. She looks at the particular components of hookah smoke, or water pipe smoke, and I will be adding in a different type of smoke or vapor into the types of exposures we are examining. Our combined analysis will allow us to identify components of the actual water pipe itself and its composition, how they effect the composition of the smoke and how those smokes affect lung cells.
How might scientific findings influence policy?
The water pipe based project is a collaboration that Dr. Hauser and I have talked about before, and the timing of it has to do with the fact that we just answered an application call from the National Institutes of Health and the FDA looking for information about the effects of hookah smoke. So it is something that we’ve had on the backburner but fortuitously this call for proposals came at the same time, so we have a grant application pending. We don’t know if we will receive government funding, but based on the fact that there was this call for proposals, I can say definitively that yes, the government and governmental agencies are looking for scientific research into the toxicology and chemistry of these different types of smoking and vaping so as to inform policy.