Possible Dangers of Vapor from Smokeless E-Cigs

By Tarah Damask. Medically reviewed by Tom Iarocci, MD. May 7th 2016

E-cigarettes bolstered hope and a fair amount of praise with their introduction as a smokeless alternative to tobacco cigarettes.

With the removal of tobacco and its carcinogenic properties, some devices also promised pure water vapor in place of the dangerous secondhand smoke of conventional cigarettes. Scientists have analyzed scores of products to date, however, and the pure water vapor claim has proven to be generally untrue.

E-cigarettes can vary greatly in their ingredients and, in addition to any toxins, may contain some flavoring compounds that may be carcinogenic. Research is limited, so there are no clear answers yet on whether secondhand vapor is safer than secondhand cigarette smoke.

Misconceptions about E-Cigarettes and Vapor

Nowadays, you may find yourself in a variety of places where people are “vaping.” This means they are inhaling nicotine, perhaps along with various other chemicals, through electronic cigarettes. While these devices heat up “e-juice” containing nicotine in a liquid solution, creating a vapor, they do not burn tobacco leaves or create smoke.

The major social benefit of e-cigarettes is that they produce no unpleasant secondhand smoke. This adds a new dimension to smoke-free establishments, such as bars and restaurants, where you may see people casually vaping.

The question remains: Will vaping in public remain socially acceptable? True, e-cigarettes burst onto the scene as a wonder-answer to people seeking a safe alternative to traditional smoking, or a gentle way to ease themselves off cigarettes. However, research on these devices and what they actually deliver to the lungs is very limited, and there still may be unknown health risks to vaping. It’s known that e-cigarette users do exhale a portion of the vapor, which raises the question of secondhand vapor and whether it is safe for people around those who are vaping.

Physician Stanton A. Glantz, professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, asserts that e-cigarettes should be treated as conventional cigarettes socially. “People should not be involuntarily exposed to e-cig aerosol,” said Glantz. “E-cigs should be included in clean indoor air laws and voluntary smoke-free policies.”  This could include private homes.

Risk Factors of Secondhand E-Aerosol

Although water vapor emitted from e-cigs seems less distasteful than smoke from conventional cigarettes, it is not pure water vapor, as many labels may suggest. E-cigarettes do not release smoke, but they do emit secondhand vapor, also known as secondhand aerosol, which may contain irritants and toxins.

The FDA does not yet regulate e-cigarettes, which means labels don’t necessarily reflect ingredients and potential health ramifications in the way consumers are used to seeing with prescriptions or drugstore medications, for instance. Having a solid handle on what you are inhaling or putting out into the environment is therefore difficult to determine. Different e-cigarettes may contain varying levels of nicotine, as well as toxins and other probable carcinogens.

Manufacturers may claim their e-cigarettes produce “harmless water vapor,” but studies reveal secondhand aerosol is anything but pure H­2O. Chemicals in the aerosol include nicotine, and may also include a variety of compounds associated with reproductive harm and cancer, including cadmium, nickel, toluene and formaldehyde.

These substances are on California’s Prop 65 list, a list of chemicals known to the state of California to cause adverse health effects like cancer and birth defects. While the aerosol is clearly not just water vapor, it’s also true that not every compound on California’s list has been proven by the scientific community to actually cause cancer, according to the American Cancer Society.

The act of breathing in the secondhand aerosol from e-cigarettes, also called “passive vaping,” could lead to health complications. The aerosol is also considered a potential threat to the environment. In addition to the ingredients in the e-juice, heated metal portions of the devices may be responsible for the vaporization of metallic particles. A single puff may release a combination of extremely small particles that can cause immediate reactions or the development of serious health issues, acutely or over time.

Aerosol from e-cigs may set off eye irritation, throat and respiratory irritation, asthma, or cardiac arrest in susceptible individuals. People, particularly children, exposed to secondhand vapor over an extended period of time may develop asthma. “There are already studies showing respiratory irritation,” Glantz explained. “While not studied scientifically, people I know who have been around a lot of people using e-cigs have experienced wheezing and eye and nasal irritation. These are real health effects.”

Although research on aerosols associated with e-cigarettes is still in its infancy, researchers warn that secondhand vapor may prove to threaten innocent bystanders. The aerosol’s dangerous blend of toxins and carcinogens may soon prove to result in serious, yet avoidable, health problems. 

Next Steps

  • If you have chosen vaping as a type of nicotine replacement therapy to quit smoking, but want an alternative that will not put others at risk of secondhand vapor, consider nicotine patches or gum. Speaking with a trusted physician for further assistance is essential in quitting in a healthy manner.
  • If you wish to protect those around you from secondhand vapor, practice the same etiquette with e-cigarettes as you would with conventional cigarettes. Consider vaping away from groups of people, and avoiding vaping indoors.
  • If you are pregnant, consider distancing yourself from people who “vape” to protect your developing baby from hazardous chemicals that you may unintentionally inhale, and which may be able to cross the placenta. 

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