Media stories about e-cigarette health risks, based on a study which found flavored e-liquids contain…. flavors

Thursday, 16 April 2015 22:40

By Dr Farsalinos

A study was published today by the journal Tobacco Control. Authors from university of Portland (the same institute that published the formaldehyde story in New England Journal of Medicine), evaluated 30 e-cigarette liquids for the presence of flavoring compounds.

They main finding from this study was that flavored e-liquids contain… flavors. It is well known for years that flavoring compounds, although approved for food use, have not been adequately tested for safety when inhaled. So, the study found nothing new. We know for years that flavoring compounds used in e-cigarettes are approved for food use only, and this is exactly what the study found. So, nothing new again. Finally, all this media frenzy about risks comes from the finding that only 2 of the 30 e-liquids exceeded the occupational exposure limits for 1 chemical each (vanillin and benzaldehyde – benzaldehyde is very commonly used as a flavoring and fragrance in food, cosmetics and pharmaceuticals, giving a characteristic almond flavor and smell). I am not underestimating this; manufacturers should use flavoring compounds in moderate amounts. However, such a finding does not justify the media campaigns and messages about risks of e-cigarette use. Moreover, it is not very common to see vapers use a single flavor all day every day.

Taking this opportunity, I think it is important to distinguish irritation from toxicity and risk. Irritation does not necessarily mean damage or long-term adverse effects. Moreover, irritation is sometimes needed by the vapers. For example, throat hit is a form of irritation and most vapers want to feel the throat hit, similarly to what they experienced with smoking. The authors mention in the abstract that aldehydes are primary irritants of mucosal tissue of the respiratory tract. However, many fragrances (which are supposed to be inhaled) are aldehydes, and in the main text of the manuscript the authors mention an occupational safety limit for benzaldehyde, confirming that any irritation (or any adverse effect) depends on the levels at which you are exposed.

Flavorings used in e-cigarettes are compounds approved for food use. We have limited data about safety when inhaled, but this does not necessarily mean that they are toxic. If any of the study (or other) authors have any alternative flavoring compounds that should be used, they should tell us. If they think that the flavor of tobacco cigarette smoke is preferable to the food flavors used in e-liquids, they should also say it. Other than that, the finding that a small minority of the liquids (2 out of 30) could expose consumers to higher levels than occupational safety does not justify the media headlines, but should be taken into consideration by the manufacturers, who should understand that flavorings should be used in moderation.