A study led by researchers at Roswell Park Comprehensive Cancer Center reports that nicotine exposure remains the same, while exposure to specific carcinogens and toxicants is reduced, among smokers who switch from tobacco cigarettes to electronic cigarettes.
Use of electronic cigarettes (e-cigarettes) has more than tripled among students in Poland, according to research led by Maciej Goniewicz, PhD, PharmD, a researcher in the Department of Health Behavior at Roswell Park Comprehensive Cancer Center.
Listen as Maciej Goniewicz, PhD discusses e-cigarettes and why these may not be the best option when trying to quit smoking.
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Are E- Cigarettes Harmful?
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Learn more about Maciej Goniewicz, PhD
Maciej Goniewicz, PhD
Maciej Goniewicz, PhD joined the staff of Roswell Park Comprehensive Cancer Center in 2013 as Assistant Member of the Department of Health Behavior, Division of Cancer Prevention and Population Sciences. In 2016, he was appointed Associate Member.Learn more about Maciej Goniewicz, PhD
Transcription:
Are E- Cigarettes Harmful?
Bill Klaproth (Host): Many people trying to quit smoking are turning to e-cigarettes, or just switching use to e-cigarettes, but are they safe? To help us learn more is Dr. Maciej Goniewicz, Assistant Professor of Oncology at Roswell Park Comprehensive Cancer Center. Dr. Goniewicz, thank you, so much, for your time today. So for smokers who switch from tobacco cigarettes to e-cigarettes, are they safe, and do they reduce cancer risk?
Dr. Maciej Goniewicz (Guest): Yeah, thank you so much, thank you for your question, and thank you for having me. Yes, for the smokers who switch to electronic cigarettes, and it’s very important to switch completely, so those who stop smoking and they start vaping, we see a really big difference in terms of the exposure to toxicants, to cancer-causing chemicals. It means that those smokers who switch to electronic cigarettes do not inhale large doses of very dangerous chemicals and that’s why we believe – that’s why the scientific data show that cancer risk among those smokers may be substantially reduced.
Bill: So straight-up vaping alone will reduce your cancer risk, less exposure to toxins – now, what about the nicotine that goes in these e-cigarettes? Is that safe?
Dr. Goniewicz: Yes, this is one of the concerns about the electronic cigarettes, but we use nicotine in nicotine-replacement therapies, so in medicines like patches or gums. Nicotine is present in all these medicines that are available in the drug stores, and there are research studies looking at the health effects of just using nicotine over the long-term. Even some smokers who decided to quit smoking and started using nicotine patches or nicotine gum, they continue to use the products for a long time. We do not see any significant health risks among those people, so even the nicotine has the effect on our body, has the effect on our cardiovascular system. When we compare the health risk associated with smoking to the risk associated with using clean forms of nicotine, there’s a huge difference between those two types of products.
Bill: So for someone that wants to continue to smoke because they like the tactile sensation of holding something in their hands and the actual act of smoking, by switching to an e-cigarette by vaping, by using it correctly, basically that is safe then?
Dr. Goniewicz: It’s safer.
Bill: It’s safer.
Dr. Goniewicz: It’s safer. Unfortunately, we cannot claim right now it is totally safe. We do not have enough data about the absolute risk of using electronic cigarettes, but we have a relative estimation – a relative risk as compared to smoking. Since smoking itself is as dangerous as it can be, it’s really, really a mixture of thousands of chemicals – a really toxic, really dangerous mixture, so switching completely to electronic cigarettes will result in a reduced harm.
Bill: Okay, so vaping then – basically, less chemicals, fewer toxins – just by that they are more safe than regular tobacco cigarettes. You mentioned something earlier, what about those that smoke and vape -- because I know people that still do that. They were long-term tobacco smokers, then they started to vape, but they still will have a couple of cigarettes the day, and in between, they’re vaping. What does the research show for someone like that?
Dr. Goniewicz: Unfortunately, the emerging science in this area about the reducing smoking showed that it’s not really a very effective strategy. Smokers reduce smoking, but when we look at the toxicants in the body, they do not reduce as much as needed to eliminate the risk. Some people may reduce significantly like switching – let’s say reducing from 20 cigarettes, a pack of cigarettes a day, to one cigarette a day, but it’s very rare. We don’t see these patterns. People usually reduce from 20 to 15, from 15 to 10, from 10 to 8 and this reduction is not enough to reduce health risks. But when we look at those smokers that completely switch to electronic cigarettes, who do not smoke tobacco cigarettes but use instead electronic cigarettes, then the effect is really strong.
Bill: So to get the benefits of vaping, you’ve got to cut out tobacco completely -- you’ve got to just vape alone?
Dr. Goniewicz: That’s a really strong message, and I would like to emphasize it. This is the most important thing about smoking and reducing harm, is to quit smoking. However, smokers can achieve it, whether with medicines, whether with some help, whether with electronic cigarettes – quitting smoking is the most important, and the most effective strategy to gain the health benefits.
Bill: And people still can use this as an aid to quit smoking, to wean themselves off of tobacco cigarettes. It’s still useful when applied in that way as well, is that correct?
Dr. Goniewicz: That’s correct. That’s correct. We see a potential in electronic cigarettes to reduce the harm associated with smoking tobacco. I do my research in the cancer prevention department, so we are looking at any way that we can prevent cancer, and smoking is a very important health risk. A lot of smokers would develop lung cancer and also the cardiovascular diseases – we just focused here on the cancer risk – and we see that the smokers here that switch to electronic cigarettes, and when we evaluation the cancer risk among those smokers – ex-smokers, now using electronic cigarettes, we see that the risk is substantially reduced
Bill: And new questions, then, have emerged because people that like to vape like to use these flavors in them now, so what about the flavors and the toxicity of these different flavors that people put in their e-cigarettes?
Dr. Goniewicz: That’s a really important question, and unfortunately, we do not have data right now to answer this question about – there are so many flavorings. There are hundreds of different flavorings in electronic cigarettes. The problem is that manufacturers of these products – manufacturers of these juices, with nicotine – the liquids with the nicotine took these flavorings from the food products. They are commonly used in food products, sometimes on cosmetics, but we don’t really know what’s going on when people inhale all these flavorings. They’ve never been used in a product for inhalation purposes, and part of our research is to answer, is to evaluate different products, is to test in a laboratory different flavorings and make a recommendation to the users, make a recommendation to the regulators what to do with these flavorings. We see differences – we see that some flavorings might be more toxic as compared to the other flavorings, but even if we choose the most toxic flavoring, something that may be dangerous and we compared the health effects of smoking tobacco cigarettes, it’s still less risky.
Bill: So it’s going to be some time, though, before we know the true long-term risks of flavorings in these e-cigarettes? And Dr. Goniewicz, any other relevant e-cigarette research that you can share with us?
Dr. Goniewicz: Yes, so when we started to research, we wanted to understand what is the health impact of electronic cigarettes? First, we tested the products in the laboratory looking at what’s inside – whether it contains any toxicants, any dangerous compounds and what we know is it contains nicotine, it contains certain chemicals, and even if it contains toxicants, the toxicant levels are very low. Then we look at the cells exposed to the electronic cigarettes -- to vapors from electronic cigarettes, and we see that yes, the vapor has the effect on the cells, but it’s less toxic than tobacco cigarettes.
Now we are doing some research with the animals, looking at what’s going on when the animals are exposed. I don’t have full data right now, but this is ongoing research, and I think what we really are searching for and really waiting for are the human subject studies. We want to know what’s really going on among the users of the electronic cigarettes. Unfortunately, this type of research takes more time, and we simply need to wait longer.
Bill: Right, but at least now you’re gaining a benchmark of research – an archive of research that you will use moving forward that you’ll be able to look back because you are starting to research this at the beginning of this vaping trend, if you will, so it’s good to have the research certainly that you’re doing now. Dr. Goniewicz, thank you, again, so much for your time today and for more information, visit RoswellPark.org, that’s RoswellPark.org. You’re listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth, thanks for listening.
Are E- Cigarettes Harmful?
Bill Klaproth (Host): Many people trying to quit smoking are turning to e-cigarettes, or just switching use to e-cigarettes, but are they safe? To help us learn more is Dr. Maciej Goniewicz, Assistant Professor of Oncology at Roswell Park Comprehensive Cancer Center. Dr. Goniewicz, thank you, so much, for your time today. So for smokers who switch from tobacco cigarettes to e-cigarettes, are they safe, and do they reduce cancer risk?
Dr. Maciej Goniewicz (Guest): Yeah, thank you so much, thank you for your question, and thank you for having me. Yes, for the smokers who switch to electronic cigarettes, and it’s very important to switch completely, so those who stop smoking and they start vaping, we see a really big difference in terms of the exposure to toxicants, to cancer-causing chemicals. It means that those smokers who switch to electronic cigarettes do not inhale large doses of very dangerous chemicals and that’s why we believe – that’s why the scientific data show that cancer risk among those smokers may be substantially reduced.
Bill: So straight-up vaping alone will reduce your cancer risk, less exposure to toxins – now, what about the nicotine that goes in these e-cigarettes? Is that safe?
Dr. Goniewicz: Yes, this is one of the concerns about the electronic cigarettes, but we use nicotine in nicotine-replacement therapies, so in medicines like patches or gums. Nicotine is present in all these medicines that are available in the drug stores, and there are research studies looking at the health effects of just using nicotine over the long-term. Even some smokers who decided to quit smoking and started using nicotine patches or nicotine gum, they continue to use the products for a long time. We do not see any significant health risks among those people, so even the nicotine has the effect on our body, has the effect on our cardiovascular system. When we compare the health risk associated with smoking to the risk associated with using clean forms of nicotine, there’s a huge difference between those two types of products.
Bill: So for someone that wants to continue to smoke because they like the tactile sensation of holding something in their hands and the actual act of smoking, by switching to an e-cigarette by vaping, by using it correctly, basically that is safe then?
Dr. Goniewicz: It’s safer.
Bill: It’s safer.
Dr. Goniewicz: It’s safer. Unfortunately, we cannot claim right now it is totally safe. We do not have enough data about the absolute risk of using electronic cigarettes, but we have a relative estimation – a relative risk as compared to smoking. Since smoking itself is as dangerous as it can be, it’s really, really a mixture of thousands of chemicals – a really toxic, really dangerous mixture, so switching completely to electronic cigarettes will result in a reduced harm.
Bill: Okay, so vaping then – basically, less chemicals, fewer toxins – just by that they are more safe than regular tobacco cigarettes. You mentioned something earlier, what about those that smoke and vape -- because I know people that still do that. They were long-term tobacco smokers, then they started to vape, but they still will have a couple of cigarettes the day, and in between, they’re vaping. What does the research show for someone like that?
Dr. Goniewicz: Unfortunately, the emerging science in this area about the reducing smoking showed that it’s not really a very effective strategy. Smokers reduce smoking, but when we look at the toxicants in the body, they do not reduce as much as needed to eliminate the risk. Some people may reduce significantly like switching – let’s say reducing from 20 cigarettes, a pack of cigarettes a day, to one cigarette a day, but it’s very rare. We don’t see these patterns. People usually reduce from 20 to 15, from 15 to 10, from 10 to 8 and this reduction is not enough to reduce health risks. But when we look at those smokers that completely switch to electronic cigarettes, who do not smoke tobacco cigarettes but use instead electronic cigarettes, then the effect is really strong.
Bill: So to get the benefits of vaping, you’ve got to cut out tobacco completely -- you’ve got to just vape alone?
Dr. Goniewicz: That’s a really strong message, and I would like to emphasize it. This is the most important thing about smoking and reducing harm, is to quit smoking. However, smokers can achieve it, whether with medicines, whether with some help, whether with electronic cigarettes – quitting smoking is the most important, and the most effective strategy to gain the health benefits.
Bill: And people still can use this as an aid to quit smoking, to wean themselves off of tobacco cigarettes. It’s still useful when applied in that way as well, is that correct?
Dr. Goniewicz: That’s correct. That’s correct. We see a potential in electronic cigarettes to reduce the harm associated with smoking tobacco. I do my research in the cancer prevention department, so we are looking at any way that we can prevent cancer, and smoking is a very important health risk. A lot of smokers would develop lung cancer and also the cardiovascular diseases – we just focused here on the cancer risk – and we see that the smokers here that switch to electronic cigarettes, and when we evaluation the cancer risk among those smokers – ex-smokers, now using electronic cigarettes, we see that the risk is substantially reduced
Bill: And new questions, then, have emerged because people that like to vape like to use these flavors in them now, so what about the flavors and the toxicity of these different flavors that people put in their e-cigarettes?
Dr. Goniewicz: That’s a really important question, and unfortunately, we do not have data right now to answer this question about – there are so many flavorings. There are hundreds of different flavorings in electronic cigarettes. The problem is that manufacturers of these products – manufacturers of these juices, with nicotine – the liquids with the nicotine took these flavorings from the food products. They are commonly used in food products, sometimes on cosmetics, but we don’t really know what’s going on when people inhale all these flavorings. They’ve never been used in a product for inhalation purposes, and part of our research is to answer, is to evaluate different products, is to test in a laboratory different flavorings and make a recommendation to the users, make a recommendation to the regulators what to do with these flavorings. We see differences – we see that some flavorings might be more toxic as compared to the other flavorings, but even if we choose the most toxic flavoring, something that may be dangerous and we compared the health effects of smoking tobacco cigarettes, it’s still less risky.
Bill: So it’s going to be some time, though, before we know the true long-term risks of flavorings in these e-cigarettes? And Dr. Goniewicz, any other relevant e-cigarette research that you can share with us?
Dr. Goniewicz: Yes, so when we started to research, we wanted to understand what is the health impact of electronic cigarettes? First, we tested the products in the laboratory looking at what’s inside – whether it contains any toxicants, any dangerous compounds and what we know is it contains nicotine, it contains certain chemicals, and even if it contains toxicants, the toxicant levels are very low. Then we look at the cells exposed to the electronic cigarettes -- to vapors from electronic cigarettes, and we see that yes, the vapor has the effect on the cells, but it’s less toxic than tobacco cigarettes.
Now we are doing some research with the animals, looking at what’s going on when the animals are exposed. I don’t have full data right now, but this is ongoing research, and I think what we really are searching for and really waiting for are the human subject studies. We want to know what’s really going on among the users of the electronic cigarettes. Unfortunately, this type of research takes more time, and we simply need to wait longer.
Bill: Right, but at least now you’re gaining a benchmark of research – an archive of research that you will use moving forward that you’ll be able to look back because you are starting to research this at the beginning of this vaping trend, if you will, so it’s good to have the research certainly that you’re doing now. Dr. Goniewicz, thank you, again, so much for your time today and for more information, visit RoswellPark.org, that’s RoswellPark.org. You’re listening to Cancer Talk with Roswell Park Comprehensive Cancer Center. I’m Bill Klaproth, thanks for listening.