Vaping: Walter Reed doctor weighs in on controversial smoking alternative

Phil Briggs
September 22, 2019 - 10:20 pm
Man vaping exhales a cloud of vapor

Getty Images


Vaping – what some have called a safer alternative to smoking cigarettes is now suspected of causing 8 deaths and hundreds of lung-related illnesses across the country.

So what’s the deal? Are people dying because they’re hitting their vapes 24-7, or is there something more dangerous within e-cigs?

We asked Dr. Michael D’Onofrio, Service Chief for Occupational Medicine, Walter Reed National Military Medical Center about e-cigs and what the medical community is saying about them.

Vaping, why are so many people getting sick from it lately?   

"You’re essentially taking a chemical, heating it up a lot, and breathing in a mixture of chemicals … What makes vaping particularly concerning is that there are multiple different devices that do this and multiple different chemicals.  So trying to say what exactly the mixture of those two do to the lungs can be very tricky because there is no standardization of the devices themselves or the chemicals, they’re breathing in … I was talking recently with a colleague of mine who is a lung specialist here in the hospital and he told me about a theory … that there’s a toxic effect with some of those chemicals where they either burn or damage the lung tissue and cause it to swell up and release fluid into places where it shouldn’t go. And once that fluid gets into the lung tissue it actually closes off lung airways and can cause breathing difficulties.”

An anti vaping ad being used by the US Army
Army Public Health Center

Above: The Army Public Health Center issued a Public Health Alert Sept. 10, 2019 warning Soldiers and Family Members who do not currently use tobacco products to avoid all e-cigarette and vaping products, particularly those sold off the street or modified to add any substances not intended by the manufacturer.

What about the claim that e-cig liquid has less cancer-causing chemicals than cigarettes?

"I would be very doubtful of a claim like that for a number of reasons.  First, there is no regulation of the chemicals. They can say, ‘our liquid is toxin-free and completely safe to use,’ but no one is actually looking at those chemicals to see if that claim is actually true or not … they can make any claim they want, but there’s no one there to hold them accountable to it.  In terms of cancer causing products I doubt these things are as harmless as they claim to be.  Partly because they already have substances like nicotine and heavy metals … and they also do release volatile organic compounds.  And these things can cause cancer in the body. And so when they say ‘safe or safer’ the problem is that they may be trading one health issue or one type of cancer for another one … I’ve heard the same claim from people who go from smoking to dipping tobacco, saying ‘oh it’s safer for me because I’m not inhaling it’.  But then I point out to ‘em that while you may not be inhaling tobacco smoke, you’re chewing it and that has been shown to cause cancer around the  mouth, nose and throat."

Many e-liquid manufacturers use propylene glycol (PG) as one of the main ingredients because it’s deemed safe for use as a food additive. So is vaping PG safe? 

"Proplene glycol is no different than anything else. In a high enough dose it can cause health issues. The other thing I do warn about is that when you vaporize PG it is interacting with other materials. And while the EPA has not classified PG specifically as being carcinogenic, remember you have other chemicals in that liquid that it could be interacting with.  There can be chemical reactions where they generate new chemicals or particles.  We just don’t know what’s happening inside this e-cigarette when it’s being heated up."

Soldiers at Fort Knox puff on vaporizers
Eric Pilgrim

What about the children? While many people are looking to ban flavored e-cig liquid because they claim the flavors are an attempt to market to teenagers, (don’t look now, but alcohol products come in dozens of sweet fruity flavors, and we’re pretty sure they’re only being sold to adults) is there an actual medical concern about flavored e-cigs?

"There is a concern about little kids, like toddlers, and if they come across their parents vaping liquid.  If it’s packaged in something colorful, they might think it’s candy and may inadvertently swallow it and get sick.

Vaping, cigs ... the bottom line

"The mechanism of smoking in general, even vaping is that you're putting some chemical or substance that doesn’t belong in the lungs, into the lungs. And in some people, it could damage tissue where it could cause what we call 'chemical pneumonitis,' where you’re damaging the lung tissue with various chemicals and things. And again, what makes it really hard to study is there is no regulation on these devices.   So, if a vaping liquid says ‘oh we don’t have any nicotine in it’ the CDC has actually looked into it and some chemicals that claimed to be nicotine-free actually had nicotine in it.  And in addition to that, you have to consider the device itself, which has no standardization on how they’re manufactured.  And some of these things may contain things like lead, nickel, tin and other heavy metals that when you breathe these things in, they could have harmful effects to the lungs."


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