Flavored E-cigarettes Leave a Bitter Taste
PC: Detroit Metro Times
A quick Google search for “e-cigarette flavors” produces results like “Smurf Cake” and “Unicorn Milk.” On a superficial level, the idea seems ridiculous—how would a consumer know what Smurf Cake tastes like? Yet flavors such as these are widely marketed to users of e-cigarettes, defined by Merriam Webster as a battery-operated device that is typically designed to resemble a traditional cigarette and is used to inhale a usually nicotine-containing vapor. E-cigarettes give users an experience similar to smoking and the nicotine hit users desire without the harmful tar, carbon monoxide, and other carcinogens found in traditional cigarettes. They also come in many flavored varieties, unlike cigarettes, which are not allowed to contain flavorings other than menthol. These flavorings are a major factor attracting many smoking adults to switch to e-cigarettes. Besides the taste, there are also pressures from social media at play. Lady Gaga, Leonardo DiCaprio, and Zac Efron are only a few of the celebrities who can be found puffing away on e-cigarettes on Instagram. With such high-profile figures using e-cigarettes, many teenagers and young adults naturally want to use them too.
Right now, 30.7% of my fellow college students have used e-cigarettes. To many, it is something fun to do with your friends after a long week of classes, and one that is viewed as a harmless alternative to cigarettes. When I asked my classmates’ opinions on the safety of e-cigarettes, almost everyone’s answer was either something like “it’s only flavored water vapor, so it’s safe,” or “it’s not healthy, but it’s not as bad as smoking.”
However, according to the e-cigarette manufacturers, I was asking the wrong group’s opinions. E-cigarette manufacturers don’t claim that their products are meant for college kids looking for something a little rebellious to do after class. The e-cigarette industry claims that their products are designed to be used by current adult smokers to help quit smoking cigarettes and ultimately switch to e-cigarettes. This may be true in some cases, but smokers who switch to e-cigarettes have a significantly lower likelihood of quitting smoking than smokers who use FDA-approved cessation aids such as nicotine patches, gum, and lozenges. Such aids have repeatedly been shown to double a user’s chances of quitting successfully. Interestingly, while their chances of quitting are nowhere near FDA-approved methods, smokers who specifically use non-tobacco- flavored e-cigarettes are more likely to quit than smokers who use tobacco-flavored e- cigarettes. This is the “scientific reason” that e-cigarette companies use to claim that fun flavorings are necessary for their products.
However, adult smokers are clearly not the only group that uses e-cigarettes for their flavors. According to a study cited by the U.S. Surgeon General in 2015, 81.5% of teenage e-cigarette users responded that they used e-cigarettes “because they come in flavors I like.” A quick Google search for “popular e-cigarette flavors” yields flavors such as “Gummi Bear,” “Blue Raz Cotton Candy,” and ”Swagger.” I find it hard to believe that a flavor called “Swagger” was created to be attractive to adult users looking to quit smoking and not to teenagers looking for a way to feel cool.
While marketing e-cigarette flavors specifically to teenagers may not be a stated goal of the manufacturers, it has drastic effects on teenagers who are lured into using e- cigarettes by their flavors. For every smoker who claims to have quit smoking through the use of e-cigarettes in 2014, 81 never-smokers tried e-cigarettes for the first time and became traditional cigarette smokers one year later. Most troubling, many of these new e-cigarette users are children and teenagers. Evidence shows that children and teens who are non-smokers but use e-cigarettes are more likely to begin smoking than their peers who neither smoke nor use e-cigarettes. 30.7% of teen e-cigarette users will start smoking cigarettes within 6 months, compared to only 8.1% of non-e-cigarette using teens.
The flavorings are more than just additives to attract underage users. There is an increasing body of evidence that many of the flavoring chemicals used in e-cigarettes have their own adverse health effects, many of which are serious. First, I should note that it is difficult to predict the extent of long-term health impacts on the bodies of either users or second-hand users. E-cigarettes as we know them today were introduced to the U.S. only in 2006, resulting in an unavoidable lack of long-term research to date.
However, what we have learned so far does not bode well for e-cigarette users. And worse, the potential harms to a user’s health are not communicated to the user when purchasing e-cigarette liquid. For example, consider diacetyl, a chemical considered “GRAS” (Generally Regarded As Safe) by the FDA. It is commonly used in butter flavoring for microwave popcorn, and is perfectly safe to consume in this manner. However, when inhaled, it can cause bronchiolitis obliterans, a potentially deadly condition known as “popcorn lung.” Over a decade after this was discovered, the U.S. government instructed the Flavoring and Extract Manufacturers Association to require manufacturers to put a warning label on substances that may be dangerous when inhaled if the substance will be heated during processing. This is a good start, however, these warnings that are required at manufacturing plants are not always passed along to consumers who will inhale those same chemicals during e-cigarette use. And the potential for danger does not end here. Some e-cigarettes flavors claiming they are diacetyl-free have been discovered to in fact contain this dangerous chemical. One can only imagine how many other chemicals listed as GRAS have never been tested for safety as an inhalant and are present in e-cigarettes, and how many chemicals that are not listed in the ingredients are in fact in e-cigarette liquid. Whether this inaccurate labeling and incomplete testing are results of conscious decisions, financial pressures, or poor manufacturing procedures, they expose users to harmful chemicals without proper warning.
The timing could not be more pressing. According to the United States Surgeon General, 40% of high schoolers in the U.S. used e-cigarettes in 2015. Those numbers have only been rising in the years since then. Young brains are especially susceptible to the addictive properties of nicotine, contributing to the fact that roughly one third of these students are estimated to be cigarette smokers by now. Even if an e-cigarette using teenager does not start smoking cigarettes, the addictive properties of nicotine encourage them to continue using e-cigarettes. Furthermore, teenagers are young, and have decades of potential e-cigarette use ahead of them. These decades may unfortunately reveal the many as yet unknown health impacts from extended inhalation of flavoring chemicals.
The presence of accurate and complete warning labels on e-cigarette liquid packages would obviously not keep every potential new e-cigarette user from buying the product. But it would at least give them the information necessary to make an informed decision, and therefore a chance to avoid nicotine addiction, a gateway to smoking traditional cigarettes, and serious health consequences due to flavoring chemicals in e-cigarettes.
References:
https://www.merriam-webster.com/dictionary/electronic%20cigarette
https://www.fda.gov/tobaccoproducts/labeling/productsingredientscomponents/ucm2019416.htm
https://harmreductionjournal.biomedcentral.com/track/pdf/10.1186/s12954-018-0238-6
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964989/#R27
https://www.juul.com/mission-values
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0198047
https://www.fda.gov/forconsumers/consumerupdates/ucm198176.htm
https://harmreductionjournal.biomedcentral.com/track/pdf/10.1186/s12954-018-0238-6
https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Full_Report_non-508.pdf p. 59 of doc, 79 of pdf
http://pinkspotvapors.com/blog/the-12-best-e-liquid-flavors-which-flavors-are-most-popular/
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193328
https://www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-e-cigarettes
http://www.casaa.org/historical-timeline-of-electronic-cigarettes/
https://ehp.niehs.nih.gov/15-10185/
https://ehp.niehs.nih.gov/15-10185/#r28
https://www.smithsonianmag.com/history/electronic-cigarettes-millennial-appeal-ushers-next- generation-nicotine-addicts-180968747/
https://www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-e-cigarettes