
Chemicals linked with severe respiratory disease found in e-cigarette flavors - smacktoward
http://www.hsph.harvard.edu/news/press-releases/e-cigarette-flavoring-chemicals-linked-to-respiratory-disease/?utm_source=Facebook&utm_medium=Social&utm_campaign=Chan-Facebook-General
======
mrbill
All the major e-cig juice vendors have been reformulating their stuff over the
past year or two to get rid of any flavors with diacetyl due to the possible
risk.

Here's the Reddit discussion:

[https://www.reddit.com/r/electronic_cigarette/comments/3vx84...](https://www.reddit.com/r/electronic_cigarette/comments/3vx84p/the_telegraph_ecigarettes_contain_flavouring/)

~~~
fein
Yep we've known about this for years. There are even some guys that do
chemical analysis of some mixes that result in some very scathing letters
regarding acetoin and diacetyl contents.

The "bad shit" list for ejuice is usually artificial sweeteners, acetoin, and
diacetyl.

------
theophrastus
In synthetic organic labs we often pass relatively small compounds (very much
like the favorants in vape juice) over heated elements in order to generate
intermediate "activated"/free-radical compounds for the next step of a
complicated reaction sequence. So no organic chemist i know is a bit surprised
that vaping exposes the user's lungs directly to significant levels of toxic
compounds like diacetyl. And they are often heard to wonder out loud: "Why has
the FDA not stepped in to regulate these? I wouldn't let any of my family do
this!"

~~~
virmundi
What regulations should they put on this? A warning like, Breathing in stuff
not air is bad for you? Should they ban adults from making up their own mind?
I'm fine with the former. I despise the later.

~~~
coffeemug
_> I despise the later._

I think in general adults should be able to make up their minds about
ingesting chemicals that might hurt them. However, it makes sense to make an
exception -- if the chemical has addictive properties and empirically is
likely to have network effects (i.e. in practice it tends to spread through
the community), it seems reasonable for the government to step in and regulate
the substance in more substantial ways than enforcing disclosure. I'd argue
adults don't make choices with respect to these chemicals out of their own
free will, but are coerced into consuming them through biological/social
rewards mechanisms, and I think it's the government's responsibility to step
in.

For example, regulating psilocybin seems like an obviously bad idea (it
doesn't seem to be addicting and doesn't devastate communities), where as
regulating crystal meth is an obviously good idea.

I don't know where the line is (e.g. what about cocaine? it's addictive and
has propensity to spread, but isn't nearly as bad as meth), but that doesn't
mean there aren't obvious extremes. I also don't know what the government can
do about it (making distribution illegal doesn't seem to work), but
philosophically, I don't think it's unreasonable for the government to step in
if it can be effective.

~~~
TimPC
There is an even stronger case for banning chemicals that are consumed in
public in a way that exposes others. I think my right to not consume that crap
trumps your right to consume it in a specific public setting, even though I
generally disagree with the government trying to protect people from
themselves.

------
keeran
The vaping enthusiast community have known about this for over a year. The
popular vendors have pretty much all converted their recipes to avoid being
the black sheep who still ship diacetyl.

I'd love to know why this story is being pushed everywhere now - is there a
bill / legislation coming up somewhere important?

------
refurb
_At least one of the three chemicals was detected in 47 of the 51 flavors
tested. Diacetyl was detected above the laboratory limit of detection in 39 of
the flavors tested. Acetoin and 2,3-pentanedione were detected in 46 and 23
and of the flavors, respectively._

The question is, how much? The lab limit of detection is often in the parts
per billion or parts per trillion.

The dose makes the poison!

Hell, frying foods creates acrolein and acylamide which is toxic as hell (it
alkylates glutathione, a key anti-oxidant in the body). However, you'd need to
eat kilograms of fried food per day to actually reach a toxic level.

Coffee is another great example. It contains 23 known carcinogens.

~~~
madeofpalk
> ranging from < limit of qualification (LOQ) to 239 μg/e-cigarette.
> 2,3-pentanedione and acetoin were detected in 23 and 46 of the 51 flavors
> tested at concentrations up to 64 and 529 μg/e-cigarette, respectively.

From the article's abstract
[http://ehp.niehs.nih.gov/15-10185/](http://ehp.niehs.nih.gov/15-10185/)

I have no idea what those numbers mean or if they're bad for you. But there
they are...

~~~
refurb
Nice! I didn't know the abstract was available.

I guess the question is what is the level of diacetyl in the vapor inhaled?
The CDC has set a limit of 25 ppb for short term exposure.

~~~
msandford
You don't want to be around any diacetyl at all. If the lab can detect it,
it's too much. It's very, very nasty business.

~~~
simplexion
You better stay away from beer then...

~~~
e12e
Or just avoid inhaling beer? Granted if it is found in beer _at all_ it would
seem likely that just slurping foam would put one over a limit of 25 parts
_per billion_?

~~~
e12e
Actually, I suppose it's entirely possible that it's only dangerous to inhale
if it is vaporised, not just encapsulated in drops?

------
mistermann
I didn't RTFA,could someone that did comment on how much insight was given
into "We selected 51 types of flavored e-cigarettes sold by leading
e-cigarette brands and flavors"? Some ecigs (disposables) are manufactured in
China where I suspect quality control might be suspect, whereas many _juices_
are manufactured by small startups in the US and I'm quite certain they take
ingredients _extremely_ seriously.

Any study that "accidentally" doesn't differentiate between the two very
different manufacturing scenarios is suspect in my opinion, as it does very
little to provide any useful information.

------
gozur88
Reading the article, it's not clear from they detected any of these chemicals
in concentrations that are known to be unhealthy. People who got "popcorn
lung" were exposed to comparatively massive doses.

~~~
isch
There was a study last year that analysed diacetyl concentrations in common
e-liquids. They found that 47% of 159 preparations examined were above the
safety guidelines for daily consumption

>The median daily exposure levels were 56 μg/day ... They were slightly lower
than the strict NIOSH-defined safety limits for occupational exposure ...
however, 47.3% of DA and 41.5% of AP-containing samples exposed consumers to
levels higher than the safety limits.

[http://ntr.oxfordjournals.org/content/early/2014/09/23/ntr.n...](http://ntr.oxfordjournals.org/content/early/2014/09/23/ntr.ntu176)

Compared to this recent study, this shows that addition of diacetyl and in
what concentration is decreasing.

------
simplexion
What about the high levels of diacetyl in cigarette smoke?

[http://www.ncbi.nlm.nih.gov/pubmed/24635357](http://www.ncbi.nlm.nih.gov/pubmed/24635357)

------
pcthrowaway
I'm reposting the top response to this same story on Reddit
([https://www.reddit.com/r/science/comments/3vxbzo/chemical_fl...](https://www.reddit.com/r/science/comments/3vxbzo/chemical_flavorings_found_in_ecigarettes_linked/cxrq6ro))
because this person says it better than I can, and no one else here has said
made these points yet:

Oh boy, time to crosspost for information's sake.

Even diactyl containing e-juice still contains 100x less diacetyl than
traditional cigarettes. [Citation:
[http://onlinelibrary.wiley.com/doi/10.1002/tox.20153/pdf[1]](http://onlinelibrary.wiley.com/doi/10.1002/tox.20153/pdf\[1\])
] And no smoker to date has ever gotten "Popcorn Lung" (Named because it
occurs years after dumping pure uncut diactyl into vats and bins when making
cheapo microwave popcorn in the factories.)

And despite all that- It's still largely the other factors and chemicals and
tar and actual combustion that damages your lungs when smoking is involved.
Not diacetyl specifically. Even 100x the amount of diacetyl as e-juice is
apparently not enough to cause the "Popcorn Lung" issue related to the
compound specifically. So why would 100x less than the amount that does not
cause it suddenly start to cause it? Not that it's 100 percent safe (As
mentioned by a replier as well- So I have appended my post some for accuracy
and fairness.) Just that it's not the immediate or unavoidable threat it's
being presented as.

And in the span of 7+ years even in the heaviest vape users no one has (yet,
mind. For the sake of fairness and caution.) reported any major health issues
tied to vaping or the compounds contained in e-juice. If the 75ml a day heavy
diactyl juice user doesn't get popcorn lung then I highly doubt popcorn lung
is a problem to watch for regarding it. Also there are many many e-juices
available without diactyl. So even if it was an issue you can actively avoid
it. And most manufacturers have discontinued it's use or clearely state if
their juices are diacetyl free so the risk factors that are purely tied to
diacetyl are avoidable and preventable.

As far as being paranoid about what's put in it- This is purely my opinion
but, I think that is razorblades in your kid's halloween candy or "Shadey
people handing out drugs for free/Lacing your kid's flintstones vitamins with
PCP" levels of unfounded overconcern. Caution is important- But so is research
and fact checking.

Edit: To append this to- I am not defending the use or previous use of the
substance, merely dispelling the immediate "Popcorn Lung" panic around it. I
personally don't use e-juice containing it for the sake of risk reduction in
general as I like to limit as many potential factors as possible in general.
And there are hundreds- if not thousands of brands and types which do not
contain diacetyl to choose from which I would recommend. I am also not
claiming vaping is 100 percent safe- Just that this instance is an avoidable
factor and has been for a while.

Personal safety and active research should always be practiced in all facets
of life.

------
snarfy
I prefer unflavored e-cig juice with nicotine, but it's actually hard to find.

~~~
devb
I get mine shipped from Mt. Baker in 8 oz bottles (about $30.. no I don't work
for them) and decant those into 30 ml bottles for use. You can even specify
what PG/VG ratio you like.

------
heroprotagonist
When reading articles like this, I often find it useful to at least skim the
paper that the article discusses.

The article's opening line seems designed to demonize:

"Diacetyl, a flavoring chemical linked to cases of severe respiratory disease,
was found in more than 75% of flavored electronic cigarettes and refill
liquids tested by researchers at Harvard T.H. Chan School of Public Health."

 _75%! Tested by Harvard! This is huge!_

However, take a look at the actual study. Specifically, page 6, under Methods,
e-Cigarette Selection

[http://ehp.niehs.nih.gov/wp-
content/uploads/advpub/2015/12/e...](http://ehp.niehs.nih.gov/wp-
content/uploads/advpub/2015/12/ehp.1510185.acco.pdf)

"A _convenience sample_ of 51 e-cigarette flavors was selected for use in this
study. Electronic cigarette cartridges, liquids, and their associated devices
and batteries were purchased online and in retail locations. We evaluated 51
flavors, including all available flavors from _three_ large cigarette
companies (Brands A, B, and C, with 2, 2, and 7 flavors, respectively); 5
flavors from _a_ large independent e-cigarette company (Brand D); and 24
additional flavors from _three_ ecigarette distributors (Brands E, F, and G,
10, 8, and 6 flavors, respectively) that we selected based on their potential
appeal to children, teenagers and young adults (Table 2). In addition, we
evaluated 11 e-liquid flavors that are inserted into a cartomizer (disposable
cartridge and atomizer system) (Brands H and I, 6 and 5 flavors,
respectively)"

To break this down a bit.. Let's start with _convenience sample_. A
convenience sample is a non-probability sampling technique. It's made up of
subjects (in this case, nicotine juice) which are easy to reach. It is _not_ a
representative sample of the products offered by the entire industry. You
can't make probability statements about non-probability samples. The numbers
are worthless in relation to the greater whole. EG, you can't say "Diacetyl
was found in more than 75% of flavored electronic cigarettes." It would be
like going to a Donald Trump campaign rally to poll public opinion because
it's close to your house and then reporting that "75% of Americans believe
Donald Trump should be the next President of the United States".

Add a couple of words, however, and although your numbers are still worthless,
you can use a technicality to slip past whatever fact-checking apparatus is in
place that would call you out on a bold-faced lie and you can lend some
additional credibility to your prejudicial pseudo-science. "Diacetyl was found
in more than 75% of flavored electronic cigarettes _tested by researchers at
Harvard_."

The average person is not going to consider the added qualifying statement in
the proper context. Technically, it lets the reporter off the hook for
generalizing because they have now (importantly) stated that the number is
only in relation to what was tested. Effectively, though, it lends a big name
institution and all that it represents in support of the reporter's agenda.
Most people will read that sentence as "Harvard reports that 75% of flavored
electronic cigarettes contain diacetyl, which causes severe respiratory
disease'.

It does help the article's credibility that this 'research' was indeed
performed at Harvard, was under grant from the NIH, and that the
probabilistically irrelevant results were posted on a Harvard website in a
fairly authoritative manner as a _press-release_. The writer of the article
isn't credited, so this appears to come from the university itself.

But anyway, back to the numbers they listed. Their sample size, of the many
thousands available, was 51. And it came from... 3 cigarette companies, 1
e-cigarette company, and 3 e-cigarette distributors. They use only seven
(convenient, non-representative) sources to paint the industry as a whole.

If we ignore the blanketing insinuation of the industry as a whole, though,
the number they came up with is still of very limited utility. One company
contributed 2 datapoints, another contributed 10. Biased contributions make
the overall '75%' figure irrelevant in describing even just those 7 companies
comprising their 'research'. If a company uses diacetyl in one of their
products, odds are very high that they will use it in their other products.
That aside, since the selection of flavors tested are not representative of
sales of individual products, there's no point in repeatedly testing the
products of a single company once a positive result has been reached.

I'm very disappointed and irritated that an institution like Harvard would
lend its credibility to a piece like this. It leads me to wonder whether they
are acting with an ulterior motivation or simply incompetently. In the end,
their intent means little, though; their words will have impact to discourage
the spread of e-cigarettes as an alternative or cessation aid for traditional
cigarettes. Is that a good thing? I don't know. We need better research into
this youthful industry that has a significant potential health impact.

We rely on valid research by trustworthy institutions to inform our decision
making process. There's an opportunity cost to choosing to perform the wrong
research and to performing the right research incorrectly. While some good
does come of this, in that specific companies are outed (sort of -- the paper
does not list the company names) for their use of dangerous ingredients, the
research does not address safety concerns around e-cigarette use in the
scenario where a responsible vendor takes precautions by ensuring that known
dangerous additives aren't added to their products. I know it's not very sexy
to report, and might require some additional effort, but why not look at the
impact of the additives that _all_ of the e-cigarette companies are using
because they are assumed benign in the absence of evidence to the contrary?

~~~
notlisted
"In the end, their intent means little, though; their words will have impact
to discourage the spread of e-cigarettes as an alternative or cessation aid
for traditional cigarettes. Is that a good thing? I don't know."

The UK department of health says no, ie please switch:
[https://www.gov.uk/government/news/e-cigarettes-
around-95-le...](https://www.gov.uk/government/news/e-cigarettes-
around-95-less-harmful-than-tobacco-estimates-landmark-review)

------
cryoshon
Who could have known that smoking chemicals could lead to respiratory disease?

~~~
refurb
It's not smoke, like in a cigarette (from combustion), it's vapor from heating
a liquid into a gas (boiling).

------
pbreit
Inhaling charred chemicals doesn't sound like the greatest idea.

~~~
morokhovets
Charred? It is called vaping for a reason.

~~~
pbreit
So folks like you don't think it's charred.

------
Phlow
Let's play a game of Guess How Many Shits The Addicted Person Gives.

I'll start. I guess 0.

~~~
profmonocle
A lot of people switch to vaping because they perceive it as less dangerous
than smoking cigarettes. So yeah, I'd say people care.

------
symlinkk
It's obvious that the government is way behind on researching ecigs and
regulating them. It's inexcusable to let these things get as popular as they
are and remain almost completely silent on the effects of them.

~~~
refurb
The FDA tried to regulate them and got slapped down.

The real question is, which is better for you, smoking tobacco or vaporizing
nicotine? Even if there are risks with vaping, I'd say they are likely far,
far less than smoking.

~~~
wutbrodo
> The real question is, which is better for you, smoking tobacco or vaporizing
> nicotine?

I disagree; I don't think this is really even a question. I do not have the
research on hand at the moment, so definitely check it out yourself before
taking this on faith, but there's already research indicating that smoking is
way worse for you than vaping. Hell, even the only chemical discussed in this
latest news (diacetyl) is present in far, far greater quantities in regular
cigarettes than in vaping.

The question of cigarettes vs vaping is not really even a question; the real
question is the risks of vaping per se (and this is where regulation/study has
not yet caught up to usage).

