
Acute Effects of Electronic Cigarette Aerosol Inhalation on Vascular Function - mzs
https://pubs.rsna.org/doi/10.1148/radiol.2019190562
======
dumbfoundded
If you believe E-Cigs are harmless, there's an easy experiment you can do for
yourself. Go on a run, time yourself. The next day, vape for 30 min and then
go on the same run.

This is what got me to personally switch away from E-Cigs. Vaping would add an
additional 30-sec to 1-min per mile on my runs. I try to only use patches or
gum now. Still not great but it's a lot better if you're trying to stay in
shape.

That being said, if you're only two choices are cigarettes and vaping.
Obviously, choose vaping.

~~~
twa927
I ride a bicycle daily and vape e-cigs. If anything I notice an increased
performance immediately after vaping, I feel like I'm less tired and have more
energy.

Overall this is an interesting topic because contrary to popular opinion many
athletes use nicotine and find that it increases their performance: _Nicotine
[...] use is widespread amongst professional team /strength sports (e.g.
American football, ice hockey, wrestling, bobsleigh, gymnastics, rugby,
skiing) whereby active consumption of nicotine and nicotine-containing
substances in-competition occurs in approximately 25–50% of such athletes_
[1].

The meta-analysis [1] found that _two studies observed an ergogenic effect,
one an ergolytic with the remaining seven reporting no change._

[1]:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684328/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684328/)

~~~
dumbfoundded
Yeah, I never said I quit nicotine. Just switched to mostly gum.

It seems as if you were trying to maximize your performance, you'll ingest
nicotine in a way that doesn't go through your lungs.

------
cr0sh
So I take it, should these results be replicated and validated as
scientifically sound, that smoke machines will be banned? Because it's the
same kind of aerosol with virtually the same ingredients.

I'm also curious - and maybe I missed it; it's a dense paper - that while they
mentioned the primary ingredients in "bare" vape liquids, they didn't seem to
mention the concentrations of each used in the study? Again, maybe I missed
it...

If it wasn't mentioned, I would be curious how different percentages of each
affect the outcome.

For that matter - I would also be curious how "vaping" something similar - say
perhaps atomized distilled water in a nebulizer - what kind of results are
seen there, too.

While it may be that vaping liquids are "bad" (and any metals from the heating
coil, as the study noted), how they compare to other similar liquids might be
important in determining their relative danger.

Also - whether this reported danger is warranted or not? That is, when
compared to other things in day-to-day breathing, where does this fall in
terms of "danger"? Is it worse than being around a camp fire or fireplace? Is
it worse than breathing air in a working kitchen? Is it worse than breathing
the air while taking a hot shower?

Sure - the numbers can be made to look scary - but what is the objective
truth, beyond the idea that "yes, vaping even base liquids is worse than just
breathing" \- I think we can agree that breathing in something more than clean
air is worse for you, no matter what it is. But for all we know, we're
constantly breathing in microparticles of plastic and other pollution in
greater rates and more often than even a heavy vaping device user.

Lots of questions and avenues that could be pursued in follow-up research on
this topic, certainly. It was interesting to read about, especially as someone
who occasionally vapes a caffeine-based (non-niccotine) liquid.

~~~
fuzz4lyfe
> smoke machines will be banned

Do people put smoke machines up to their mouths and inhale it many times a day
over many years?

~~~
jdietrich
Theater technicians and performers often spend many hours per day for most of
their career in close proximity to large smoke machines - essentially huge
mains-powered e-cigarettes that use nicotine-free vape juice by the quart.

~~~
icebraining
> often spend many hours per day for most of their career

Assuming you mean _running_ smoke machines, no they don't. Smoke machines are
occasionally used, but not in most plays, let alone for hours. And even if the
were, most actors _rehearse_ for weeks or months between plays, and nobody is
using a smoke machine on rehearsals, except maybe in the last few.

------
program_whiz
Many people seem to believe that vaping is harmless, this is good to make the
point clearly that vaping, while not as harmful as smoking cigarettes, isn't a
"cost free" activity. I personally didn't realize that it could have these
effects either.

~~~
InvaderFizz
My main concern with the way things are going is that it looks an awful lot
like attacks on vaping are for the purpose of driving smokers back to
cigarettes. I know of no one that things vaping is harmless. It is certainly
much, much less harmful than cigarettes and is infinitely preferable to
cigarettes.

I quit smoking, with the help of vaping. I was a pack-a-day Newport smoker
that started on a ludicrously high 36mg nicotine level. I was down to 3mg
within a year and quit entirely a year later.

This is a very common story for former smokers that switched to vaping. There
is a theory in the vaping community, or maybe its an urban myth, that the lack
of MAO inhibitors is what allows people who vape to essentially lose their
addiction. What I can tell you is that stopping vaping after two years was
painless, very much unlike attempting to cold turkey cigarettes.

~~~
Duhck
What's the supporting evidence for your concern that "attacks on vaping are
for the purpose of driving smokers back to cigarettes"

Philip Morris (now known as Altria) put $13bn into Juul to do the exact
opposite. The margins on vaping are higher, the current perception of vaping
is that it's better than smoking, and it's way easier to get kids addicted to
vaping than cigarettes.

I see too much evidence to the contrary... that big tobacco is now big vaping
(which is really big nicotine).

We dont know just how bad vaping really is, it's hard to say its better than
smoking, and its impossible to say its not bad for you at all.

~~~
JamesBarney
It's not hard to say it's better than smoking. Every study done to date
comparing the two days it's not nearly as harmful as smoking.

Smoking is one of the most harmful things you can possibly do to your body.
Many people underestimate how much of a low bar being better than smoking is.

~~~
Duhck
That seems like a foolish argument. The time horizon in which we discovered
smoking was bad for you was decades, and over a massive population of users.

E-Cigarettes are only now becoming mainstream, and have only been in use for
the better half of a decade.

We wont truly know the effects until we have a large sample size over a long
period of time.

Ultimately, saying it's conclusively better for you than smoking is short
sighted. We thought smoking was good for you in the 1920s...

~~~
JamesBarney
You're right that science sometimes makes mistakes, though probably less than
they used to. And we won't know conclusively for decades.

But best available evidence says 5% right now.

------
Medicalidiot
The number one controllable risk factor for stroke and heart attack is
smoking. By far. Not diet, not exercise, smoking. A significant part of that
is because nicotine will constrict blood vessels leading to hypertension[1],
this leads to destruction of the surface of an artery, leading to
atherosclerosis formation. One day the atherosclerotic plaque ruptures and
then you see me.

We once thought that atherosclerosis is an old persons disease, where health
habits later in life lead are what predicates plaque formation. The Army
started noticing fatty streak formation(first stage of atherosclerosis)[2] in
arteries of dead soldiers during autopsy, which now leads us to believe this
starts in youth and progresses from there.

1)
[https://www.ingentaconnect.com/content/ben/vdp/2005/00000002...](https://www.ingentaconnect.com/content/ben/vdp/2005/00000002/00000002/art00006)

2) [https://media.jamanetwork.com/news-item/autopsy-based-
study-...](https://media.jamanetwork.com/news-item/autopsy-based-study-
examines-prevalence-of-atherosclerosis-among-u-s-service-members/)

~~~
JamesBarney
Smoking is one of the leading risk factors for cardiovascular disease: agreed

It starts earlier than a lot of people thought: agreed

The primary contributor to smoking's detrimental effects on the cardiovascular
system is nicotine: disagree

Mind linking to something that shows this? That doesn't agree with the results
from the UK study on effects of nicotine versus smoking which puts nicotine's
effects at about 5% of the risk of smoking.

~~~
abstractbarista
This is definitely a point which needs more exploring. Seems to me most damage
from smoking is all the crap in smoking. The chemical nicotine - by itself -
transiently raises BP, feels nice, and that's about it.

It's also only a part of the addictiveness of smoking. Probably a small part,
as everyone I know who has consumed nicotine in any form has no trouble
without it if they vape, but often shows discomfort/restlessness if they
smoke. Amazingly, this holds true for those who consume far more nicotine
through vaping compared to others that get it through smoking.

~~~
caymanjim
I've been a long-time smoker, and at least for me, nicotine alone does
absolutely nothing to alleviate cravings. Gum, patches, lozenges, vaping, etc.
do zero to alleviate my craving for a cigarette. I'm not discounting that
nicotine is addictive (I'm in no position to say), but there's got to be
something else in tobacco that is part of the addiction.

~~~
01100011
Nicotine only makes me sick. I've tried gums, vapes, and nicotine salt
pouches. I smoke a tobacco pipe when I want to relax.

There are MAOIs in tobacco smoke. I'm not sure that's what makes me feel calm
though.

~~~
Jarwain
It could be the interaction between the MAOIs and the nicotine. Or more
accurately, the MAOIs altering how your body handles nicotine.

~~~
caymanjim
There are sibling comments discussing MAOIs, and I've heard about them before
in relation to smoking. It makes me wonder if MAOIs alone would be better for
smoking cessation. I don't think I'm all that addicted to the nicotine itself.
There are plenty of other supposedly-addictive stimulants that I can take or
leave at will and with no feelings of withdrawal, and nicotine does nothing to
alleviate cigarette withdrawal for me, so I'm not sure it's even a necessary
component. There are some NIH studies about MAOIs and smoking, but I'm not
going to link them because I find them incomprehensibly dense.

~~~
tonyarkles
I don’t remember what family of antidepressant Bupropion (Wellbutrin/Zyban)
is, but it helped me immensely the first time I quit. I literally just woke up
one day (a few days before my target quit date) and had no craving at all.

It also made me a little bit manic, and weaning off it sucked, but it worked
well in general.

------
magashna
One of the frustrating things about ecig studies is that they always use the
worst quality hardware and puff really hard on them. The "Epuffer" looks like
one of those "cig-a-like" which are notoriously worse than the much more
expensive hobbyist mech mods. The cig-a-likes usually don't get enough juice
to the heating element so when you're puffing a lot (16 consecutive 3s pulls)
you end up burning the wick.

~~~
epmaybe
Out of curiosity, are most people that use ecigs going for the expensive mods,
or are they going for the more popular brands that are closer in quality to
the epuffer?

~~~
travelton
I don't have any science to back up this, just an opinion. Epuffer is like a
conversion product. Once you try it, you likely invest in better equipment.
This is what happened to me... Started with a cheap gas station stick, then
quickly upgraded to a decent set up. Was able to get my dad to stop smoking by
buying him a cheap puffer to test it out. Now he has a full set up.

------
charliesharding
I'm a little confused - can someone knowledgable in the area help out? In the
introduction they assert:

"Once inhaled, ultrafine particles and the oxidant species located on their
surface can translocate into the vascular space (13), resulting in a state of
chronic vascular inflammation and oxidative stress noxious to endothelial
function."

However in the conclusion they state:

"Inhaling nicotine-free electronic cigarette aerosol transiently impacted
endothelial function in healthy nonsmokers"

It sounds like in the introduction they are aware of studies that concluded
the aerosol inhalation causes chronic issues with endothelial function, but
they concluded that it only has a transient effect. Are they refuting those
claims? Did I miss something?

~~~
close04
Transient in healthy _non_ smokers. Since most vapers do it regularly it's a
fair to assume that they are in a "permanently transient" state. A permanently
acute state is basically a chronic state.

~~~
filoleg
Imo permanent === persisting after whatever was causing this state in the
first place is gone. If those "transient" effects are gone after a chronic
user is done using after a long time, then I would still consider the effect
to be transient rather than permanent.

~~~
close04
The study is about the transient effects of vaping on healthy never-smokers.
The chronic effects were observed as part of other studies and just cited
here.

------
MayeulC
Are there good comprehensive guides out there regarding vaping?

My mother has been a smoker for a long time, and she bought a "myblu" on a
whim. However, she is concrned about the need to buy small recharges, as it is
obviously not environment-friendly. Moreover, she had issues with the battery
(I think it's not charging anymore, or maybe charged but not producing vapor)
after a couple months of extremely light use. As she finds the product
unreliable (battery capacity, etc), she always have cigarette "backups".

I do not know anything about the mechanical parts used, nor the chemicals (for
DIY liquid), or even the various vapes on the market.

Are there good, reputable and independent review sites or wikis on this topic?
Preferably not with toxic kitchen recipes. I think a good vape could accept
either standard or homemade products, with a standardized battery, and as much
replaceable parts as possible.

~~~
ogwh
I started with a myBlu and ended up going through 6 different devices before
finding one that doesn't suck. There is a huge quality problem in the market
at the moment. The device I settled on, and which I've had zero problems with,
is the "Smok Nord AIO 19". It's about 25GBP. Note that I had also bought a
"Smok Novo" and DID have problems with that, it leaked everywhere, so even
within the same brand quality varies dramatically.

The reviews on YouTube aren't useful because they don't usually use a device
long enough for problems to become apparent. I've been using the Nord AIO 19
for several weeks now and swear by it. And it's not to be confused with the
regular Nord... Which looks like the Novo and also has leaking problems.

If you're in the UK, Totally Wicked are a company that, while expensive, can
be trusted. They only sell quality devices, but they're all rebranded versions
of other manufacturers. They've recently struck a deal with WHSmith who will
also be selling their kits (that's how trustworthy they are).

------
sharadov
Why don't ecigs come with the same warnings that regular cigs do?

~~~
83457
Because nicotine doesn't kill you, the way it is delivered does. Tobacco
products are the most popular delivery method and is especially harmful due to
level of carcinogens and other elements. Essentially no one cared much about
nicotine as a chemical specifically much more than they did about caffeine.

------
xyst
While I have no doubts or reservations about the ill effects of E-cigarettes,
can a sample size of 31 people provide a definitive conclusion?

------
carbocation
I readily buy their conclusions, but this really should be placebo controlled.

MRIs are loud and obnoxious and upleasant. If you told me that this result
(observed on MRI#2) was entirely the consequence of having done MRI#1, I would
find it plausible.

------
bobwaycott
> _... on healthy non-smokers ..._

That’s unlikely to be surprising. Would really love to know what the impact is
in _smokers_ versus an actual cigarette.

Isn’t nicotine already known to have this effect?

~~~
ceejayoz
It seems clear that e-cigs are better than smoking.

It also seems clear that e-cig manufacturers are hoping to hook young non-
smokers to expand their market.

Both are valuable bits of info, but "e-cigs do confirmed damage" is extremely
important info from a public health perspective.

~~~
tinus_hn
It should also be clear that not using electronic cigarettes is better than
using them.

~~~
oarabbus_
I've never seen anyone argue they are harmless, just that they are _less
harmful_ than actual cigarettes.

The problem is that places are banning e-cigs, which presumably drives people
back to smoking. Which is worse for everyone.

~~~
aketchum
Anecdotally, I hear many friends say they are harmless. Surprisingly a nurse
friend of mine vapes Juuls and isn't worried about the health impacts. I think
plenty of people actually take it that since they are not cigarettes and are
"just nicotine" they don't worry about their safety.

~~~
filoleg
She probably just thinks that those risks are acceptable, not that she doesn't
understand them.

Quite a few doctors I know drink alcohol, but it doesn't mean they don't know
the health risks of that activity.

------
billfruit
Is there a theoretical model for the effect of ecigs on the effect on the
human body? What would such a model say about their safety in comparison to
normal cigarettes.

------
rkimmel
I’m tired of vaping companies claiming it’s safe. Glad the truth is finally
getting out. The only safe alternative to cigarettes is to not smoke at all.

~~~
glloydell
Can you point me towards any advertising campaigns or promotional material
claiming that vaping is "Safe"? Not safer, but safe.

------
ozzmotik
sorry if this comment is against the spirit of the community (i don't think it
is, but I have been blocked from posting in the past oblivious to the fact
that I wasn't contributing anything meaningful), but that being said...

am I the only one who isn't surprised that someone managed to find that if you
introduce something into the body that isn't generally there, that there is
obviously going to be an acute response of some sort? seems sort of like a
simple "you introduce a thing to your body, your body responds to it" type
thing, though perhaps I misunderstood the nature of the acute systems that
were measured? they just didn't seem too horribly negative to me from my
reading of it. granted, that being said, im all for further testing and
gathering of further evidence, as a vaping enthusiast myself i think it's
quite important that science keeps studying it so that we know exactly what it
does, especially over long term exposure. and perhaps maybe I'm just being
unnecessarily reactive against some imagined people that might take this and
say "hey look it's proof that vaping is bad for you because things happen when
you do it!"

~~~
ozzmotik
sometimes i really wish that people would actually tell me why they downvote
what I have to say, rather than just silently doing so and condemning me to
the bottom of the comments. i can't really really do the revision part of
performance, feedback, revision without any actual feedback of substance to
inform me as to what it is that I did wrong in the first place.

~~~
mturmon
Downvotes usually equilibrate "correctly" over time. Best response to
downvotes is to re-read and see if anything said was wrong or inflammatory,
and if not, just wait it out.

In general, I'd say that using proper capitalization and avoiding walls of
text - stripping down to your actual point - would help your comments.

~~~
ozzmotik
oh interesting, i never seem to find mine to equilibriate over time; they
generally get zero engagement. i honestly did not realize that people really
put that much import into proper capitalization; i figured most people
understand that, given the heavy market share of mobile users, that most of
the time, all lowercase text is more often an intentional choice and not
necessarily one made of intellectual laziness.

as for the wall of text thing, that certainly makes sense to me. i always have
a tendency to write those, and i could understand why others would find them
cumbersome to parse. all in all, good advice, and i highly thank you for
sharing it with me. i suppose i may have to rethink how i present myself here,
esp wrt the whole orthography of my posts :)

~~~
ycombinete
> given the heavy market share of mobile users, that most of the time, all
> lowercase text is more often an intentional choice and not necessarily one
> made of intellectual laziness.

This formatting works in instant messengers because people use short discrete
messages, which are visually bound in little highlighted boxes. In a paragraph
you don't have the same visual aid, and it makes it harder to read.

------
denkmoon
Very frustrating that there is so much attention around e-cigarettes and so
little around cannabis vaporisers.

------
aphextim
I would be curious to compare this to smoking an actual cigarette to see if
there is any difference. Inhaling any vapor/smoke that isn't meant for your
lungs is going to cause damage and it would be neat to see a comparison
between the two.

Anecdotal story time:

My grandfather who is currently 81, has been smoking since he was 12. He grew
up in a very small town, and had 6 people in his graduating class other than
himself.

Around January of this year, during a visit he seemed inquisitive as to the
vaping device I was using. He still at this time was smoking 1.5-2 packs a day
of roll-your-own cigarettes.

The reason he still was smoking so much is he has severe health issues from
being legally blind from diabetes, and having extreme back pain since he
returned from the service. In his hold age the only place he can sit and relax
is this very old chair that sits on his porch that for whatever reason the
angle on it relieves his back pain. He sits on that porch, smoking I would say
85% of his time, and the habit of playing with cigarettes while sitting there
was the biggest factor.

After inquiring about my device and having me explain it to him he wanted to
buy one right away and get on the e-cig bandwagon. I was skeptical as he has a
whole multitude of health issues and if I were to switch him without
consultation and something were to happen the guilt would be very great and I
could not live with that.

I went with him to one of his visits to the V.A. and he brought up the subject
of e-cigs to his doctor. We all had a conversation that pretty much came to
the conclusion that continuing to smoke cigarettes wouldn't be any better than
e-cigs, and there is always a chance that the e-cig could be worse but there
was nothing definitive.

I was able to get him to transition to smoking 0% nicotine juice, with a
higher PV/VG ratio (from what I've gathered online in smoker forums high VG
juice tends to inflame those with asthma more than the PG). He did use
nicotine patches for two weeks when he came off the cigarettes.

He slipped up and did smoke about 3 cigarettes during this transition, but
starting the beginning of February he has been nicotine free and smoking the
e-cig.

He recently had a lung test or something where they measure your 02 etc. He
had said when he was smoking his 2 packs a day that his 02 was at 65% or so,
and that it had gotten up to 78% at his last test.

Now I'm not a doctor and there are probably a billion variables that are
unaccounted for, however he said that his breathing is much easier and doesn't
have a hard time sleeping when it is hot and humid out as much as before. For
him the switch seems to be working with regards to his lungs/breathing.

As far as other issues becoming more exacerbated because of this, only time
will tell I guess.

He does want to quite completely, I suggested switching to sugar free candies
or something to keep his oral fixation at bay while he sits in his chair. He
seemed open to the idea, but like most smokers it really is a mental game and
trying to get him to change his ways is pretty tough as he is a stubborn old
man.

~~~
robbiep
If your 02 is 68%, or even 75%, you’re likely about to be put in a coffin.
Patients with severe COPD/emphysema might have arterial oxygen levels in the
mid to high 80s without supplemental oxygen

~~~
pcj-github
Yeah, the mortality rate of people in this condition (resting O2 levels in the
60-70%) is probably at least 50% 1-year mortality (half will die in the next
year).

Which is not exactly the population this paper is trying to shed light on, but
thanks for sharing his experience.

~~~
aphextim
Yeah he is in rough shape, to be honest we (doctors/wife/family) expected him
to go when he was 75-76 or so. He has been hanging on that is for sure. I
figure if I can extend his 1 year, to be even say 1 year and 6 months, it
would be worth it.

He has been on/off oxygen in the past and he's at that stage where he is
waiting to kick the can, and is a very lucky man who has a wife of 66 years,
who still takes care of him everyday.

I can guarantee if his wife passed, he would go the next day and that he is
holding on because he knows how much she loves him.

------
pcj-github
Increases my conviction that vaping products should only be available by
prescription, which any primary care physician would be more than happy to
prescribe for a smoker hoping to quit.

As for the ~40% of 7th and 8th graders that are vaping at my kids middle
school, well, that number would hopefully decrease.

