E-cigarette fluid affects respiratory tracts

E-sigaretid leiavad Eestis üha rohkem kasutajaid.

PHOTO: Elmo Riig / Sakala

This is the way web store Skysmoke introduces e-cigarettes: «Smoking may cause stroke, heart attack, lung cancer, throat cancer, pneumonia, osteoporosis, Alzheimer’s disease and many other fatal diseases. With e-cigarette use there are no risks of contracting aforementioned diseases.»

Recently, CityCig went after new clients with an ad stuck in magazines saying «Get delivered from smoking harmful tobacco by CityCig e-cigarettes».

In its web environment, the E-cigarette retailer has created a separate section offering texts of varying origin contesting claims regarding health hazards of e-cigarettes.

These and many other e-cigarette selling websites promote their products as offering savings on money, safety and health advantages, with no reviewed research available to convincingly support their claims. Rather, there is research available to question their claims.

Having investigated how e-cigarette fluid affects respiratory tract cells, University of Tartu medical faculty Doctoral student Argo Aug finds such claims are unfoundedly biased. «In a way that they present unfoundedly positive claims regarding health,» said Mr Aug.

The way an e-cigarette works is to vaporise fluid inhaled by a smoker just like the ordinary tobacco smoke. The fluids available come with and without nicotine; the effect of the latter was searched into by Mr Aug and his colleagues.

In a study completed in cooperation with professor Ursel Soomets, Kalle Kilk and Siiri Altraja of biological and transplantation medicine institute biochemistry department, and professor Alan Altraja of University of Tartu lung clinic, Mr Aug found that the nicotine-containing e-cigarette fluid brings about partially the same processes in respiratory tract cells as ordinary tobacco smoke.

The discovery came by comparing e-cigarette research with earlier results of tobacco smoke research.

Changes in an hour

The effect of tobacco smoke and e-cigarette on cells was shown in rise of free form amino acids concentration. «From this, one may conclude that both tobacco smoke and e-cigarette mist trigger in a cell the disintegration of proteins,» says Mr Aug.

Secondly, the scientists found out that in cells impacted by either smoke, energy consumption increased already during the initial hour after smoking.

In the first study, they observed an ordinary cigarette burning with open flame, using specially grown primary bronchial epithelial cells split into three groups. The first group was affected with e-cigarette fluid, the second with cigarette smoke concentrate, and the third with nothing at all. 

«With nothing affecting a cell, and the cell being in a stable environment, the metabolites of cellular origin i.e. substances mediating all processes related to being alive are in a secure balance. With an out-of-ordinary affecting agent introduced, changes are caused,» explains Mr Aug.

The study was aimed at observing to which extent and in which time dynamic ordinary cigarette smoke affects respiratory tract cells and to obtain as much new information as possible on how effect of cigarettes is related to sicknesses caused on molecular level. It was even investigated if any antioxidant was able to reduce the negative effect of cigarettes on health.

«One antioxidant that we used was experimental, synthesised in laboratory. The other was a widely used active coughing medicine substance N-acetyl cysteine. We found that to a degree antioxidants are able to alleviate the effect of tobacco smoke, but definitely not to an extent that by them cigarettes might be made healthier,» observes Mr Aug.

The survey provided for information regarding the scope of tobacco smoke effect being related to the so-called oxidative stress.

«Tobacco burns at a low temperature at which the entire organics contained in a cigarette is not conclusively consumed. The substances in it, part natural and part artificial, only burn partially. If the burning process of such long organic molecule is half finished, it remains highly reactive i.e. is prone to interfere in all kinds of biological processes. Hence a reason why smoking or smoke in general – like also diesel smoke or the smoke in the air due to heating a chimney – are risk factors of lung cancer and chronic obstructive pulmonary disease,» says Mr Aug.

Unexpected results

In the second test, in which they observed e-cigarette effects on respiratory tract cells, the scientists saw unexpectedly numerous similarities with cigarette smoke effect.

«We did not expect to find similarities. We thought some disturbances might occur in the functioning of the cells, but we were surprised that such a large commonality emerged with ordinary cigarette smoke,» says Mr Aug while underlying that the work is definitely not concluded and poses more questions than answers.

Even so, the test showed changes occurring in the cells pointing to increased energy consumption. «At the expense of that, less energy will be left over for all other tasks of the cells. Will this exceed any critical level, hard to tell. But, obviously, a cell also reacts to e-cigarette mist which triggers changes in the metabolism of the cell,» said Mr Aug.

To provide a simplified picture of how a cell works, Mr Aug compares it to energy consumption of the entire organism. When an individual is starving, the organism starts by using up its entire store of glucose. As carbohydrates are exhausted, the organism will gradually enhance disintegration of fats, and in the final desperation with nothing else to consume it goes after he very muscles.  

Simply put, with tobacco smoke and e-cigarette vapour alike, a cell is in a forced situation and has to acclimatise with the new situation.

«What is best to inhale is, after all, the clean air with optimal humidity content. While with foods it makes sense to add vitamins and food supplements, if needs, with inhaled air nothing additional is needed to make it better for us. Alas, while viewing the content, e-cigarettes contain no water at all,» observes Mr Aug.

The main ingredient of e-cigarettes on the basis of which the mist occurs is propylene glycol. «Over the decades, this substance has been used to imitate smoke for instance at fire trainings, and for this purpose the use of it has been assessed as harmless. However, there has not been sufficient research into joint effect of propylene glycol with various flavours and fragrances and glycerol used in e-cigarette fluids,» says Mr Aug.

World Health Organisation (WHO), for one, will not provide clear advice whether it makes sense to shift from ordinary cigarettes to e-cigarettes or not. «In this regard, the line between potential benefit or harm is rather vague. For a non-smoker, however, it is obvious – nothing inhaled with fresh air can make a healthy person’s health stronger. Rather, the effect can only be to the opposite,» underlines Mr Aug.

A point of hazard with e-cigarettes however, in the mind of Mr Aug, is that while tobacco ads and smoking is being curbed by law and the society is increasingly against smoking thanks to awareness to health risks, the new trendy products on the market may make smoking more glamorous again. «The main message that smoking is harmful may become blurred as e-cigarettes as an alternative spread,» worries Mr Aug.