Study finds e-cigarette use increases risk of exposure to toxic metals

(CNN) — Vaping has been known to be linked to respiratory illnesses and nicotine addiction. Now a new study, building on earlier data, has found that vaping may increase the risk of exposure to lead and uranium and potentially harm brain and organ development in teenagers.

“This study analyzed a nationally representative sample of e-cigarette use among adolescents in the United States to examine whether urinary metal levels (cadmium, lead, and uranium) varied by frequency of use and flavor type,” says Dr. Hongying Daisy Dye, lead author of the study published Monday in the academic journal Tobacco Control, explained this in an email.

E-cigarette use among teens has declined slightly. E-cigarette use among high school students dropped from 14.1% to 10% from 2022 to 2023, according to the 2023 National Youth Tobacco Survey. But for this group, this behavior remains a public health problem and the most popular way to use tobacco. (in nicotine form) since 2014, Dye said.

As of December 2023, the US Food and Drug Administration (FDA) has approved only 23 tobacco-flavored e-cigarettes for sale in the country, after the agency effectively banned all cartridge vaping device flavors except menthol and tobacco prevent youth from smoking.

The ban, however, does not apply to disposable e-cigarettes or related e-liquids, which come in a variety of flavors.

Dai and his co-authors found that urinary lead levels in adolescents who smoked occasionally (6 to 19 days total in the past 30 days) were 40% higher than those who smoked regularly (one to five days in the past 30 days). last month). . For frequent users (20 days or more), levels were 30% higher. Additionally, e-cigarette users who preferred the sweet flavor had higher levels of uranium in their urine than those who preferred the menthol flavor, according to Dye, a professor in the department of biostatistics at the University of Nebraska Medical Center.

According to the National Youth Tobacco Survey, nearly 90% of youth who vape use flavored e-cigarettes.

Since e-cigarette aerosol is known to contain several potentially harmful compounds, including metals, Dye was not surprised by the results.

However, chronic exposure to metals, “even at low levels, can have detrimental health effects, affecting cardiovascular, renal, cognitive and psychiatric function,” he added.

The study was purpose-built so the authors could not control for chronic or long-term exposure. But “no form of tobacco use is safe for young people,” Dye said. “Parents should be aware of the dangers of vaping and advise their children to stop vaping.”

The study results are based on responses and biospecimens from 200 adolescents who participated in the Population Assessment of Tobacco and Health (PATH) youth study from December 2018 to November 2019.

Vaping and harm to health

Expert opinions on the results are mixed.

“This is a well-conducted study that highlights the need for careful monitoring of exposure among e-cigarette users and highlights the fact that e-cigarettes are not safe,” said Dr. Lyon Shahab, professor of psychology in the University College School of Medicine. London and co-director of the UCL Tobacco and Alcohol Research Group, in a press release.

“However, these results also need to be taken in context,” added Shahab, who was not involved in the study. “Uranium in particular has many important exposure sources (including food and water related to geographic location) that were not controlled for in this analysis. “Cigarette users did not detect uranium in e-cigarette aerosol, suggesting that other factors may explain this finding.”

However, previous studies have found lead in e-cigarette aerosols, Shahab added. However, the urine levels reported in this study, even in people who vape frequently, are lower than or similar to those observed in the general population and in adults who do not vape.

“However, it is important to note that no level of lead exposure is safe,” Shahab said.

The authors acknowledged that their study was observational in nature, meaning it did not find a cause-and-effect relationship between vaping and levels of toxic metals.

But the authors believe the presence of metals in participants’ urine may be related to the way e-cigarettes work.

“E-cigarettes are battery-powered devices that generate aerosols by heating a liquid solution with a metal coil,” explains Dai. “This heating process can introduce metal particles into the liquid inhaled by e-cigarette users.”

Teens prefer sweet flavors over others because sweet flavors can suppress the harsh effects of nicotine, enhancing its beneficial effects, Dye said. But more research is needed to understand why this preference led to greater exposure to uranium. However, a 2021 study found that ethyl maltol, an artificial sweetener used in some cotton candy-flavored vaping liquids, can help transport heavy metals into cells and, in the presence of copper, can lead to the death of cells lining the lungs. .

And “because exposure to heavy metals depends primarily on the type of device used,” Shahab says, “future research should investigate whether there are significant differences between different types of e-cigarettes to inform regulatory agencies, for example, to limit the use of e-cigarettes.” . -cigarettes.” Using devices that expose users to more heavy metals.

If you want to quit smoking or are a parent or caregiver who wants to help your teen quit smoking, there are several steps you can take today.

Knowing your personal reasons for quitting smoking can help you make decisions that will lead to success more than simply knowing about the harm to your health. Setting a quit date can help you mentally prepare for any challenge. Working with a therapist can help you identify what causes and problems you may have, and you can even create a personalized quit plan based on your daily life.