Getting your fix: Formaldehyde released from E-cigarettes

As smokers huddle in the winter cold outside of work, home, or pretty much anywhere these days to get their nicotine fix, the current availability and popularity in E-cigarettes has reduced some of the shame and self-consciousness associated with satisfying a nicotine habit. It is the toxic effects of burning tobacco and the other compounds in traditional cigarettes that are the primary offenders and emphasis of anti-smoking campaigns. E-cigarettes appeared on the scene within the past several years, and have gained popularity and increased use as an alternative by many smokers looking to try and kick the habit altogether or those just wanting a safer way to get nicotine than traditional cigarettes. Many in medical practice suggest these cigarettes are likely safer than old-fashioned tobacco cigarettes, and may serve as a useful alternative to help smokers quit cigarette smoking. Others withhold comment and recommend Food and Drug Administration (FDA)-approved nicotine replacement products (NRTs) such as Nicotrol inhalers, Nicorette gum or similar products (though E-cigs and NRTs were recently compared to assess what types of smokers choose one or there other as cessation tools).

It would seem that E-cigarettes, that come in a variety of styles and flavors, might be safer than cigarettes as they do not actually involve inhaling smoke but rather vapor from heating nicotine-containing liquids. However, with all non-FDA approved products, the buyer or user beware, as the actual contents of the products, and thus any potential hazards, do not have to be displayed on the products’ packaging. This has shielded general understanding of the both the benefits and risks of using E-cigarettes. Even so, the days of deregulated E-cigarette sales and use may be numbered.

A recent editorial article by Jensen and colleagues in the prestigious New England Journal of Medicine reported preliminary evidence that E-cigarettes actually pose a risk of producing toxic formaldehyde. This article is one of the first providing scientific documentation of clear risks associated with E-cigarettes. The formaldehyde results from the heating of the liquid which generally contains glycerol, propylene glycol, and nicotine as primary components. The super-heating of this liquid to produce vapor that is inhaled causes a chemical byproduct of a change in propylene glycol to fomaldehyde. Thus, when inhaling the vaporized liquid, intake of formaldehyde occurs.

For those unfamiliar with the uses of formaldehyde, it is used as a fixative for preserving animal tissue or cells for microscopy in scientific research. It is also used as a preservative in resins added to wood and wood-based products used in construction. Formaldehyde is also a known human carcinogen as recorded by the International Agency for Research on Cancer. The researchers of the published study in the New England Journal stated that, based on their evidence, a person vaping 3 ml of liquid per day would inhale approximately 14 mg of formaldehyde each day in formaldehyde-releasing agents. The amount of formaldehyde suggested to be in one pack of cigarettes is about 3 mg. The authors of the paper indicate that, all things considered equal between traditional cigarettes and E-cigarettes, the risk of cancer due to formaldehyde intake from E-cigarettes could be from 5 to 15 times higher than the risk from traditional cigarettes. Things are not equal between these two products, however, so much research is still needed to fully understand the risks of formaldehyde intake from E-cigarettes. Importantly, this study will likely push efforts to regulate E-cigarettes further faster which will likely be a good thing overall.