- Electronic cigarettes (e-cigarettes or vapes) are a growing health concern linked to a range of diseases and death.
- Researchers have found that using pod-based e-cigarettes daily can elevate inflammatory markers across multiple organ systems.
- The scientists saw that e-cigarettes caused a marked increase in inflammation within the brain’s reward pathways and that these effects also varied depending on e-cigarette flavor.
- The study also suggested that e-cigarettes may influence how organs respond to infections such as SARS-CoV-2.
Over 12 million adults in the United States use e-cigarettes, battery-operated devices used as a smokeless tobacco option. The highest rates of use are among individuals ages 18-24.
In 2021, over 2 million middle and high school students vaped at least once. Nearly 85% of these people used flavored e-cigarettes.
Earlier studies on short-term vape use involving lower nicotine concentrations have shown inflammatory changes within the lungs, brain, and heart.
The current study, appearing in the journal eLife, uncovers more effects of e-cigarette aerosol exposure on different organs in mice. It also assesses how specific e-cigarette flavors contribute to such effects.
This investigation was led by senior study author Dr. Laura Crotty Alexander, an associate professor of medicine at UC San Diego School of Medicine and section chief of Pulmonary Critical Care at Veterans Affairs San Diego Healthcare System.
Confirming prior evidence
The health consequences of tobacco consumption are well established. Since vaping devices are still relatively new, data on their effects are limited.
In an interview with Medical News Today, Dr. Santosh Kesari said that this study “[confirms] that what we knew before about tobacco applies to these newer nicotine products.”
Dr. Kesari is a neurologist at Providence Saint John’s Health Center in Santa Monica, CA, and the regional medical director for the Research Clinical Institute of Providence Southern California. He was not involved in the study.
Observing inflammatory markers
Dr. Crotty Alexander and her team focused on JUUL, a currently popular vape brand in America, and its most popular flavors: mint and mango.
They exposed mice to aerosols three times a day for 60 minutes per day, for one to three months.
The researchers noted several elevated inflammatory markers, most remarkably in the brain.
They discovered changes in gene expression within the brain area linked with motivation and reward processing. These changes may be associated with addictive behaviors, anxiety, and depression, triggering further substance use and addiction.
Colon samples showed increased inflammatory gene expression, which might indicate a heightened risk of gastrointestinal disease.
On the other hand, heart tissues had decreased levels of inflammation. The authors believe this may indicate suppressed immunity, making the heart more susceptible to infection.
In this study, the hearts of mice exposed to mint aerosols were significantly more sensitive to some of the effects of bacterial pneumonia compared with mice exposed to mango-flavored aerosols.
Dr. Crotty Alexander found this surprising: “This shows us that the flavor chemicals themselves are also causing pathological changes.”
She hypothesized that the organs of people frequently using mint-flavored e-cigarettes may respond differently to infections, such as SARS-CoV-2, the virus that causes COVID-19.
In her interview with MNT, Dr. Crotty Alexander also mentioned that scientists are working on creating a “high throughput system” that can rapidly detect the toxicity of multiple samples.
She said the study’s findings made it clear that every e-cigarette device and flavor should be studied to determine its effects across the body.
A lasting effect?
Dr. Kaseri said that vaping and being exposed to tobacco regularly could cause chronic long-term health problems that compound over time.
He noted that the low level of inflammation caused by e-cigarettes in various tissues “may not be clinically apparent as a problem on a day-to-day basis but could help explain the deleterious effects of nicotine products in the long run.”
However, Dr. Kaseri said he also believes that the extent of damage from vaping depends on how well each organ can repair itself.
Studies in animals
It’s important to note that the current study involves small rodents, not humans. However, Dr. Crotty Alexander argued:
“I think we can get enough data from our animal models that it would give enough insight [to inform] parents and regulators and healthcare practitioners.“
Her team hopes to impact public health by pinpointing the most toxic components in vaping devices. Ideally, manufacturers “would design their devices and their liquids in a safer way” with that information.
Ethical issues limit the feasibility of adolescent human studies, but Dr. Crotty Alexander sees a viable option:
“[…]By using nonhuman primates, [in] very small numbers, exposing them at the same ages that would correlate to a child in middle school or high schooler, we can get information about what e-cigarette aerosol use is doing in terms of lung development and [whether it is] increasing or changing the risk of developing pulmonary and cardiovascular disease.”
A moment of transparency
Dr. Chrystal Burwell, a psychotherapist and mental health advocate who regularly helps people deal with vaping and nicotine addiction, who was not involved in this study, said that she had noticed a pattern among vape users.
“I do see more of a chronic, low-grade difficulty with mental health [among people who vape] because I think vapes can be like pacifiers,” she said.
“[Vaping] placates. It temporarily gives you a kind of natural like high, and it feels innocent, but it’s not,” she stressed.
However, Dr. Burwell also admitted that she is currently trying to quit vaping herself:
“We all find ways to cope, some of which are maladaptive, some of which are healthy. [I] want to use my own struggle to be transparent[…] Reading [this study] was really helpful because it forced me to be honest.”
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