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What we know about the dangers of e-cigarettes
Compared to traditional cigarettes, e-cigarettes are extremely understudied. There is, however, some evidence on their negative effects on your health.
- Traditional cigarettes have the benefit of decades' worth of research on their harmful effects. E-cigarettes are relatively new, and our understanding of their long-term effects is limited.
- To fill this gap, researchers are conducting studies to identify exactly how e-cigarettes effect our bodies.
- To date, it appears that e-cigarettes are better for you than traditional cigarettes, but that doesn't make them harmless.
E-cigarettes are, in all likelihood, better for your health than smoking cigarettes. There's a general agreement among the medical community that vaping exposes people to fewer toxic chemicals than cigarettes, but that doesn't mean they're consequence-free.
For one, e-cigarettes use a different cocktail of chemicals than cigarettes, which, even if they're fewer in number, may be of a more dangerous variety. But more importantly, cigarettes have had the benefit of many decades worth of research; e-cigarettes are simply too new for us to know what the long-term consequences will be.
That being said, there is some empirical evidence as to the negative health effects of e-cigarettes. Here's what we know so far.
Nicotine alone isn't harmless
The main appeal of e-cigarettes is that they deliver nicotine, which functions as a stimulant, ensuring both that e-cigarettes are enjoyable and addictive. However, even by itself, nicotine can do a number on your body.
It's been implicated in cardiovascular diseases such as coronary artery disease, atherosclerosis, and aortic aneurysms. Though nicotine is not a carcinogen in and of itself, new research suggests it promotes tumor growth, the formation of blood vessels that supply tumors with nutrients, and metastasis. Hopefully this doesn't need to be said, but it's also quite unhealthy for pregnant mothers and young children.
Exposure to metals from e-cigarette coils
Most e-cigarettes produce an aerosol by heating an e-liquid with a metal coil. These coils are made out of a variety of metals, with the majority made out of Kanthal (an alloy of iron, chromium, and aluminum) and nichrome (an alloy of nickel and chromium). A 2018 study found that the metals associated with these heating coils were leaching into the liquid solution — and, commensurately, into the bodies of the people inhaling them — at unsafe levels. Chronic exposure to such metals has been linked to lung, liver, heart, and brain damage, and may also depress immune function and increase cancer risk.
The cocktail of flavoring agents
E-liquids for use in vaporizers on display. Image source: Justin Sullivan / Getty Images
One of the biggest concerns with vaping is the chemicals used to flavor e-liquids. While many chemicals used in e-cigarettes are labelled as safe for human consumption by the FDA, typically, this labeling applies to their ingestion. Inhaling them may have very different consequences. While there are far too many to go through individually, a few stand out:
Cinnamaldehyde — which, as you may have guessed, has a cinnamon-like taste — has been found to be significantly toxic. Four very common flavoring agents — vanillin, ethyl maltol, ethyl vanillin, and methol — are either carcinogenic or toxic and contribute to cardiopulmonary and neurodegenerative diseases. In general, many of the sweeter flavorings tends to be more toxic. Diacetyl is sometimes found in flavored e-liquids, which provides a sort of buttery flavor. Originally, it was used in microwave popcorn, but manufacturers stopped including it when it was revealed to contribute to bronchiolitis obliterans, also known as popcorn lung.
Propylene glycol and vegetable glycerin
While flavoring chemicals can vary from e-liquid to e-liquid, propylene glycol (PG) and vegetable glycerin (VG) are essentially universal. As mentioned above, these are considered non-toxic when ingested, but their toxicity when inhaled is not clear. Some research, however, has been conducted on these chemicals.
One study, for instance, focused on testing a wide variety of e-liquid chemicals on cell cultures. Based off of the reduced rates at which the treated cells grew, the researchers could then evaluate the toxicity of e-liquid chemicals on those cells. In addition to testing a number of flavoring compounds, they also tested a pure PG/VG treatment, and found that it significantly impacted cell growth.
That being said, the evidence isn't entirely conclusive on PG/VG's toxicity. Another study, for instance, found no toxic effects in mice exposed to aerosolized PG/VG. Ultimately, the preliminary evidence seems to suggest that inhaling PG/VG over the short-term is not toxic, but there is a serious lack of data on their effects over the long-term.
There's another potential concern related to PG/VG in e-cigarettes: formaldehyde exposure. When PG/VG is heated, it can become oxidized to produce carbonyl compounds, such as glyoxal, acrolein, acetaldehyde, and formaldehyde, especially at higher wattages. However, a report by the Royal College of Physicians states that "In normal conditions of use [i.e., low wattages/temperatures], toxin levels in inhaled e-cigarette vapour are probably well below prescribed threshold limit values for occupational exposure."
Ultimately, vaping can be said to be safer than smoking traditional cigarettes, but it's clearly not harmless. If you use e-cigarettes and are concerned about the toxicity of the chemicals in your e-liquid, the Center for Tobacco Regulatory Science and Lung Health maintains a database on the toxicity of a variety of e-liquid brands at eliquidinfo.org
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Innovation in manufacturing has crawled since the 1950s. That's about to speed up.
Health officials in China reported that a man was infected with bubonic plague, the infectious disease that caused the Black Death.
- The case was reported in the city of Bayannur, which has issued a level-three plague prevention warning.
- Modern antibiotics can effectively treat bubonic plague, which spreads mainly by fleas.
- Chinese health officials are also monitoring a newly discovered type of swine flu that has the potential to develop into a pandemic virus.
Bacteria under microscope
needpix.com<p>Today, bubonic plague can be treated effectively with antibiotics.</p><p style="margin-left: 20px;">"Unlike in the 14th century, we now have an understanding of how this disease is transmitted," Dr. Shanthi Kappagoda, an infectious disease physician at Stanford Health Care, told <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">Healthline</a>. "We know how to prevent it — avoid handling sick or dead animals in areas where there is transmission. We are also able to treat patients who are infected with effective antibiotics, and can give antibiotics to people who may have been exposed to the bacteria [and] prevent them [from] getting sick."</p>
This plague patient is displaying a swollen, ruptured inguinal lymph node, or buboe.
Centers for Disease Control and Prevention<p>Still, hundreds of people develop bubonic plague every year. In the U.S., a handful of cases occur annually, particularly in New Mexico, Arizona and Colorado, <a href="https://www.cdc.gov/plague/faq/index.html" target="_blank">where habitats allow the bacteria to spread more easily among wild rodent populations</a>. But these cases are very rare, mainly because you need to be in close contact with rodents in order to get infected. And though plague can spread from human to human, this <a href="https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague#Heres-how-the-plague-spreads" target="_blank">only occurs with pneumonic plague</a>, and transmission is also rare.</p>
A new swine flu in China<p>Last week, researchers in China also reported another public health concern: a new virus that has "all the essential hallmarks" of a pandemic virus.<br></p><p>In a paper published in the <a href="https://www.pnas.org/content/early/2020/06/23/1921186117" target="_blank">Proceedings of the National Academy of Sciences</a>, researchers say the virus was discovered in pigs in China, and it descended from the H1N1 virus, commonly called "swine flu." That virus was able to transmit from human to human, and it killed an estimated 151,700 to 575,400 people worldwide from 2009 to 2010, according to the Centers for Disease Control and Prevention.</p>There's no evidence showing that the new virus can spread from person to person. But the researchers did find that 10 percent of swine workers had been infected by the virus, called G4 reassortant EA H1N1. This level of infectivity raises concerns, because it "greatly enhances the opportunity for virus adaptation in humans and raises concerns for the possible generation of pandemic viruses," the researchers wrote.
So far, 30 student teams have entered the Indy Autonomous Challenge, scheduled for October 2021.
- The Indy Autonomous Challenge will task student teams with developing self-driving software for race cars.
- The competition requires cars to complete 20 laps within 25 minutes, meaning cars would need to average about 110 mph.
- The organizers say they hope to advance the field of driverless cars and "inspire the next generation of STEM talent."
Indy Autonomous Challenge<p>Completing the race in 25 minutes means the cars will need to average about 110 miles per hour. So, while the race may end up being a bit slower than a typical Indy 500 competition, in which winners average speeds of over 160 mph, it's still set to be the fastest autonomous race featuring full-size cars.</p><p style="margin-left: 20px;">"There is no human redundancy there," Matt Peak, managing director for Energy Systems Network, a nonprofit that develops technology for the automation and energy sectors, told the <a href="https://www.post-gazette.com/business/tech-news/2020/06/01/Indy-Autonomous-Challenge-Indy-500-Indianapolis-Motor-Speedway-Ansys-Aptiv-self-driving-cars/stories/202005280137" target="_blank">Pittsburgh Post-Gazette</a>. "Either your car makes this happen or smash into the wall you go."</p>
Illustration of the Indy Autonomous Challenge
Indy Autonomous Challenge<p>The Indy Autonomous Challenge <a href="https://www.indyautonomouschallenge.com/rules" target="_blank">describes</a> itself as a "past-the-post" competition, which "refers to a binary, objective, measurable performance rather than a subjective evaluation, judgement, or recognition."</p><p>This competition design was inspired by the 2004 DARPA Grand Challenge, which tasked teams with developing driverless cars and sending them along a 150-mile route in Southern California for a chance to win $1 million. But that prize went unclaimed, because within a few hours after starting, all the vehicles had suffered some kind of critical failure.</p>
Indianapolis Motor Speedway
Indy Autonomous Challenge<p>One factor that could prevent a similar outcome in the upcoming race is the ability to test-run cars on a virtual racetrack. The simulation software company Ansys Inc. has already developed a model of the Indianapolis Motor Speedway on which teams will test their algorithms as part of a series of qualifying rounds.</p><p style="margin-left: 20px;">"We can create, with physics, multiple real-life scenarios that are reflective of the real world," Ansys President Ajei Gopal told <a href="https://www.wsj.com/articles/autonomous-vehicles-to-race-at-indianapolis-motor-speedway-11595237401?mod=e2tw" target="_blank">The Wall Street Journal</a>. "We can use that to train the AI, so it starts to come up to speed."</p><p>Still, the race could reveal that self-driving cars aren't quite ready to race at speeds of over 110 mph. After all, regular self-driving cars already face enough logistical and technical roadblocks, including <a href="https://www.bbc.com/news/technology-53349313#:~:text=Tesla%20will%20be%20able%20to,no%20driver%20input%2C%20he%20said." target="_blank">crumbling infrastructure, communication issues</a> and the <a href="https://bigthink.com/paul-ratner/would-you-ride-in-a-car-thats-programmed-to-kill-you" target="_self">fateful moral decisions driverless cars will have to make in split seconds</a>.</p>But the Indy Autonomous Challenge <a href="https://static1.squarespace.com/static/5da73021d0636f4ec706fa0a/t/5dc0680c41954d4ef41ec2b2/1572890638793/Indy+Autonomous+Challenge+Ruleset+-+v5NOV2019+%282%29.pdf" target="_blank">says</a> its main goal is to advance the industry, by challenging "students around the world to imagine, invent, and prove a new generation of automated vehicle (AV) software and inspire the next generation of STEM talent."
A new Harvard study finds that the language you use affects patient outcome.
- A study at Harvard's McLean Hospital claims that using the language of chemical imbalances worsens patient outcomes.
- Though psychiatry has largely abandoned DSM categories, professor Joseph E Davis writes that the field continues to strive for a "brain-based diagnostic system."
- Chemical explanations of mental health appear to benefit pharmaceutical companies far more than patients.
Challenging the Chemical Imbalance Theory of Mental Disorders: Robert Whitaker, Journalist<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="41699c8c2cb2aee9271a36646e0bee7d"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/-8BDC7i8Yyw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>This is a far cry from Howard Rusk's 1947 NY Times editorial calling for mental healt</p><p>h disorders to be treated similarly to physical disease (such as diabetes and cancer). This mindset—not attributable to Rusk alone; he was merely relaying the psychiatric currency of the time—has dominated the field for decades: mental anguish is a genetic and/or chemical-deficiency disorder that must be treated pharmacologically.</p><p>Even as psychiatry untethered from DSM categories, the field still used chemistry to validate its existence. Psychotherapy, arguably the most efficient means for managing much of our anxiety and depression, is time- and labor-intensive. Counseling requires an empathetic and wizened ear to guide the patient to do the work. Ingesting a pill to do that work for you is more seductive, and easier. As Davis writes, even though the industry abandoned the DSM, it continues to strive for a "brain-based diagnostic system." </p><p>That language has infiltrated public consciousness. The team at McLean surveyed 279 patients seeking acute treatment for depression. As they note, the causes of psychological distress have constantly shifted over the millennia: humoral imbalance in the ancient world; spiritual possession in medieval times; early childhood experiences around the time of Freud; maladaptive thought patterns dominant in the latter half of last century. While the team found that psychosocial explanations remain popular, biogenetic explanations (such as the chemical imbalance theory) are becoming more prominent. </p><p>Interestingly, the 80 people Davis interviewed for his book predominantly relied on biogenetic explanations. Instead of doctors diagnosing patients, as you might expect, they increasingly serve to confirm what patients come in suspecting. Patients arrive at medical offices confident in their self-diagnoses. They believe a pill is the best course of treatment, largely because they saw an advertisement or listened to a friend. Doctors too often oblige without further curiosity as to the reasons for their distress. </p>
Image: Illustration Forest / Shutterstock<p>While medicalizing mental health softens the stigma of depression—if a disorder is inheritable, it was never really your fault—it also disempowers the patient. The team at McLean writes,</p><p style="margin-left: 20px;">"More recent studies indicate that participants who are told that their depression is caused by a chemical imbalance or genetic abnormality expect to have depression for a longer period, report more depressive symptoms, and feel they have less control over their negative emotions."</p><p>Davis points out the language used by direct-to-consumer advertising prevalent in America. Doctors, media, and advertising agencies converge around common messages, such as everyday blues is a "real medical condition," everyone is susceptible to clinical depression, and drugs correct underlying somatic conditions that you never consciously control. He continues,</p><p style="margin-left: 20px;">"Your inner life and evaluative stance are of marginal, if any, relevance; counseling or psychotherapy aimed at self-insight would serve little purpose." </p><p>The McLean team discovered a similar phenomenon: patients expect little from psychotherapy and a lot from pills. When depression is treated as the result of an internal and immutable essence instead of environmental conditions, behavioral changes are not expected to make much difference. Chemistry rules the popular imagination.</p>