Teens Who Use E-Cigarettes Exposed to Toxic Chemicals, Study Published in Medical Journal Pediatrics


More and more teenagers have been trying e-cigarettes in recent years. Now, a new study shows adolescents who use them are exposed to significant levels of chemicals that could potentially cause cancer. CBS News’ Kenneth Craig reports.

A study published March 1, 2018 in the medical journal Pediatrics discovered toxic and carcinogenic chemicals in vapor from e-cigarettes. Researchers of the study also pointed out that common messages found on Electronic Cigarette (e-cigarette) websites stated that e-cigarettes do not produce the same cancer-causing agents as traditional cigarettes.

The participants were 16.4 years old on average. Urine excretion of metabolites of benzene, ethylene oxide, acrylonitrile, acrolein, and acrylamide was significantly higher in dual users (e-cigarette and cigarette users) versus e-cigarette–only users (all P < .05). Excretion of metabolites of acrylonitrile, acrolein, propylene oxide, acrylamide, and crotonaldehyde were significantly higher in e-cigarette–only users compared with people who do not use either products. Although e-cigarette vapor may be less hazardous than tobacco smoke, the researchers' findings challenged the common product messages that e-cigarette vapors are safe, because many of the volatile organic compounds the researchers identified in the study are carcinogenic. The researchers recommended that messaging to teenagers include warnings about the potential risk from toxic exposure to carcinogenic compounds generated by these products. Urine excretion of metabolites was detected by markers, noted in parentheses. For example, PMA is phenylmercapturic acid, which is detected in urine is a marker consistent with exposure to benzene.


AAMA — 2-carbamoylethylmercapturic acid
CNEMA — 2-cyanoethylmercapturic acid
HEMA — 2-hydroxyethylmercapturic acid
HMPMA — 3-hydroxy-1-methyl-propylmercapturic acid
NNAL — 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol
PMA — phenylmercapturic acid
2-HPMA — 2-hydroxypropylmercapturic acid
3-HPMA — 3-hydroxypropylmercapturic acid

Urine excretion of metabolites of benzene (PMA), ethylene oxide (HEMA), acrylonitrile (CNEMA), acrolein (3-HPMA), and acrylamide (AAMA) was significantly higher in dual users versus e-cigarette–only users and non-users. Excretion of metabolites of 5 VOCs was significantly higher in e-cigarette–only users compared with controls:
acrylonitrile (341% higher than in controls but 327% lower than in dual users),

acrolein (20% higher than in controls but 11% lower than in dual users),

propylene oxide (51% higher than in controls but 8% lower than in dual users; 2-HPMA),

acrylamide (30% higher than in controls but 23% lower than in dual users),

and crotonaldehyde (20% higher than in controls but 7% lower than in dual users; HMPMA).

Electronic cigarettes are marketed to promote smoking cessation or reduced cigarette smoking in adults, but teens more teens start out on electronic cigarettes. Social influence and marketing strategies for these products have clearly are connected with statistics that show teens now use electronic cigarettes more than traditional cigarettes, according to studies cited by the researchers.

A dramatic increase in adolescent e-cigarette use was connected with peer influence, enticing flavors, and extensive marketing presenting e-cigarettes as safer.

Researchers discovered that use of fruit-flavored products produced significantly higher levels of the metabolites of acrylonitrile.

Health Effects of Acrylonitrile

Acrylonitrile is irritating to the skin, eyes, and respiratory tract.

Toxic effects range from headache, fatigue, dyspnea, nausea and vomiting to asphyxiation, lactic acidosis and cardiovascular collapse.

Toxic effects are due primarily to the bioreactivity of acrylonitrile with cellular proteins and to its epoxide intermediate that is mutagenic and genotoxic.

Toxicity of acrylonitrile also involves the release of cyanide during the metabolism of acrylonitrile.

Acrylonitrile is possibly carcinogenic to humans.

— Agency for Toxic Substances and Disease Registry

According to researchers studying Acrolein in 2006, the toxin and major irritant of skin, eyes and nasal passages, is a major etiological agent for cigarette smoke-related lung cancer and results suggest Acrolein contributes to lung carcinogenesis through two detrimental effects: DNA damage and inhibition of DNA repair.

— Feng Z1, Hu W, Hu Y, Tang MS

The study’s authors did not mention secondary “smoke” or secondary vapors from e-cigarettes, but another study has mentioned that acrolein, for example, is prevalent in side stream smoke (secondary smoke) from cigarettes, and is not controlled by cigarette filters. It is likely that secondary vapors also contain the potentially harmful volatile organic compounds that the researchers discovered in their study.

See also …
Mark L. Rubinstein, Kevin Delucchi, Neal L. Benowitz, Danielle E. Ramo Adolescent Exposure to Toxic Volatile Organic Chemicals From E-Cigarettes Pediatrics March 2018

Feng Z1, Hu W, Hu Y, Tang MS. Acrolein is a major cigarette-related lung cancer agent: Preferential binding at p53 mutational hotspots and inhibition of DNA repair. Proc Natl Acad Sci U S A. 2006 Oct 17;103(42):15404-9. Epub 2006 Oct 9.

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