Researchers analyzed urine samples and data on tobacco use from 5105 participants. Some smoked cigarettes. Some vaped. Some did both.
Concentrations of 50 separate biomarkers from 5 major classes of tobacco product ingredients were measured: nicotine, tobacco-specific nitrosamines (TSNAs), metals, polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs).
While those who used only e-cigarettes did show “10% to 98% significantly lower concentrations of biomarkers of exposure” than those who only smoked, they were still routinely exposed to such toxins.
More concerning is the fact that most people who vape also smoke tobacco. In the JAMA study, dual users had the highest concentration of tobacco-related toxicants.
The smoke-only group showed 10-30% lower concentrations of toxicants than the dual user group.
There were some important limitations to the study, such as the types of vaping devices not being tracked and the focus solely on known toxins. Proprietary chemicals used in the vape juice (liquid) may contain additional toxins that weren’t tracked.
The data was also collected before high-dose devices like Juul became really popular. Now, in fact, Juul dominates the e-cigarette market.
But the company has also come under fire for its products’ appeal to teens – users who are apt to move on to regular cigarettes later. Just this past fall, the FDA noted the rapid rise in teen vaping.
From 2017 to 2018, there was a 78 percent increase in current e-cigarette use among high school students and a 48 percent increase among middle school students. The total number of middle and high school students currently using e-cigarettes rose to 3.6 million — that’s 1.5 million more students using these products than the previous year.
Of course, it’s not just exposure to the sorts of toxins the JAMA study considered. We’ve looked before at exposure to heavy metals through vaping, which can have oral effects, as well as systemic. As one 2017 paper summarized, exposure to toxic metals
may adversely affect soft tissues, teeth, the saliva secretion process or taste sensations. There is also risk of developmental defects of the facial skeleton, particularly the cleft palate and impaired tooth buds mineralization.
Vaping can have other oral health effects, as well. As one hygienist put it,
Clinically, I have seen everything from stomatitis to what appears as chemical burns. The most common effects of vaping I see are in the form of xerostomia, and often the patient may complain of a dry cough as well.
Stomatitis is an inflammation of the mucous membranes of the mouth and lips, with or without oral ulceration. Xerostomia is dry mouth from reduced or absent saliva flow.
The nicotine itself can cause problems, as well – beyond the mere fact of its being highly addictive. For instance, it reduces blood flow, depriving your gums of the oxygen and nutrients they need to stay healthy. It reduces saliva flow, too.
Gum disease is thus a common problem among users – a condition that can ultimately lead to tooth loss if not properly treated. Yet treatment is less effective when nicotine continues to be used.
And just like regular smoking, vaping appears to raise the risk of oral cancers, as well.
If you can’t stop the vaping habit, then choosing a juice with less nicotine or no nicotine may help reduce some of the ill effects.
Your best bet, though, is to quit nicotine in any form. It can be tough to do, but the long-term benefits are worth it.
Bottom image by James Dunworth