Smoke or Vape: Pick Your Poison

UTS Staff Writer | SQ Online (2014-15)


“More doctors smoke Camels than any other cigarette!” “To keep a slender figure, no one can deny…Lucky!” Newspaper ads making such outrageous claims were the norm 60 years ago. Undoubtedly, ads like these encouraged the use of cigarettes, but as federal agencies in the United States began to publicize the serious and potentially fatal health effects of tobacco, rates of cigarette smoking have steadily declined since the 1950s. As reported by the Centers for Disease Control and Prevention, cigarette smoking may cause coronary heart disease and lung cancer and doubles the risk of stroke.

To evade these lethal health effects, many young people have turned to electronic cigarettes, more commonly known as “e-cigarettes,” as an alternative to cigarette smoking. A new trend that has begun to swiftly dominate high schools and colleges, smoking e-cigarettes is becoming more popular as claims of e-cigarette safety increase.

Are these claims real or unfounded? Several labs at the UC San Diego School of Medicine are diving into e-cigarette research, the prevalence of e-cigarette smoking and the health effects that come with it. Studies have shown that the online market for e-cigarettes is booming and particularly targets teens and young adults. Additionally, studies have discovered that e-cigarettes are being advertised and marketed in a similar manner as tobacco cigarettes were decades ago, with celebrity endorsements and catchy slogans advertising the product’s safety and benefits.

Here at UCSD, it is not unusual to notice a fellow student charging his or her e-cigarette at Geisel Library late at night. Many students and young adults targeted by e-cigarette companies are unaware of health risks associated with e-cigarettes because life-threatening hazards have not yet been reported. While research is being done on the health effects of e-cigarettes, very little is currently known about the true harmful effects of smoking e-cigarettes, much as it was 60 years ago, when tobacco cigarettes were seemingly harmless. Studies have shown that “e-cigarettes are not as bad as tobacco” (Dr. Laura Alexander Crotty), but are they as risk-free as many people believe they are?

MSRA attacking human immune cells
MSRA attacking human immune cells

In a recent study conducted by Dr. Alexander Crotty at the VA San Diego Healthcare System, e-cigarettes appear to be harmful in a way that most users probably do not expect. While some researchers hypothesized that e-cigarette vapor exposure increased airway resistance in the lungs and enhanced cancerous behavior in human cells, Dr. Alexander attempted to investigate the relationship between e-cigarette vapor and MRSA (methicillin-resistant Staphylococcus, a drug-resistant bacteria that causes infections and is most common among people who have frequent exposure to hospitals or other healthcare settings). Surprisingly, she found that when exposed to e-cigarette vapor, MRSA developed changes in its surface charge as well as biofilm formation. By causing a rise in pH levels, e-cigarette vapor forced the bacteria to positively charge their surfaces to avoid contact with human immune cell defense mechanisms. These bacteria that were exposed to vapors consisting of nicotine secreted a thicker and more protective biofilm coating that made it more difficult for drugs and human cells to kill them. Additionally, human cells exposed to e-cigarette vapor had a decreased ability to fight and kill disease-causing pathogens.

A similar project was conducted using a mouse model of pneumonia. In this study, mice breathed air containing harmful MRSA bacteria that had been exposed to e-cigarette vapor. It was concluded that these mice had three times as much bacteria growing in their lungs than the mice that breathed unexposed MRSA. After finishing her study, Dr. Crotty concluded, “We started these studies so that we could advise our smoking patients on whether they should try switching to e-cigarettes. My data now indicate they might be the lesser of the two evils. But e-cigarettes are definitely not benign.”

Dr. Crotty’s research is only the beginning to finding the true benefits and risks of e-cigarette smoking. Realistically, it is often difficult for people to quit smoking entirely, in which case the e-cigarette may prove to be the better option. But while e-cigarette advertisements continue to shamelessly flaunt the risk-free option of vaping using e-cigarettes, young adults should keep in mind that, as Dr. Crotty concluded, e-cigarettes are not harmless.

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  • L.E. Crotty Alexander et al. Electronic cigarette vapor (ECV) exposure decreases Staphylococcus aureus susceptibility to macrophage and neutrophil killing. American Thoracic Society International Conference, San Diego. May 18, 2014.
  • Dunford N, Kell B. E-cigarettes May Boost Resistance of Drug-Resistant Pathogens. News release. American Thoracic Society International Conference, San Diego. May 18, 2014.
  • Zhu SH, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, Lee M. Four Hundred and sixty brands of e-cigarettes and counting: implications for production regulation. Tob Control. 2013 Jul;23 Suppl 3:iii3-9. doi: 10.1136/tobaccocontrol-2014-051670. PubMed PMID: 24935895; PubMed Central PMCID: PMC4078673.

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