In a recent article from Med Page Today, the authors note that a study revealed that even short-term exposure to electronic cigarette (or e-cigarette) flavorings could negatively impact endothelial cells. Laboratory studies suggest that, with frequent use, these substances could impede blood vessels over extended periods of time and cause heart damage. Jessica Fetterman, Ph.D. […]
In a recent article from Med Page Today, the authors note that a study revealed that even short-term exposure to electronic cigarette (or e-cigarette) flavorings could negatively impact endothelial cells. Laboratory studies suggest that, with frequent use, these substances could impede blood vessels over extended periods of time and cause heart damage. Jessica Fetterman, Ph.D. led the study. Dr. Fetterman works for Boston University School of Medicine.
The researchers looked at nine favorite flavorings that are added to e-cigarettes, as well as hookahs, little cigars, and other tobacco-containing products. At the conclusion of this experiment, the researchers found that every single one of the nine flavorings impacted endothelial function. Specifically, these flavorings reduced nitric oxide production, which reduces clotting and inflammation. It also regulates the enlargement of blood vessels to accommodate blood flow.
Vanillin (vanilla), eugenol (clove), acetylpyridine, and cinnamaldehyde (cinnamon) affected the production of nitric oxide, as well as the expression of interleukin-6, a proinflammatory mediator. The authors state that the results suggest “that the endothelium is particularly sensitive to these flavors.” The study was printed in Arteriosclerosis, Thrombosis and Vascular Biology.
Currently, there are over 7,000 e-cigarette flavors enthusiasts may purchase. The most popular e-liquids are fruity, sweet, or menthol flavored. Many flavorings are safe when ingested in food items, but their impact on the lungs has not been determined.
Dr. Fetterman said, “When we eat something, the stomach has a lot of mechanisms to detoxify, but the lungs and blood vessels are largely unprotected. People aren’t meant to inhale a lot of stuff into their lungs other than air.”
The other flavorings that were studied include isoamyl acetate (banana), dacetyl (butter), eucalyptol (spicy cooling), and dimethylpyrazine (strawberry).
In isolated endothelial cells from subjects who used menthol or non-menthol flavored tobacco cigarettes exhibited reduced nitric oxide production when compared to subjects who did not smoke.
Endothelial cells from nonsmoking subjects that had been treated with either eugenol or menthol also showed decreased production of nitric oxide.
The researchers also isolated aortic endothelial cells with each of the nine flavorings for a 90-minute period. At the end of the ninety minutes, the researchers examined interleukin-6 expression, cell death, nitric oxide, and reactive oxygen species production.
The study showed, “Cell death and reactive oxygen species production were induced only at high concentrations unlikely to be achieved in vivo. Lower concentrations of selected flavors (vanillin, menthol, cinnamaldehyde, eugenol, and acetylpyridine) induced both inflammation and impaired A23187-stimulated nitric oxide production consistent with endothelial dysfunction.”
The additives impeded stimulated nitric oxide production as well as inflammation, which was “suggestive of endothelial dysfunction across a range of concentrations likely to be achieved in vivo.”’
Dr. Fetterman explained that in vivo experiments are necessary to understand both the short-term and long-term effects of exposure to e-cigarette flavorings.
The researchers commented that there were some limitations to their study. For example, the flavorings were not heated and did not include the other ingredients that are found in e-liquids, such as propylene glycol and glycerol. The authors noted, “Heating or combustion of the flavoring compounds likely alters the compounds, making them more or less toxic.”
However, the study’s conclusions “provide quantitative support for the regulatory prohibition or the establishment of limitations on allowable levels of these flavorings in electronic liquids and other tobacco products.”
Presently, the United States Food and Drug Administration is looking into whether a ban on specific flavors in tobacco products and e-cigarettes is necessary. In March of 2018, the FDA asked the public to provide input on restricting or outright banning menthol and other flavors in at least some of the tobacco products available on the market.
Fetterman said, “Our work and prior research have provided evidence that flavorings induce toxicity in the lung and cardiovascular systems. Flavorings are also a driver of youth tobacco use and sustained tobacco use among smokers.”
The study was funded by the FDA Center for Tobacco Products, the American Heart Association, and the National Heart, Lung and Blood Institute.
Product manufacturers have a duty to market and distribute products that are safe for consumption. If it is determined that a product is not safe or is defective, consumers may recover damages in a products liability lawsuit. The consumer does not have to show that the manufacturer was negligent or intentionally did something wrong to prevail in a products liability lawsuit—instead, the consumer must demonstrate:
All of these factors must be proven in a products liability case. Without one of the elements, the claim will fail and the consumer will not be entitled to any compensation from the manufacturer. Instead, the consumer will be responsible for the financial losses he or she has incurred.
A single defect may be present in a product, or all three types of defects may be present. Each type of defect must be proven with objective, admissible evidence. Engaging a products liability attorney as soon as possible increases your chance of winning your product liability lawsuit. These attorneys know how to identify defects and how to prove that these defects caused injuries to a consumer.
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The vast majority of product liability cases will settle long before they go to court. There will be numerous opportunities to settle the claim, and many manufacturers would rather agree to a private settlement than endure a public trial that may damage their reputations. Once enough evidence has been gathered, the parties may engage in settlement negotiations. They may also use a third party, such as a mediator, to help them come to an agreement. Even if a trial date is set, it is not unusual for the parties to settle in the hours before the trial’s start time. This is called a “courthouse steps settlement.” With your products liability attorney by your side, your legal rights will be protected.
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