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Formaldehyde on my mind

The Vape-bashing witch hunt in the press continues drearily on. Some public health advocates and journalists hope so earnestly that vaping will be found toxic that they are willing to spin research data according to worst case scenarios rather than following promising research leads on making vaping as safe as it can be.

The usually reputable New York Times is no exception. Responding to a study (abstract) by cancer researcher Miaciej Goniewicz and his colleagues which was guardedly optimistic about vaping as a harm reduction strategy, the Times produced the headline: Some e-cigarettes deliver a puff of carcinogens. This reminds us of the story a few months ago, when careless parents left un-childproofed bottles of e-liquid lying around, only to be ingested by their children, who promptly vomited harmlessly, either with or without a hospital visit. This incident elicited the inflammatory Times headline: "Selling poison by the barrel." This kind of journalism exacerbates polarization in a passionate public health where lives depend on coming together for unity of purpose and progress.

Formaldehyde is what's at issue. Goniewicz, like Burstyn, Farsalinos, and many others, have found nothing harmful in the vapor itself at concentractions any higher than trace. But the study by the Goniewicz team at the Roswell Cancer Research Center in Buffalo, found that the process of intensely heating e-liquid (as in some tank systems) is capable of producing the carcinogen formaldehyde at levels ranging from trace to potentially dangerous. Vapers who drip their liquid directly on the heating element can produce even higher temperatures that can raise the formaldehyde level, reports a newer study that will be forthcoming soon. So it is not e-cigarettes, as suggested in the Times headline, but tank systems and the practice of "dripping", that may be likely to produce more dangerous amounts of formaldehyde.

Formaldehyde is found in many substances we use regularly, at trace levels deemed acceptable by the appropriate agencies. It is present in automotive exhaust and smog-laden air. It is present at trace levels in the vapor produced by a medicinal nicotine inhaler, which was the reference product for the Goniewicz study. It is present in cigarette smoke at concentrations 9-450 times greater. Goniewicz studied vapor from 12 e-liquids and found formaldehyde was produced at variable levels, from 3.2 micrograms per 150 puffs, the same as the medicinal inhaler, to a level almost 20 times that.

Michael Siegel, a prominent harm reduction advocate at Boston University, suggests that the take-away from the Goniewicz study should be a commitment to work together to discover why the level is so much lower in some liquids, with an eye toward approaching that level in all liquids.

Says Goniewicz (in the article abstract): "Our findings are consistent with the idea that substituting tobacco cigarettes with e-cigarettes may substantially reduce exposure to selected tobacco-specific toxicants. E-cigarettes as a harm reduction strategy among smokers unwilling to quit, warrants further study." In the full text of the study (available for purchase at the website for the journal Tobacco Control) Goniewicz goes on: "The results of this study support the proposition that the vapour from e-cigarettes is less injurious than the smoke from cigarettes. Thus one would expect that if a person switched from conventional cigarettes to e-cigarettes the exposure to toxic chemicals and related adverse health effects would be reduced." (quoted in Siegel's blog)