“Bad quality studies accompanied by impressive press statements are becoming increasingly frequent … I think we will see some interesting developments in this aspect soon,” said Farsalinos back in 2016, when asked about his predictions for 2017. The anti-smoking expert is a research fellow at the Onassis Cardiac Surgery Center in Athens and at the Department of Pharmacy, University of Patras in Greece, and has been conducting laboratory and clinical research on e-cigarettes since 2011.
The necessity of taking dry puff conditions into account
The study titled, Hidden Formaldehyde in E-Cigarette Aerosols was published in The New England Journal of Medicine in January 2015, and had concluded that “long-term vaping is associated with an incremental lifetime cancer risk of 4.2×10−3. This risk is 5 times as high, or even 15 times as high as the risk associated with long-term smoking.
Farsalinos and his colleagues replicated this study, using “exactly the same e-cigarette devices, batteries and liquid as the research letter above”, and instructed the participants to report any dry puffs that they detect. Dry puffs were detected at 4.2 V, therefore 4.0 V was the maximum realistic use voltage, and as expected the researchers found that there was a significant increase in formaldehyde emissions at dry puffs.
A dry puff is a dreaded phenomenon, that all vapers do their best to avoid. It happens when an atomizer heats up and has no liquid to vaporize. This results in the wick drying out and charring any available liquid, leading to a terrible taste. The aforementioned replicated study indicated that in realistic conditions, formaldehyde levels in e-cigarettes are lower than those found in cigarette smoke, and that alarming levels are only produced in “unrealistic (dry puff) conditions.”
A look at emissions in two different scenes
Another study looking into possible harmful emissions was published in Environmental Science & Study , and suggested that although e-cigarettes are likely to carry lower risks than regular cigarettes, in some cases the risks were comparable to those from smoking.
Following the release of this study, Vaping Post contacted study author Hugo Destaillats, who said that despite using a limited number of models for the study, it is clear that the number of toxic emissions released, is directly affected by the kind of vaporizers used.
“We studied only two vaporizers, three e-liquids and 4 battery settings. Of course, we cannot cover the whole universe of vaping with just those limited tests. But one thing we learned is that the emissions of potentially harmful compounds changed by factors of x10 or even x100 depending on which combination of vaporizer and voltage was used for puffing.” he said.
Vaping behaviours have a direct impact on the toxin levels one inhales
The study author added, that the kind of vaping behaviour one subscribes to, also has a major impact on the amount of toxins that one inhales. “You have to integrate the different puffing behaviors, which really affect dramatically the vaper’s intake of chemicals and their emissions into indoor air. This is one of the most important differences with combustion cigarettes. When you test combustion cigarettes using the different standard methods, the emissions rates may increase by a factor of x3 when you go from the milder ISO method to the more intense HCI method. So, for combustion cigarettes there is much less variability in emissions.”
Destaillats had concluded his communication with Vaping Post by pointing out that his team is not trying to condemn vaping products, but rather encouraging the production of solely the safer models. “To be clear, our intention is not to demonize e-cigs. On the contrary, the formation of aldehydes is a problem that can probably be minimized with new technologies and better designed vaporizers.”
However on replicating this study, once again using the same variables, Farsalinos and his team found that this time “the problem was not only dry puffs; the reported results were also hugely overestimated.” Farsalinos explained that they found 6 to 25-fold lower levels of aldehydes at the same dry puff conditions, and these levels were so low “that a liquid consumption of 5 mL per day would expose vapers to 94.4-99.8% lower aldehyde levels compared to smoking 20 tobacco cigarettes.” `
Researchers should look for possible errors before publishing inaccurate data
“Both studies clearly show that it is highly important to evaluate for the generation of dry puffs when measuring e-cigarette emissions in the laboratory. Although this has been known for years (from vapers) and has been mentioned in the literature since 2013, still many (if not most) studies fail to examine this,” concluded Dr. Farsalinos on discussing both replicated studies.
The public health expert said that unfortunately “the field of e-cigarette research has an unusually high number of studies reporting “strange” (to say the least) results.” He added that a basic principle to follow should be looking for possible errors when data do not make sense, rather than publishing results and causing a media sensation that leads to spreading dangerous misinformation.
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