Actor Leonard Nimoy — Mr. Spock to his legions ofStar Trek fans — has died at age 83 from a destructive lung disease called COPD, telling his fans in a poignant tweet last month: “Don’t smoke. I did. Wish I never had.”
His wife confirmed his death to the New York Times,saying the cause was end-stage COPD, or chronic obstructive pulmonary disease. He had been hospitalized earlier in the week.
COPD is one of the most common lung diseases and the third leading cause of death in the U.S., causing nearly 135,000 deaths a year. There is no cure. COPD causes inflammation and damage to the lung tissue, making it increasingly difficult to breathe. Symptoms include a chronic cough, shortness of breath and frequent respiratory infections.
Vapor produced by electronic cigarettes can contain a surprisingly high concentration of formaldehyde — a known carcinogen — researchers reported Wednesday.
The findings, described in a letter published in the New England Journal of Medicine,intensify concern about the safety of electronic cigarettes, which have become increasingly popular.
“I think this is just one more piece of evidence amid a number of pieces of evidence that e-cigarettes are not absolutely safe,” says David Peyton, a chemistry professor at Portland State University who helped conduct the research.
The e-cigarette industry immediately dismissed the findings, saying the measurements were made under unrealistic conditions.
“They clearly did not talk to [people who use e-cigarettes] to understand this,” says Gregory Conley of the American Vaping Association. “They think, ‘Oh well. If we hit the button for so many seconds and that produces formaldehyde, then we have a new public health crisis to report.’ ” But that’s not the right way to think about it, Conley suggests.
E-cigarettes work by heating a liquid that contains nicotine to create a vapor that users inhale. They’re generally considered safer than regular cigarettes, because some research has suggested that the level of most toxicants in the vapor is much lower than the levels in smoke.
Some public health experts think vaping could prevent some people from starting to smoke traditional tobacco cigarettes and help some longtime smokers kick the habit.
But many health experts are also worried that so little is known about e-cigarettes, they may pose unknown risks. So Peyton and his colleagues decided to take a closer look at what’s in that vapor.
“We simulated vaping by drawing the vapor — the aerosol — into a syringe, sort of simulating the lungs,” Peyton says. That enabled the researchers to conduct a detailed chemical analysis of the vapor. They found something unexpected when the devices were dialed up to their highest settings.
“To our surprise, we found masked formaldehyde in the liquid droplet particles in the aerosol,” Peyton says.
He calls it “masked” formaldehyde because it’s in a slightly different form than regular formaldehyde — a form that could increase the likelihood it would get deposited in the lung. And the researchers didn’t just find a little of the toxicant.
“We found this form of formaldehyde at significantly higher concentrations than even regular cigarettes [contain] — between five[fold] and fifteenfold higher concentration of formaldehyde than in cigarettes,” Peyton says.
And formaldehyde is a known carcinogen.
“Long-term exposure is recognized as contributing to lung cancer,” says Peyton. “And so we would like to minimize contact (to the extent one can) especially to delicate tissues like the lungs.”
Conley says the researchers found formaldehyde only when the e-cigarettes were cranked up to their highest voltage levels.
“If you hold the button on an e-cigarette for 100 seconds, you could potentially produce 100 times more formaldehyde than you would ever get from a cigarette,” Conley says. “But no human vaper would ever vape at that condition, because within one second their lungs would be incredibly uncomfortable.”
That’s because the vapor would be so hot. Conley compares it to overcooking a steak.
“I can take a steak and I can cook it on the grill for the next 18 hours, and that steak will be absolutely chock-full of carcinogens,” he says. “But the steak will also be charcoal, so no one will eat it.”
Peyton acknowledges that he found no formaldehyde when the e-cigarettes were set at low levels. But he says he thinks plenty of people use the high settings.
“As I walk around town and look at people using these electronic cigarette devices it’s not difficult to tell what sort of setting they’re using,” Peyton says. “You can see how much of the aerosol they’re blowing out. It’s not small amounts.”
“It’s pretty clear to me,” he says, “that at least some of the users are using the high levels.”
So Peyton hopes the government will tightly regulate the electronic devices. The Food and Drug Administration is in the process of deciding just how strict it should be.
Click Here to read the National Public Radio (NPR) story
PHOTO: The number of calls to poison-control centers about electronic cigarette incidents more than doubled last year, which has prompted the Campaign for Tobacco-Free Kids to call on the Food and Drug Administration to finalize regulations. Photo courtesy of the U.S. Department of Health and Human Services.
WASHINGTON – The number of calls to poison-control centers about electronic cigarette incidents more than doubled last year compared with 2013, according to new data from the American Association of Poison Control Centers. Children under age six were the victims in more than half the cases.
The rise in calls has the Campaign for Tobacco-Free Kids calling on the U.S. Food and Drug Administration to finalize its proposed rule to regulate the products. Campaign vice president for communications Vince Willmore says the agency also needs to crack down on companies’ marketing and flavors, such as “gummy bear” and bubble gum.
“Given how they’re being marketed, and given these sweet flavors, it’s not surprising more kids are using e-cigarettes, and that they’re attracted to nicotine liquids and being poisoned by them,” Willmore says.
While there are no federal regulations to restrict the sale of electronic cigarettes and nicotine liquids, most states require that purchasers be 18 years of age. Willmore says his group wants the FDA to finalize and strengthen rules by the end of April.
Willmore says the colors and packaging of e-cigarettes also appeal to kids, yet nicotine is highly dangerous and not only because of potential addiction.
“Nicotine is a very toxic substance and exposure to even small amounts of nicotine, whether it’s through the skin or through ingestion, can cause vomiting and seizures,” he says. “Unfortunately, it can even be lethal.”
A 1-year-old child in New York died last month after swallowing liquid nicotine. Willmore says the FDA should require childproof packaging, and adults need to keep the devices and supplies out of sight and out of reach of children.
On January 22nd the New Orleans City Council passed an ordinance making all indoor public spaces smoke-free!
Residents and tourists alike will now be able to enjoy all that the Big Easy has to offer while enjoying clean air. And employees in bars, music venues, casinos and other workplaces won’t be forced to breathe secondhand smoke in order to earn a paycheck.
This huge victory is the result of months of work by the Campaign for Tobacco-Free Kids and our partners in the #SmokeFreeNOLA campaign – and supporters like you who helped us send a clear message to City Council.
Smoking Cessation Among Users of Telephone and Web-Based Interventions — Four States, 2011–2012
Tobacco cessation services are available for free in every state. Smokers who use these services better their odds of successfully quitting smoking. Smoking causes 480,000 deaths a year in the United States. All states offer access to telephone or web based tobacco cessation services, and these services are freely available to people who want to quit smoking. Using these services, and in particular, using both services in combination, increases the chances of quitting successfully. States can help a greater number of people quit smoking by offering both telephone and web-based tobacco cessation services instead of offering only one.
Tetrodotoxin Poisoning Outbreak from Imported Dried Puffer Fish — Minneapolis, Minnesota, 2014
Health care providers who work in emergency departments or with persons from countries with a tradition of puffer fish consumption should be aware of the potential public health threat of puffer fish poisoning and should coordinate with their local poison centers and health departments to investigate any suspected cases. Puffer fish is a highly regulated product in the U.S. due to its potential toxicity yet is a delicacy in many cultures. Health care providers who work in emergency departments or with persons from countries with a tradition of puffer fish consumption should be aware of this potential public health threat and coordinate with their local poison centers and health departments to investigate any suspected cases of puffer fish poisoning to determine the source of the fish, whether it was legally imported, and whether additional contaminated product needs to be removed from commerce.
Perceptions of the Risk for Ebola and Health Facility Use Among Pregnant and Lactating Women and Community Health Workers — Kenema District, Sierra Leone, September 2014
During a complex humanitarian crisis such as the Ebola epidemic in West Africa, it is critical to consider the impact of the crisis on the delivery of routine health services and on health care seeking among vulnerable populations. Fear and misconceptions of Ebola were found to contribute to decreased health facility use in focus group discussions with health workers and pregnant and lactating women in Kenema District, Sierra Leone. In a country with the highest ratio of maternal deaths and fourth highest rate of newborn deaths in the world, use of routine maternal and newborn health care is essential to reduce the risk of adverse health outcomes. Infection prevention and control trainings were found to reduce fear among health care workers and may be an important strategy to increase women’s confidence in health facility safety. This information is being used to create messaging to encourage use of maternal and newborn health care services across Sierra Leone.
Notes from the Field:
Aseptic Meningitis Outbreak Associated with Echovirus 30 Among High School Football Players — Los Angeles County, California, 2014
Yavapai County supervisors agreed to a new countywide policy Monday that bans e-cigarettes in county buildings and vehicles.
They also agreed to a new Human Resources Department proposal to require all employee disciplinary action appeal hearings to be open to the public.
A new state law requires such hearings to be public if they relate to certain law enforcement positions, a county Human Resources memo explains. So HR is proposing a single policy that would make all such hearings open. Currently, county hearings to appeal disciplinary actions are automatically closed to the public unless employees ask for them to be public.
The county didn’t get any employee comments about the HR policy changes relating to appeal hearings and e-cigarettes, HR Director Wendy Ross said.
Supervisor Rowle Simmons cited a Sunday New York Times article about how China manufactures 90 percent of the world’s e-cigarettes, aka electronic cigarettes, personal vaporizers and electronic nicotine delivery systems.
The article states that the industry has little oversight, and studies have found tin particles and other metals in e-cigarette vapors that appear to come from the “solder joints” of e-cigarettes.
Supervisor Jack Smith said any kind of smoking in county vehicles could reduce their sale value.
“For me, there’s a zero tolerance on it,” Smith said.
The HR department will continue to work on revisions to a third policy after hearing employee comments, Ross said. A draft would ban the use of electronic equipment while county employees are driving, but it would allow them to use hands-free cell phones.
Ross said she’ll probably bring that draft policy to the supervisors in January.
Also at Monday’s meeting:
• Supervisor Chip Davis asked his fellow supervisors to vote against his proposal to donate $4,500 of his district’s park fund money to the City of Sedona to build a wildlife viewing platform at the Sedona Wetlands Preserve, where the city processes and cleans wastewater.
Davis explained that voters apparently don’t want non-essential services since the majority voted in November against doubling the county’s jail sales tax to build a new jail in Prescott.
“I’m going to take the first step and ask that we not honor that” request for $4,500, Davis said. “The citizens have spoken and nothing is sacred.”
• The supervisors approved using the remaining $30,463 in the Yavapai County Water Advisory Committee fund to collect hydrologic data in the Verde Valley.
Most of the remaining money, $27,500, was contributed by municipalities in the Verde Valley.
The committee hasn’t met since the summer, shortly after most of the supervisors said they wanted to dissolve the 15-year-old group. They stopped paying dues and also stopped paying for the committee’s long-time coordinator position.
It was the only organization that brought the county and all its municipalities and tribes together to discuss common issues.
The survey, released Tuesday by the National Institute on Drug Abuse, measured drug and alcohol use this year among middle and high school students across the country. More than 41,000 students from 377 public and private schools participated. It is one of several such national surveys, and the most up-to-date.
It was the first time this survey measured e-cigarette use, so there were no comparative data on the change over time. Other surveys have shown e-cigarette use among middle and high school students to be much lower, but increasing fast.
The survey found that 17 percent of 12th graders reported using an e-cigarette in the last month, compared with 13.6 percent who reported having an traditional cigarette. Among 10th graders, the reported use of e-cigarettes was 16 percent, compared with 7 percent for cigarettes. And among 8th graders, reported e-cigarette use was 8.7 percent, compared with just 4 percent who said they had smoked a cigarette in the last month.
A 2013 youth tobacco survey by the federal Centers for Disease Control and Prevention released in November found that the share of American high school students who use e-cigarettes rose to 4.5 percent in 2013 from 2.8 percent in 2012. The share of middle school students who use e-cigarettes remained flat at 1.1 percent over the same period.
The gap between the two sets of findings was substantial, and researchers struggled to explain it. Both are broad, reliable federal surveys that go back years, and their methodologies do not differ greatly. The drug abuseinstitute uses individual school grades, while the disease centers combine grades, which may account for some of the difference.
Some experts said that the new data suggested the rate may have increased substantially since 2013, though it will be impossible to know for sure until the C.D.C. releases its 2014 data sometime next year.
E-cigarettes have split the public health world, with some experts arguing that they are the best hope in generations for the 18 percent of Americans who still smoke to quit. Others say that people are using them not to quit but to keep smoking, and that they could become a gateway for young people to take up real cigarettes.
But that does not seem to be happening, at least so far. Daily cigarette use among teenagers continued to decline in 2014, the survey found, dropping across all grades by nearly half over the past five years. Among high school seniors, for example, 6.7 percent reported smoking cigarettes daily in 2014, compared with 11 percent five years ago.
Most experts agree that e-cigarettes are far less harmful than traditional cigarettes. But they contain nicotine, an addictive substance that some experts contend is potentially harmful for brain development. Some experts also warn that nicotine use could establish patterns that leave young people more vulnerable to addiction to other substances.
The survey found significant declines in the use of other drugs. Among high school seniors, about 6 percent reported having taken a prescription drug, substantially down from the peak of 9.5 percent in 2004. Abuse of Vicodin, the opioid pain reliever, declined by nearly half among 12th graders over five years.
In states with medical marijuana laws, 40 percent of high school seniors who reported using marijuana in the past year said they had consumed it in food, compared with 26 percent in states without such laws.