E-cigarettes are often touted as a good alternative for people trying to wean themselves from tobacco.
But a new study from researchers at the University of Southern California reveals a certain kind of e-cigarettes may do the complete opposite.
The researchers found the use of ‘ice’ flavoured e-cigarettes is positively associated with smoking conventional cigarettes among young adults.
‘Ice’ e-cigarettes are marketed with both sweet and cooling properties, in combination with fruit or desserts (such as ‘blueberry ice’ and ‘melon ice’).
The researchers also noted that the use of ice e-cigarettes is linked with nicotine vaping frequency and dependence.
While e-cigarettes contain fewer toxic chemicals than traditional cigarettes, they usually contain nicotine, an addictive chemical.
It’s already known that nicotine constricts blood vessels and over time this leads to a loss of elasticity, which can increase the risk of developing heart disease.
E-cigarettes are particularly risky for the developing brains of teenagers and can also damage babies in the womb, according to the World Health Organisation.
Whether using e-cigarettes – known as vaping – is safe has been a topic of debate for years as their use has increased rapidly, particularly among young people (stock image)
Despite this, the NHS says: ‘Many thousands of people in the UK have already stopped smoking with the help of an e-cigarette, and there is growing evidence that they can be effective.
It’s thought switching to e-cigarettes provide a safer alternative to traditional cigarettes while still providing a nicotine hit.
The NHS says the liquid and vapour in e-cigarettes contain some potentially harmful chemicals also found in cigarette smoke but at much lower levels.
Public Health England and the Royal College of Physicians estimate e-cigarettes are at least 95 per cent less harmful than traditional cigarettes.
This new study hints at the possibility that there’s something about ice e-cigarettes in particular that makes them a possible gateway to both smoking traditional cigarettes and more frequent vaping – but the experts aren’t sure what.
Public Health England and the Royal College of Physicians estimate e-cigarettes are at least 95 per cent less harmful than traditional cigarettes (stock image)
‘Young adult use of ice flavoured e-cigarettes may be common and positively associated with combustible tobacco use, nicotine vaping frequency and dependence and use of disposable e-cigarette devices,’ the authors say.
‘Because ice flavours represent a hybrid that may contain both cooling and fruity flavouring constituents, it is unclear how these flavours fit into current and future regulatory policies that place differential restrictions across different flavour categories.
‘Further studies of the specific cooling agents and chemical constituents in ice flavoured products and health effects of ice flavoured e-cigarette use are warranted.’
As ice e-cigarettes have only recently entered the US market, the researchers wanted to gauge their appeal and see if they’re linked to other behaviours around vaping and/or smoking among young adults.
For their study, they drew on 344 online survey responses submitted between May and August 2020.
The survey was part of the Happiness & Health Study – a prospective study of health behaviours which originally recruited 3396 ninth grade students in Los Angeles in 2013.
The survey aimed to find out if respondents vaped and if so, which flavour they had used most often in the preceding 30 days – menthol/mint, fruit/sweet or ice.
Respondents, whose average age was 21, were also asked if they smoked regular cigarettes, what symptoms of vaping dependency they had and how often and what type of vaping device they used.
Overall, 168 (49 per cent) reported most often using ice flavours, 60 (17 per cent) menthol/mint and 116 (34 per cent) fruit/sweet.
Compared with the vapers of menthol/mint flavoured e-cigarettes, those vaping ice flavoured e-cigarettes were more likely to report smoking regular cigarettes over the previous 30 days – 31.5 per cent versus 22 per cent.
Ice flavour vapers were more likely to report symptoms of vaping dependence than fruit/sweet flavour vapers (67 per cent versus 43 per cent).
They were also more likely to have started vaping during high school (74 per cent versus 65 per cent), and to report more daily vaping episodes – 11 versus eight.
And they were also more likely than fruit/sweet or menthol/mint flavour vapers to report more vaping days over the past month – 17 versus 12 on average.
The study authors point out that their research relied on recall and didn’t measure nicotine intake, nor did it differentiate between e-cigarettes containing nicotine and those that didn’t.
‘While causality cannot be inferred from this cross sectional study, it is possible that exposure to e-cigarettes in ice flavours may somehow increase nicotine vaping frequency and dependence,’ they say.
One possibility is that the novel combination of flavours in ice e-cigarettes make users more inclined to take a puff, or they’re just a more appealing purchase in vape shops.
‘Previous clinical laboratory studies show that fruit and menthol flavours each independently increase the appeal of e-cigarettes and suppress the aversive qualities of nicotine in young adults by creating perceptions of sweetness and coolness, respectively,’ the authors say.
‘Ice flavours represent a hybrid that may contain both cooling and fruity flavouring constituents.
‘Further studies of the specific cooling agents and chemical constituents in ice flavoured products and the health effects of ice flavoured e-cigarette use are warranted.’
The peer-reviewed study, which was also authored by experts at the University of Nebraska Medical Center, has been published in Tobacco Control.
Earlier this year, a study warned that taking up vaping increases the likelihood that young people will end up smoking traditional cigarettes daily by threefold.
The authors, from UC San Diego, said: ‘Trying e-cigarettes and multiple other tobacco products before age 18 years is strongly associated with later daily cigarette smoking.’
A report ordered by the Department of Health in the UK found that vaping, which is touted as a healthier alternative to smoking, would be a harmful choice unless replacing cigarettes (stock image)
Last year, a UK government-commissioned report found that e-cigarettes can worsen heart disease and lung disorders while the risks posed by inhaling flavouring ingredients are still ‘unknown’.
The report warned users who do not already use tobacco products ‘risk negative effects on their health’ by vaping, although vaping is a better option for traditional smokers than sticking with the cigarettes.
Health threats to bystanders were considered low but people can suffer an increased heart rate from high nicotine exposure, if stood close to someone vaping, the report added.