Flavored E-Cigarette Side Effects Can Damage Blood Vessel Linings: Study

New research indicates the flavorings used in e-cigarette devices may cause damage to blood vessel cells. 

In a study published on June 14 in Arteriosclerosis, Thrombosis, and Vascular Biology, researchers warn that nine popular flavorings added to electronic cigarette devices may harm endothelial cells and prevent the production of nitric oxide, posing future and long term heart complications.

According to lead author Jessica Fetterman, assistant professor of medicine at Boston University School of Medicine, flavorings approved for e-cigarettes and other tobacco products were found to cause endothelial cell death.

Endothelial cells are the inner lining of blood vessels and lymphatic vessels that carry blood plasma around the body. Endothelial cells are also found on the inner walls of the heart chambers and releases substances that control vascular relaxation and contraction, as well as enzymes that control blood clotting, immune functions and platelet adhesion.

Fetterman and her colleagues exposed endothelial cells to nine different flavorings commonly used in e-cigarette devices and flavored tobacco products sold across the United States. Researchers tested flavorings such as menthol (mint), acetylpyridine (burnt flavor), vanillin (vanilla), cinnameldehyde (cinnamon), eugenol (clove), diacetyl (butter), dimethylpyrazine (strawberry), isoamyl acetate (banana) and eucalyptol (spicy cooling).

The results showed all nine chemicals caused endothelial cell death at the highest level of exposure. When testing cells at low levels of exposure, vanilla, cinnamon, clove and burnt flavor were found to impair nitric oxide production and boosted an inflammatory chemical call interleukin-6, suggesting an increased sensitivity to those specific flavorings.

Researchers suggest that the impairment of nitric oxide creation within the blood vessels can result in prevention of blood flow, increased plaque growth and raise the risk of blood clotting exponentially over long periods of exposure.

Flavored E-Cigarette Concerns

E-cigarette flavorings have become popular among the legalized age for consumption, however companies have been noticed selling products with labels or advertising that closely resembles products for children; such as juice boxes, candy, or cookies. Some of the products have cartoon images and one product is even sold with a lollipop.

On May 1, the U.S. Food and Drug Administration and the Federal Trade Commission (FTC) jointly sent 13 warning letters to manufacturers, distributors, and retailers of e-liquid products used in e-cigarettes that closely resemble candy or other food products intended for children.

The warning letters cited the companies for intentionally using packaging and advertising that appealed to children, which is a violation of the Federal Food, Drug, and Cosmetic Act as well as Section 5 of the Federal Trade Commission Act.

Poison centers nationwide have received thousands of reports of children poisoned after mistakenly consuming e-cigarette liquid. More than 1,400 exposures were logged for the first half of 2014 and liquid nicotine exposures increased 1500% between 2013 and 2015.

Children exposed to liquid nicotine often face serious side effects, requiring medical treatment and hospital admission, and some cases are fatal. The National Poison Data System records indicate that between 2012 and 2017 there were 8,269 liquid nicotine exposures among children under six years of age that were reported to U.S. poison control centers. That averages to nearly 130 calls per month, or four poisoning calls every day.