Čeprav za e-cigareto trdimo, da je vsaj za 95 % manj škodljiva od tobačne cigarete, to še ne pomeni, da je popolnoma neškodljiva. Pretiravanje nikakor ni priporočljivo, ne glede na to, ali govorimo o e-cigareti ali katerikoli drugi stvari. Verjetno bi se strinjali, da ena skodelica kave na dan ne škodi preveč. 10 skodelic kave na dan pa verjetno ni najbolj v redu. Takšnih in podobnih primerov bi lahko naštevali v nedogled. Z e-cigareto ni nič drugače.
Podobnega mnenja je tudi eden izmed vodilnih raziskovalcev na področju e-cigaret dr. Konstantinos Farsalinos, ki smo vprašali za mnenje. Zanimal nas je predvsem njegov komentar v članku – What do scientists think about vaping? – Konstantinos Farsalinos at Vapexpo 2016, Paris. Dr. Farsalinos poudarja, da 95 % manjša škodljivost najverjetneje ne velja za vse načine uporabe e-cigarete, ker je ta številka izpeljana iz raziskav, narejenih, ko DTL metoda vejpanja (neposredno v pljuča oz direct to lung) še ni obstajala. V času teh raziskav je bila povprečna dnevna poraba e-tekočine 3–4 ml/dan z MTL načinom uporabe (iz ust v pljuča oz mouth to lung), z osvojitvijo DTL načina uporabe, pa se je ta poraba v ekstremnih primerih dvignila tudi na 30 ml/dan in več, kar pa je zanj in tudi za vse nas pri ZVS zaskrbljujoče. Dr. Farsalinos tako priporoča vejperjem, da stopnje nikotina v e-tekočinah ne znižujejo prehitro, ker s tem v večini primerov le povečajo dnevno porabo e-tekočine, posledično pa tudi vnos potencialno škodljivih snovi, dnevni vnos nikotina v telo pa ostane isti. Že iz prejšnjih pogovorov z zdravnikom si je vredno zapomniti, da potencialne škode našemu telesu ne povzroča nikotin, ampak vse druge potencialno škodljive snovi, ki so v e-tekočini ali pa ki nastanejo pri samem procesu uparjanja. Dr. Farsalinos pravi tudi, da je vsakršen način uporabe, ne glede na količino porabljene e-tekočine, najverjetneje manj škodljiva kot kajenje tobačnih cigaret, vendar pa ne smemo prezreti dejstva, da je veliko podjetij, ki se ukvarjajo s proizvodnjo in mešanjem e-tekočin neodgovornih, z nizkimi standardi kakovosti, kar pomeni, da tekočine proizvajajo le na podlagi okusa, ne polagajo pa zadostne pozornosti na varne sestavine. To pa je tudi razlog, zaradi katerega ZVS in velika večina vejperjev zahteva ter pozdravlja določene ustrezne državne regulacije na tem področju.
Za ponazoritev problematike prekomerne dnevne porabe e-tekočine, ki se predvsem navezuje na način uporabe, nam je dr. Farsalinos posredoval tabelo iz katere je na primeru formaldehida razvidno, da dnevna poraba e-tekočine lahko določa tveganje za zdravje. Formaldehid je toksična, alergena, kancerogena in mutagena snov, ki je prisotna pravzaprav povsod. V naravi, domu, pohištvu, tobačni cigareti, e-tekočini ipd.
Če je bilo zaznati pri testu neke e-tekočine pri porabljenih 3 ml/dan (MTL način uporabe) 423,8 ug formaldehida je to še vedno precej manj v primerjavi s pokajenih 20 tobačnih cigaret na dan, kjer je vrednost formaldehida 1480 ug. Pri porabi 12 ml na dan (DTL način uporabe) testne e-tekočine pa se sprosti 1695,2 ug formaldehida, kar je pa že pravzaprav več v primerjavi s pokajenih 20 tobačnih cigaret na dan. 12ml/dan količina formaldehida je še vedno pod varno dnevno količino, ki je določila SZO – 2000 ug. Vsekakor je treba poudariti, da tukaj govorimo le o formaldehidu, ki je skupen e-tekočini in tobačni cigareti. Z eno pokajeno navadno, klasično cigareto vnesemo v telo še preko 4.000 drugih škodljivih snovi, med katerimi je več kot 60 znanih rakotvornih, ki jih v e-tekočini načeloma ni.
Če strnemo misli …
Da bo e-cigareta res vsaj 95% manj škodljiva od tobačne toplo priporočamo MTL način uporabe, s katerim boste porabili bistveno manj e-tekočine. Na ta način boste v telo vnesli bistveno manj morebitnih škodljivih ali potencialno škodljivih snovi, ki jih lahko vsebujejo e-tekočine oz. ki lahko pri e-tekočinah nastanejo ob procesu uparjanja. Poleg tega boste z bistveno manjšo porabo e-tekočine tudi bistveno prihranili.
ZVS vprašanje #1:
Hello mr. Farsalinos
We in our association are debating over this article:
What do scientists think? – Konstantinos Farsalinos at Vapexpo 2016, Paris
According to an article you said on Vapexpo:
“The message I want to pass to vapers is that your consumption level defines the risk: the more you consume e-liquid, the more you will be exposed to toxicity, nicotine is no danger. Direct lung inhalation is pleasant but a risky pattern. At least you are aware about the risk”.
What this actually mean? That M2L is 95% safer than smoking cigarettes and D2L can be as harmful as smoking cigarettes? I am referring to this graph:
We have D2L vapers who vape 30ml/day low NIC, high flavoured e-liquids (30%) @ 100W (0.2 – 0.8 Ohm) and we have M2L vapers who vape 5ml/day higher NIC, unflavoured e-liquids @ 8W – 12W (above 1 Ohm) and we are constantly in “war” who is safer and how much safer is one method of vaping over another.
Can you please put us in more scientific perspective?
Thank you for your answer in advance and sorry for bothering you.
Dr. Farsalinos odgovor #1:
Sorry for not been able to reply previously, and now it is 3am and i need to sleep. I will get back to you tomorrow or the day after (tomorrow i return back to Greece from India). But, i will say something and give you some time to think.
Three years ago, the surveys on vapers identified an average daily consumption of 3-4ml per day.
Can you tell me of one consumer product (anything) for which a consumption 7-times higher than average would not be associated with some harmful effects? Do you think that if you drink 7 times more water than average there will be no potential risks? What about eating 7 times higher amounts of anything (fruits, meat, sweets, whatever)? Is it normal for a daily consumption of anything to be 7 times higher than the average value of just 3 years ago?
I will let you think about it, and once i get back to Greece we will discuss it further. Please send me a reminder email.
The graph you send me is absolutely accurate, but do not forget that formaldehyde is 1 of the many toxins that exist in tobacco cigarettes. So, equal or higher levels of 1 toxicant in e-cigs compared to smoking does not necessarily mean that the whole risk is equal or higher.
Konstantinos Farsalinos, M.D.
Onassis Cardiac Surgery Center, Athens Greece
University of Patras, Greece
Tel nr: +30 6977 45 48 37
ZVS vprašanje #2:
Hello mr. Farsalinos and thank you for your reply.
I perfectly understand you and I agree with you. I also think that 20ml/day or 30ml/day or even 15ml/day e-liquid is too much. My opinion was ever that D2L is more dangerous than M2L but I am a person who view vaping and risks of vaping in absolute terms from health point of view but many vapers don’t. They always say that they are not smoking and that’s a good thing, right? And in my honest opinion probably is… They say that vaping is 95% safer than smoking in general and their method (D2L) is in 95% range and my method (M2L) is in 97% range… Not a big difference and who I am to say otherwise to them?
But in the same time I am also worried. Why? Because of the future of vaping industry and the current smokers which can be “saved” by vaping in the future. I am afraid that so much of daily e-liquid consumption (in my opinion this the result of D2L vaping) will lead to some diseases (maybe even deaths) in the future, maybe not so serious diseases (and as much deaths) as cigarette smoking but some diseases (I’m just speculating I am not a doctor nor any kind of scientist). And I am afraid that these hypothetical diseases can lead to an end of vaping industry. We all know how desperate are anti-smoking (now they are also anti-vaping) and public health organizations in finding the evidence which can prove harmfulness of vaping and this can be an answer to their prayers. I don’t know. What do you think?
I prefer M2L vaping because I think that this method of vaping can be pretty much close to harmless. I personally vape unflavoured (maybe I’m too cautious), 100% VG (diluted with distilled water) e-liquids at low wattages (7 – 12 Watts) and on above 1 Ohm coils, I prefer Kanthal wire because I think is the safest wire. My daily consumption is about 5ml (+- 1ml) with 0,7mg/ml NIC and I don’t want to go with higher NIC levels because then the vapour is too much peppery and bittery (there is no flavours in my e-liquid so they can’t mask a peppery taste of NIC). In our vaping association (ZVS) I am the most stubborn, cautious and sometimes paranoid vaper. We have vapers who vape @ 150 Watts all the time, they’re mixing high flavored (even 30%) low NIC juices and consuming from 15 – 30 ml/day of e-liquids but before vaping they were very heavy smokers (up to 3 packs/day) and vaping is probably the best thing that happened in their lives so I don’t judge them (vaping probably save my life too) but I silently suppose that’s not a very good way of vaping… Today one of our members asked: “Why nobody tell us what is an acceptable daily e-liquid consumption?”. I and a couple of other members said that nobody can’t tell us that but we think up to 5ml is probably not too much. Others said 10ml is OK. Third said you are not smoking so you are fine with every quantity… And then we started to argue who is right. Debates like that are in our association almost regular. Can you please give us some advice on that one?
About that graph and formaldehyde. We in our association are concerned that somebody from public health who is anti-vaping propagandanist or some reporter who loves anti-vaping sensationalism will see this graph and soon we will have new first-page hammer titles like: “Even top vaping scientist recognizes dangers of formaldehyde in e-cigarettes!” or “Vaping has the same levels of formaldehyde as smoking!” or “There is a proof that formaldehyde is dangerous in e-cigarettes!”. What is your opinion on that?
Sorry mr. Farsalinos for long email and I hope I will receive your reply soon.
Our association is very thankful for what you’ve done and what you are doing for vaping.
Dr. Farsalinos odgovor #2:
That is the main problems with vapers. They think that the 95% less risk applies similarly to them (using 20 or 30ml per day) and to those using 4-5ml per day. I doubt this will be the case.
Moreover, the vast majority of DLI users quit smoking when D2L did not even exist. And they were fine with M2L vaping and the devices of that time. However, they have just transitioned to a new pattern and this is irrelevant to smoking cessation.
If you give a smoker an EC to do DLI, they will start coughing like crazy. Do you think they will be able to quit smoking when they see such a reaction. They will mostlikely consider that e-cig is not for them and they will just abandon it. I have witnessed such cases.
This is another typicalcase showing how stupid the e-cig industry is. Instead of realizing that the biggest market (by far) is the number of smokers who have not switched, they are competing who will get the most wattage which is relevant to established vapers but totally irrelevant to smokers. To give you an example, in the EU in late 2014, the proportion of smokers who were using e-cigs daily was 2.3%. Of course now there will be more, but how many? 4%? 5%? That is nothing compared to the 95-98% of smokers who are not using e-cigs.
So, let them compete for the DLI devices and atomizers, and when the tobacco industry will prevail in the whole market, then they will start complaining… That is truly unfortunate, but they should blame themselves only.
As for the graph, i did not mention anything about danger and i did not discuss anything about harms. I just presented the levels, and it is true that the more you vape the more you will be exposed to formaldehyde (and in many case, more than what you get from cigarettes). I cannot just hide it, and there is no reason to hide it.
Konstantinos Farsalinos, M.D.
Onassis Cardiac Surgery Center, Athens Greece
University of Patras, Greece
Tel nr: +30 6977 45 48 37
ZVS vprašanje #3:
Thank you mr. Farsalinos.
What do you think how much less riskier will be vaping in comparison to smoking for D2L, high consumption (lets say 20ml/day), high flavoured vapers?
Thank you for your answer in advance.
Dr. Farsalinos odgovor #3:
To be honest I have no Idea. I consider vaping 20 and 30ml per day as extreme. So, it is hard to tell. Also, flavors are currently the biggest unknown. This does not mean they are dangerous, but we have no idea about many of the flavoring compounds.
To clarify my position, my intention is not to judge anyone or force him to vape as I suggest. But the problem is that they do not make informed choices. Vapers should be informed, should understand the problem of consumption and then they should decide what to do.
ZVS vprašanje #4:
Thank you. But it’s still far less harmful than smoking isn’t? I am worried for few of my friends in association which are extreme vapers as you said.
Dr. Farsalinos odgovor #4:
Rok, let’s be honest.
Most e-cig companies are totally irresponsible, have no quality criteria in liquid production and only make liquids based on flavor perception. The majority have no idea what they are doing. I do not trust the current market.
In that perspective, i suppose it is safer but none knows what exactly these people (who use high flavors and extreme levels of consumption) are vaping.
ZVS vprašanje #5:
Hello again mr. Farsalinos.
Do you mind if I publish our conversation somewhere where everyone can see it? On public blogs, forums, etc.?
Sorry to bother you again.
Dr. Farsalinos odgovor #5:
No problem Rok.
I am sure many vapers will not like it, but my responsibility is to inform people and not to say only things they like.
So, i am fine with this.
Thank you very much.
Keep up the good work.