The emergence of electronic cigarettes (e-cigs) on the market several years ago as an alternative to traditional tobacco cigarettes — and a potential aid to help smokers wanting to kick the habit — has quickly ballooned into what medical experts say is a public health problem in urgent need of regulation. “The general perception among the public is that e-cigs are ‘safer’ than cigarettes. The reality is that the industry is changing so fast that usage is outpacing the rate of our scientific understanding,” says Peter Shields, MD, deputy director of The Ohio State University Comprehensive Cancer Center and a thoracic oncologist at The James Cancer Hospital and Solove Research Institute. “It’s becoming a public health crisis we should all take very seriously from a general lung health, cancer risk and addiction perspective. E-cigs may be safer than smoking, but that is not the same as safe, and we need to know how unsafe they are. The recent outbreak for serious lung effects and deaths linked to vaping shows us how serious the adverse impacts can be.” Rates of e-cig product usage — also known as vapes, e-hookahs, vape pens, tank systems, mods and electronic nicotine delivery systems (ENDS) — has risen at alarming speeds, especially among youth, so that more are using e-cigs than smoking cigarettes. How e-cig use will affect developing adolescent brains as well as long-term health impacts are unknown. Limited data exists confirming whether e-cigs help current smokers quit or are more effective than nicotine replacement therapy. “What is seen in the general population is that many smokers do not quit and many add e-cig use to their smoking. If e-cigs are not helping adult smokers quit, then there is strong rationale to ban them, in large part because we do not know their health consequences,” adds Shields. E-cigs work by heating a liquid to produce an aerosol that users inhale into their lungs. In August 2016, the U.S. Food and Drug Administration was granted regulatory power over e-cig design but data is urgently needed to justify industry regulation. “Many people are using e-cigs not just for nicotine but to inhale other drugs like THC. It is this latter use that is likely causing the outbreak of serious lung toxicity,” says Shields. Many e-cig users have found ways to modify these devices to deliver higher levels of nicotine and THC liquids, which Shields says is concerning because the health impact of heating and then inhaling these multi-ingredient compound liquids (and associated chemicals) is unknown. The U.S. Centers for Disease Control and Prevention (CDC) only recently identified the outbreak of serious lung injury related to vaping. As of late October 2019, more than 1,600 vaping-related lung injuries and dozens of deaths had been reported across 49 states. Researchers at Ohio State are actively working with the CDC and others to find out the cause. E-cigs research at Ohio State Researchers from various disciplines across The Ohio State University are conducting tobacco research studies to help put science behind the FDA’s regulation of all tobacco products, including e-cig devices. These studies include people who are vaping THC and other drugs. One study examines the health impact of e-cig devices and other tobacco products. Researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) are using tiny cameras to look inside the lungs of e-cig users to evaluate and measure changes in inflammation. Blood and urine samples are also collected to evaluate circulating markers of inflammation. Volunteers for the study are still needed, and those who complete the bronchoscopy and the follow-up visit are compensated for their time. Healthy never smokers, e-cig users, cigarette smokers and THC vapers (including medical marijuana) between ages 18-45 are eligible to participate in the study. Subjects will be paid for their participation. Numerous mechanisms are in place to maintain confidentiality of study participants. The OSUCCC – James research team recently reported data from this ongoing study showing that even short-term e-cig use results in inflammation in the lung. Shields says any level of cellular inflammation correlated with e-cig use is concerning because the biological and health effects of e-cig constituents such as propylene glycol and vegetable glycerine — while “generally regarded as safe” by the FDA when used in foods and cosmetics — are unknown when heated and inhaled with e-cigs. “The implication of this study is that longer-term use, increased daily use, and the addition of flavors and nicotine may promote additional inflammation,” says Shields. Recruitment is ongoing for e-cig and THC vaping studies at the OSUCCC – James. For more information about this and other tobacco product studies, visit go.osu.edu/tobacco-research or contact 844-744-2447 or Ecig-study@osumc.edu.