A study by JUUL Labs, an electronic cigarette company, and presented before the Society for Research on Nicotine & Tobacco 2019 annual meeting in San Francisco on Saturday has found that some advanced e-cigarettes reduce the exposure to carcinogens.

Specifically, the study found that electronic nicotine delivery systems (ENDS) reduce harmful exposure to addictive nicotine and chemicals known to cause cancer, and present a safe alternative to smoking. The study was based on a clinical analysis of biomarkers of smokers, non-smokers and people who vaped (used electronic cigarettes) using a closed nicotine-salt pod system (NSPS).

“Although addictive, nicotine is not directly responsible for the cancers that are commonly associated with cigarette use; rather it is the harmful constituents that are present in combustible smoke. The more that can be done to eliminate cigarettes, the greater the impact will be on the public health,” Kevin Burns, chief executive officer, JUUL Labs, in a statement.

The researchers tested nine biomarkers (a biological indicator of a condition or disease) for known carcinogens in the urine and blood of adults who used their usual brand of combustible cigarette, completely abstained and those who switched from their usual cigarette brand to the exclusive use of JUUL’s NSPS, which aerosolizes an e-liquid solution through vaporization.

The urine biomarkers for adult smokers who used NSPS for five days and those who didn’t smoke were almost at par, with the NSPS group reporting an aggregate mean reduction of 99.6% relative to the reduction associated with five days of abstention, found the study titled, “Changes in Biomarkers of Exposure Associated with Switching for 5 Days from Combusted Cigarettes to Nicotine Salt Pod System”.

Close to a billion adults smoke tobacco globally, which is a prevalence of 10.7%; of this, 19% are men and 2% are women, according to the Global Adult Tobacco Survey-2 (GATS). In India, an estimated 99.5 million adults smoke cigarettes, bidis, hookah and other forms of smoking tobacco, found the survey done in 2016-17. For the US study, 90 adults were divided into three groups -- people who smoked their usual brand, those who abstained, and the ones who switched to JUUL NSPS -- and tested in a clinical research facility in California for five days.

The subjects were all healthy smokers between the ages of 22 and 62 years, with a minimum 12-month history of smoking 10 or more king-size manufactured, combustible cigarettes each day.

The researchers found equivalent reductions in select short-term biomarkers of exposure between adult smokers who exclusively switched to JUUL products and those who abstained from smoking over a five-day period. “These results support the hypothesis that complete switching from cigarettes to the NSPS may lead to meaningful reductions in multiple key, short-term biomarkers of exposure observed with combustible use,” the study concluded.

“The equivalent reductions in these specific cigarette-related biomarkers across the groups who abstained from smoking and those who used JUUL products reaffirms the role vapor products can have for the adult smoker,” added Burns.

The incomplete switching from cigarettes to NSPS dual-use was not studied. “In contrast to combustible cigarettes, all the bio-markers were significantly reduced in the blood and urine of smokers who switched to any of the NSPS flavours, and the mean percent reduction was similar to the percent reduction seen in the abstinence arm…,” says the study.

A study published on January 30 this year in the medical journal, New England Journal of Medicine, had found e-cigarettes accompanied by behavioural support were almost twice as effective as nicotine replacement treatments in helping smokers to quit tobacco use. Electronic cigarettes are approximately 95% less harmful than smoking cigarettes, according to Public Health England, an executive agency of the UK’s department of health and social care.

The advocacy organizations say it can be seen as a harm-reduced alternative. “This is not to say vaping is safe, it is definitely not recommended to non-smokers, but for those who smoke it is a significantly harm-reduced alternative,” said Samrat Chowdhery, director, Association of Vapers India.

Several de-addiction experts also say it does help in cutting down on cigarette smoking. “I have seen smokers cutting down on cigarette use after the use of e-cigarettes. They are going a step down at least,” says Rajesh Shrivastava, who runs the de-addiction centre, Tapasya Nasha Mukti Kendra in Sector 45, Noida.

First Published: Feb 24, 2019 08:00 IST