Carcinogen found in menthol electronic cigarettes

MONDAY, Sept. 16, 2019 (HealthDay News) – While doctors are trying to figure out what causes serious, sudden lung disease in some vapers, new research finds dangerously high levels of a known carcinogen in electronic cigarettes flavored with menthol.

The chemical (pulegone) is used as a menthol and mint flavor, although it has recently been banned in foods, the researchers said.

"If pulegone is not allowed in foods, there is no reason for it to be allowed in electronic cigarettes," said lead researcher Sven-Eric Jordt. He is an associate professor of anesthesiology at the Duke University School of Medicine in Durham, NC.

Because pulegone is known to cause lung and liver cancer in animals, the US Food and Drug Administration banned its use in food in 2018 as a result of pressure from consumer groups, said Jordt.

But the FDA does not regulate the use of pulegone in electronic cigarettes or smokeless tobacco, which are considered safer than tobacco-based cigarettes, he added.

Jordt said that tobacco companies had begun to remove pulegone cigarettes in the 1960s and 1970s because it was an irritant and that consumers did not like it.

This same strategy has not been transferred to e-cigarette companies, which use pulegone because it is much cheaper than other flavors of menthol and mint, explained Jordt.

"Many are small businesses that are probably buying a cheap compound, maybe even a skin oil or lamp oil or something like that," he said. "They simply buy the cheapest thing that they can add to get the flavor."

In response to a series of serious pulmonary infections related to vaping and the growing popularity of electronic cigarettes among teens, the Trump administration announced last week its intention to ban flavored electronic cigarettes.

On Monday, Democrat Andrew Cuomo, governor of New York, said he would use a decree to ban most flavored electronic cigarettes in that state, with the notable exception of the menthol aroma. Cuomo said that he would not ban that flavor, as this could help menthol-smokers quit, but added that it could change in the future. On September 4, Michigan became the first state to ban all flavored electronic cigarettes.

According to Erika Sward, deputy vice president of national advocacy at the American Lung Association, "we have a fundamental failure to protect the public from dangerous chemicals." That's why the FDA needs to step up its efforts and -Cigarettes. "

Sward also noted that e-cigarettes have only been on the market for about a decade, so the long-term effects of vaping are not yet fully known.

"That's what the American Lung Association has sounded the alarm on," she said. "The Wild West has been allowed to exist for far too long, we will see the consequences for decades, so do not use electronic cigarettes."

For the study, Jordt and his colleague, Sairam Jabba, a senior researcher at Duke, analyzed several brands of regular mint cigarettes, three brands of electronic cigarettes and a brand of smokeless tobacco, all containing pulegone.

The researchers compared the pulegone levels in these products with the level of pulegone known to cause cancer in animals.

Electronic cigarettes and smokeless tobacco contained higher levels of pulegone than the FDA considers safe. The researchers found that in regular menthol cigarettes the pulegone level was below the level of danger.

Stanton Glantz is a professor of medicine at the Center for Tobacco Control, Research and Education at the University of California at San Francisco. "This is a disturbing study that highlights the fact that the FDA's persistent refusal to remove menthol from cigarettes and other tobacco products is harming people."

Glantz added that the FDA has announced that it would suspend the sale of menthol electronic cigarettes, but the official policy has not yet been released.

The research letter was published online September 16 in JAMA Internal Medicine.