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Study Claims That E-Cigarettes Could Cause Bladder Cancer

A report presented at the recent American Urological Association’s Annual Meeting claimed that the use of electronic cigarettes can lead to increased risks of bladder cancer. In a small pilot study, researchers at the Vanderbilt-Ingram Cancer Center in Nashville found two of the five compounds linked to bladder cancer in the urine of e-cigarette users.

bladder-cancer-e-cigsNews of the potential link between vaping and bladder cancer has been making the rounds online for the past couple of weeks, with most major media outlets warning of the dangers of electronic cigarettes, and how they are not as harmless as everyone thinks. They’re actually not, but as long as they are safer than smoking tobacco, I’m still pretty happy. Anyway, bladder cancer is the latest thing you have to worry about if you happen to be using e-cigarettes, which is pretty surprising, considering respiratory and cardiac problems are at the top of most people’s list of concerns when it comes to inhaling nicotine and vapor and/or smoke.

Everyone’s been referring to the research presented at the AUA meeting as a study, but it’s not that at all. At least not yet, because it hasn’t been peer reviewed or published in any scientific journal, so right now we are talking about an abstract presented during the conference. Nobody knows the methodology used during testing, the levels of carcinogens detected, or any details apart from what was presented during the recent event, and we all know how sometimes the result of studies can be spun into something they’re not.

The first thing you should know is that this was a small pilot study, and by small I mean it was done on just 23 test subjects, 13 e-cigarette smokers and 10 non-smokers. That’s a reasonable number if you’re only trying to form a hypothesis, but you can’t go out and present it as an actual study, which is exactly what newspapers and large news sites did. Some literally put “chemicals in vaping trigger bladder cancer” in their title, which is just mind-blowing.

After analyzing samples from all  participants, the researchers found that urine from 92 percent of e-cigarette users tested positive for two of the five carcinogenic compounds – o-toluidine and 2-naphthylamine – and concluded that e-cigarette smokers have a high bladder cancer risk. Granted, 92% is a scary percentage, considering that none of the samples from the non-smokers tested positive for the two substances. Or at least, that’s what the authors claim, because while the biomarkers for the e-cigarette users were included in the report press release, those for the non-smokers were not. But, I guess that makes sense if they all tested negative, right?

Here’s where things get a bit weird, though. Dr. Farsalinos, a long-time supporter of electronic cigarettes as a safer alternative to smoking, tackled this controversial report, in an article on his website, E-Cigarette Research. Among other things, he quotes Stephen S Hecht, a well-known expert of biomarkers of smoking exposure, who wrote a review on human urinary carcinogen biomarkers in 2002. In it, he states:

“In one study, smokers excreted 6.3 ± 3.7 μg/ 24 h of 2-toluidine while levels in non-smokers were 4.1 ± 3.2 μg/24 h, not significantly different from smokers (93). Another investigation reported higher levels of 2-toluidine in smokers than in non-smokers (94). There appear to be significant sources of human uptake of 2-toluidine in addition to cigarette smoke. Smokers excreted similar amounts of 4-aminobiphenyl (78.6 ± 85.2 ng/24 h) as non-smokers (68.1 ± 91.5 ng/24 h), and similar amounts of 2-naphthylamine (84.5 ± 102.7 ng/24 h) as non-smokers (120.8 ± 279.2) (95).”

So an expert on smoking-related biomarkers found that smokers and non-smokers excreted comparable levels of chemicals reportedly linked to bladder cancer, in their urine, yet this new report either found ZERO o-toluidine and 2-naphthylamine in the urine of non-smokers it tested, or just doesn’t want to reveal their biomarker data, for some reason. Doesn’t enyone find that a bit bizarre, that the results of this test contradict Hecht’s findings completely?

Furthermore, scientists apparently found it of no importance to compare the biomarkers of e-cigarette users to those of cigarette smokers. After all, vaping has never been about zero risks, just about considerably lower risks compared to smoking tobacco. But warning that e-cigarette users were at a higher risk of getting bladder cancer than non-smokers – despite never actually showing the correlation in a direct manner – was more important.

“These studies raise new concerns about the harmful impact of e-cigarettes on bladder cancer,” study author, Dr. Sam Chang, said. “We’ve known traditional smoking raises bladder cancer risk, and given the surge in popularity of e-cigarettes, it’s imperative we uncover any potential links to e-cigarette smoke and bladder cancer.”

How about you do that then, doctor, instead of attacking vaping without any concrete evidence?

The bottom line is that while this story might sound scary, there is a lot of misinformation here. I am not saying that electronic cigarettes are not linked to bladder cancer, but I am pretty sure that the link isn’t nearly as strong as that between bladder cancer and smoking. So unless you can quit both vaping and smoking right now (which would be great, by the way), I would say you’re better of with e-cigs than tobacco cigarettes.

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