Health Concerns From A Medic

[Gamer]

Hello, I am an EMT and i vape and i run on a 20hr truck with a Paramedic that smokes. He has an E-Cig but he is worried about a few things and he drives me NUTS talking about this crap. Even though he smokes analogs he gives me the 1,000questions a shift about E-Cigs. Maybe you guys can help me a bit with some of these.

Here we go:
1) E-Cigs and Antifreeze!? He stated that he found some data from the FDA stating that they found a chemical that was present in AntiFreeze also present in E-Cigs. Is this true? What is the chemical? What is the activating property of the chemical? Is it Toxic? What quantity is it harmful if it is toxic?


2) How much are you really getting!? Metered doses? One of the largest gripes that we get into is that he tells me that "Well with those things your not sure how much you are really getting. You are not receiving a metered dose. You are getting different doses each time, determining factors being: how fast you inhale, how long you inhale, strength of E-juice, size of hole, how hot the atty is burning".... I don't really know how to form this into a question haha. Just any info at all would be appreciated. Is there a study of how much an average e-cig puts out?


Thanks in advance guys. I am off to try and catch some Z's ;-)

 

[fishops]

1) E-Cigs and Antifreeze!? He stated that he found some data from the FDA stating that they found a chemical that was present in AntiFreeze also present in E-Cigs. Is this true? What is the chemical? What is the activating property of the chemical? Is it Toxic? What quantity is it harmful if it is toxic?

Propylene Glycol is a main component of most e-juice. It is a type of antifreeze.

It's also used in injected pharmaceuticals, aircraft de-icer, UV tattoo ink, food additive, fog machines and thousands of other uses. In fact, it's an ingredient in those analogs your buddy smokes. He breathes, handles, eats and drinks it every day whether he knows it or not. It won't hurt you.

2) How much are you really getting!? Metered doses? One of the largest gripes that we get into is that he tells me that "Well with those things your not sure how much you are really getting. You are not receiving a metered dose. You are getting different doses each time, determining factors being: how fast you inhale, how long you inhale, strength of E-Juice, size of hole, how hot the atty is burning".... I don't really know how to form this into a question haha. Just any info at all would be appreciated. Is there a study of how much an average e-cig puts out?

The nicotine content and ingredients of e-liquid are stated on the package. You can figure out how much nicotine you're consuming by how much you use. If you vape 2ml a day of 18mg/ml e-liquid, you can safely say you consumed 36mg of nicotine that day. It isn't exactly complex.

Ask your buddy exactly how much nicotine he consumes a day.

 

[justsomeguy]

Antifreeze - Wikipedia, the free encyclopedia

From Wikipedia in regards to Propylene Glycol and Antifreeze:

Propylene glycol, on the other hand, is considerably less toxic and may be labeled as "non-toxic antifreeze." It is used as antifreeze where ethylene glycol would be inappropriate, such as in food-processing systems or in water pipes in homes, as well as numerous other settings. It is also used in food, medicines, and cosmetics, often as a binding agent. Propylene glycol is "generally recognized as safe" by the Food and Drug Administration (FDA) for use in food. However, propylene glycol-based antifreeze should not be considered safe for consumption.

And as far as the nicotine question - I would agree with the above point, the standard shouldn't suddenly be set so high, the standard seems as though it should be to be reasonably safer than analog cigarettes. To add to the above point, I would point out to your friend that factors like "how fast you inhale, how long you inhale" will also affect how much nicotine he is getting out of his smokes. So those concerns are a moot point. As far as the rest, a reasonable counter might be that while the 'metered dose' of both analogs and e-cigs may be quesitonable, at least wiht e-cigs you are relatively certain of what you are inhaling, and what you are not.

A few ingredients in e-liquid (most of which are already in analogs) vs. THOUSANDS of chemical ingredients in analogs.

No contest for me.

 

[Katattack]

Propylene Glycol is a main component of most e-juice. It is a type of antifreeze.

It's also used in injected pharmaceuticals, aircraft de-icer, UV tattoo ink, food additive, fog machines and thousands of other uses. In fact, it's an ingredient in those analogs your buddy smokes. He breathes, handles, eats and drinks it every day whether he knows it or not. It won't hurt you.

Pharmaceuticals intended for inhalation as well. Check out the inactive ingredients on rescue inhalers and nebulizer ampules. Not all use it but many do.
As mentioned..metered doses...just like a cigarette right? (sarc)

Also might want to mention to him that most e-juice contains some water which can also be found in anti-freeze. Could play a mind game on him about it calling water oxidane, dihydrogen monoxide or hydroxylic acid.

 

[Spiker]

Well, everyone knows that cigarettes give a perfectly metered healthy dose of nicotine in each and every puff, and there is no way an ecig can match the precise microgram equivalent delivered in a measured puff of the real thing.

 

[yvilla]

1) E-Cigs and Antifreeze!? He stated that he found some data from the FDA stating that they found a chemical that was present in AntiFreeze also present in E-Cigs. Is this true? What is the chemical? What is the activating property of the chemical? Is it Toxic? What quantity is it harmful if it is toxic?

While I agree with what the other responders said about PG, the truth is that the FDA was NOT referring to propylene glycol in that infamous press release trumpeting the supposed "dangers" of ecigs. Actually, this is a persistent misunderstanding here. The FDA was talking about a tiny amount of DEG (diethylene glycol) when they condemed that one SE cartridge (out of the 18 they tested) as having a "toxic chemical" found in antifreeze. Here, in fact, is a quote from the FDA press release of last year:

"In one sample, the FDA’s analyses detected diethylene glycol, a chemical used in antifreeze that is toxic to humans, and in several other samples, the FDA analyses detected carcinogens, including nitrosamines."

FDA and Public Health Experts Warn About Electronic Cigarettes

So, the FDA's scare tactics have always been about the less than 1% of DEG they found in that one cartridge (and the tiny amount of TSNAs, commensurate with the level found in approved NRT products), and not the PG used as the base ingredient in liquid. Other uninformed or deliberately ignorant opponents of the ecig have complained about the PG in eliquid, but not the FDA.

The FDA could not get away with condemning the ecig use of PG actually, precisely because it is in such common and ubiquitous use, not only in flavoring and foodstuffs, as the other posters have mentioned, but also in literally dozens of FDA approved drug products of all types.

But to be clear, DEG is not an "ingredient" in anybody's liquid. It (and ethylene glycol/EG too) is sometimes found in very low quantities as a contaminent in PG (see the USP standards for PG for more info about this) and that fact may account for its presence in that one cartridge noted in the FDA lab report. It has not been found present in numerous other toxicological analyses of various liquids that have been conducted. I did see one lab report, however, that reported a similarly small amount of EG found in one vendors liquid. Again, not as an "ingredient", but most likely a PG contaminent. Here is a quote from the USP:

"Based on a request from of the Food and Drug Administration (FDA) in February, 2009, USP has revised and strengthened its monographs for four pharmaceutical excipients used in drug formulations-Propylene Glycol, Sorbitol Solution, Sorbitol Sorbitan Solution, and Noncrystallizing Sorbitol Solution. These efforts are to assist in preventing future diethylene glycol (DEG) and ethylene glycol (EG) adulteration.

The proposed revisions to the USP Propylene Glycol, Sorbitol Solution, Sorbitol Sorbitan Solution, and Noncrystallizing Sorbitol Solution standards include limits for DEG and EG, each at a level of not more than 0.10 percent in the Identification test. These revisions are consistent with the recent USP Glycerin monograph revision to help prevent future episodes of pharmaceutical adulterations with these poisonous chemicals."

Hot Topics: USP Propylene Glycol and Sorbitol Solution Information

 

[Dudeman]

Well, everyone knows that cigarettes give a perfectly metered healthy dose of nicotine in each and every puff, and there is no way an ecig can match the precise microgram equivalent delivered in a measured puff of the real thing.

Great answer... lol

Maybe you should ask that guy whats in his cigarettes and see if he can answer THAT question.
I went through this with a guy at work and he couldn't answer it. He googled it that night and came back the next day asking me where he should order a 510 kit from.

 

[SquirrilahFish]

HellO im also an EMT and I vape on my rig all the time! I also get alot of questions, and alot of mis information about ecigs. Looks like these guys already gave u pretty good answers just want to say, sup to a fellow EMTvapr

also Diethylene Glycol is also found in a lot of plastics, the FDA found this in 1 of 19 carts tested, IMO they probally melted a cart

 

[Gamer]

These answers pretty much shut up my partner for the moment. I appreciate all the responses. I do apologize for not using the "Search" function because im sure the answers to these questions were already in the forum. But i was looking for Quick answers with some backing behind them, and not dozens of pages of talk about opinions. I was also out on calls since my first post (12:43 am EST) so there wasn't much time to search and i wanted the answers to show him before we got off this morning.

Thanks again

-Gamer

 

[voltaire]

But to be clear, DEG is not an "ingredient" in anybody's liquid. It (and ethylene glycol/EG too) is sometimes found in very low quantities as a contaminent in PG (see the USP standards for PG for more info about this) and that fact may account for its presence in that one cartridge noted in the FDA lab report. It has not been found present in numerous other toxicological analyses of various liquids that have been conducted. I did see one lab report, however, that reported a similarly small amount of EG found in one vendors liquid. Again, not as an "ingredient", but most likely a PG contaminent.

Some people have speculated that the DEG may have come from the nicotine extraction process from tobacco rather than from the PG. (although I think use of non-pharmaceutical/non-USP/ PG is more likely to be the cause) This is because DEG has been used in tobacco processing as a humectant, though I'm not clear if it is still commonly used or not. According to the link below, "The list of additives released by the tobacco industry in April 1994 does not include DEG".

Here's some interesting related links:
The Cigarette Papers
(this is just one DEG-related part of the whole book "The Cigarette Papers" that's online - it's very interesting, browse through it with the left column)

Legacy Tobacco Documents Library
(this is an example of one of the many tobacco company documents about use of DEG in tobacco processing - it's really hard to read though)

 

[Katattack]

So a contaminant was found not an ingredient.

 

[jj2]

http://www.e-cigarette-forum.com/fo...n-vg-polyethylene-glycol-peg.html#post1100528

Bunch of links are there that might be helpful.

 

[jennlsnoopy]

Great answer... lol

Maybe you should ask that guy whats in his cigarettes and see if he can answer THAT question.
I went through this with a guy at work and he couldn't answer it. He googled it that night and came back the next day asking me where he should order a 510 kit from.

Here's whats in a cigarette: List of additives in cigarettes - Wikipedia, the free encyclopedia

Show this to anyone who questions you. Thats what they should be worried about.

 

[four2109]

Hello, I am an EMT and i Vape and i run on a 20hr truck with a Paramedic that smokes. He has an E-Cig but he is worried about a few things and he drives me NUTS talking about this crap. Even though he smokes analogs he gives me the 1,000questions a shift about E-Cigs. Maybe you guys can help me a bit with some of these.
...
Thanks in advance guys. I am off to try and catch some Z's ;-)

Give him the URL to the forum and let HIM do his own homework!
You go get some Z's. It's not on you to save him or convince him. He has one, let him figure it out and make his own decision. I would enjoy my ecig and change the subject. He's making conversation, you're doing all the work.

 

[Kate51]

jennlsnoopy, that's a good one! Was just going to put it in, you're on the ball.
Gamer, copy the contents of that link jennlsnoopy posted, print it out, shouldn't take more than 40 pages or so, make a book out of it, and next time he lights up ask him what's in his analog. When he looks confused, hand him the book and tell here, do some research. (Maybe you can bait him a bit, just for fun!)
I'll take my nic dose (about 1/20th of his dose), vegetable glycerine, and a little caramel over his kill sticks anyday. Talk about end-of-season soup! I almost made it to my end-of-season, until I found an e-cig. You're doing the right thing, so put the blooter's bias and misinformation out on display so even he can see it. Maybe have a card ready so he can order one forthwith!

 

[miss MiA]

2) How much are you really getting!? Metered doses? One of the largest gripes that we get into is that he tells me that "Well with those things your not sure how much you are really getting. You are not receiving a metered dose. You are getting different doses each time, determining factors being: how fast you inhale, how long you inhale, strength of E-Juice, size of hole, how hot the atty is burning".... I don't really know how to form this into a question haha. Just any info at all would be appreciated. Is there a study of how much an average e-cig puts out?

I never really get why that matters so much to some anyway, beyond choosing an initial liquid strength to try/use. If the strength you're using isn't eliciting any symptoms of taking in too much (nausea, dizziness, racing heartbeat, etc.); and it's keeping cravings at bay... good enough for me! And he could even go ahead and keep stepping down if he wanted and see how low he can go, while still having his cravings satisfied!

Of course I know that's not a sufficient 'measure' for science, but for the individual current user or those wanting/willing to be; and considering that (to be general) nic itself isn't exactly bad for you anyway if you don't have some pre-disposing health condition...

 

[Madame Psychosis]

Or, print/show him the post at the top of this page, from an MD and harm-reduction researcher:
The Rest of the Story: List of Identified, Known Carcinogens in Electronic Cigarettes vs. Conventional Cigarettes, and Which Anti-Smoking Groups are Telling Smokers to Smoke

As far as nicotine intake, like miss MiA said, there are clear signals when one is getting a little too much. It's easier to move up or down in nic with e-cigs because of the ability to mix/purchase different strengths and still satisfy the behavioral desire to simulate smoking. With cigarettes, you can't adjust it like that so easily.

 

[jennlsnoopy]

jennlsnoopy, that's a good one! Was just going to put it in, you're on the ball.
Gamer, copy the contents of that link jennlsnoopy posted, print it out, shouldn't take more than 40 pages or so, make a book out of it, and next time he lights up ask him what's in his analog. When he looks confused, hand him the book and tell here, do some research. (Maybe you can bait him a bit, just for fun!)
I'll take my nic dose (about 1/20th of his dose), vegetable glycerine, and a little caramel over his kill sticks anyday. Talk about end-of-season soup! I almost made it to my end-of-season, until I found an e-cig. You're doing the right thing, so put the blooter's bias and misinformation out on display so even he can see it. Maybe have a card ready so he can order one forthwith!

Also if he has a problem with the PG then you can show him (under P on the list) that he's inhaling it already.

 

[sjohnson]

Heh - the ego of a paramedic at work (Former EMT-B here)

Don't get me wrong, it's the ego that MAKES a medic tick, and makes them so effective in EMS. But socially, they're all alphas or alpha wannabees. He may just be baiting you to make the boredom in-between calls a little more exciting. Coming down off an adrenaline high from that last MVA IS depressing, I've even been prone to make things "exciting" because the crash sucks. You're never more alive than when safely and efficiently saving lives in those inevitable extreme scenarios.

 

[5cardstud]

You might also tell him this: (an average cigarette yields about 1 mg of absorbed nicotine
This is from Wikipedia under nicotine.