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Though e-cigarettes are often advertised as being “safer” than traditional cigarettes because they lack tobacco, a number of studies have found that e-cigarettes have other dangerous and potentially toxic ingredients that can have long-term effects on health.

In a recent study published in the scientific journal, Arteriosclerosis, Thrombosis, and Vascular Biology, researchers found that the flavorings used in e-cigarettes could damage blood vessels and, over time, potentially lead to heart damage and cardiovascular disease.

Study Finds E-Cigarette Flavorings Could be Toxic to the Human Heart

For the study, scientists isolated endothelial cells (cells that line blood vessels) from humans and then exposed them in the lab to a variety of e-cigarette flavorings. Scientists tested nine e-cigarette varieties, including banana, butter, cinnamon, clove, eucalyptus, mint, strawberry, vanilla, and “burnt,” which is meant to create a tobacco-like flavor.

Results showed that at high concentrations, all of the flavorings damaged the cells. Five of them, including mint, cinnamon, burnt, vanilla, and clove, interfered with the production of nitric oxide. This is a critical component of cardiovascular health, as it causes blood vessels to dilate when needed so that blood can flow through more easily. A lack of adequate nitric oxide has been linked to an increased risk of heart attack and stroke.

Lead study author Jessica Fetterman told Reuters, “Our study suggests that the flavoring additives, on their own in the absence of the other combustion products or components, cause cardiovascular injury.”

It’s already known that traditional smoking affects endothelial cells, but up until this point, it wasn’t clear whether e-cigarettes might do the same. The researchers caution that this was a small test, and that more research needs to be done on these flavorings to determine their potential impact on human health.

Study Shows Young People Drawn to Sweet Flavors

**The fact that these flavorings may be harmful to health is concerning particularly because they’re often used to entice young users to try e-cigarettes. According to a 2017 study, young people used flavored e-cigarettes more than adults, especially when first starting the habit. They also preferred the sweet flavors.

The researchers surveyed nearly 4,000 school-age and over 5,400 college-age students, as well as over 6,000 young and older adults between 2014 and 2015. They found that most e-cigarette users said their first and “usual” e-cigarettes were flavored, and that “flavors were an especially salient reason to use e-cigarettes.” The researchers concluded that restricting the range of e-cigarette flavors “may benefit youth and young adult prevention efforts.”

FDA and FTC Warn E-Cigarette Companies to Avoid Misleading Marketing Tactics

On a related note, in May 2018, the FDA sent out warning letters to e-cigarette manufacturers, distributors, and retailers warning against “labeling and/or advertising that cause them to resemble kid-friendly food products, such as juice boxes, candy or cookies, some of them with cartoon-like imagery.”

On September 12, the FDA announced they are taking further actions against 1,300 retailers and 5 manufacturers to combat e-cigarette usage among teens.

The FDA stated that the companies should not be using imagery that misleads kids into thinking these products are something they should eat or drink, noting that nicotine consumption can be extremely dangerous for young children.

“Nicotine is highly toxic,” said Acting FTC Chairman Maureen K. Ohlhausen, “and these letters make clear that marketing methods that put kids at risk of nicotine poisoning are unacceptable.”

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