These days it’s nearly unfathomable to imagine a marathoner crossing the finish line, only to light up cigarette. And even ordinary exercisers may subject themselves to dirty looks if they puff near their gym. But what if they’re smoking an e-cigarette?
Introduced to the public as a product with the potential to shield smokers from the dangerous effects of Marlboros, e-cigarettes are marketed as a way to get your nicotine fix without inhaling all that lung-blackening smoke that’s been directly linked to cancer and heart disease.
But it turns out e-cigarette vapors may be full of suspected lung irritants, chemicals with addictive properties that could contribute to heart troubles down the road, says Dr. Norman Edelman, senior consultant for scientific affairs at the American Lung Association and a professor of preventive medicine and internal medicine at Stony Brook University on Long Island.
Here’s the scoop on how this controversial device could impact your health — and your workouts.
The “Health Halo” Surrounding E-Cigarettes
According to the U.S. Centers for Disease Control and Prevention (CDC), nearly 250,000 youths who had never before smoked tried e-cigs in 2013 — a threefold increase since 2011. What’s more, about three out of every four teen smokers goes on to smoke as an adult, due to their addiction to nicotine (the primary ingredient in e-cigs), according to the CDC.
“We don’t know what’s in [the e-cigarette vapors], because they are not regulated…”
Young and otherwise healthy people might be reaching for an electronic fix for numerous reasons, including the potential for nicotine to reduce appetite, boost mood or increase their heart rate and alertness.
Nicotine is also a known stimulant, and has been shown in studies to have a positive effect on endurance, according to Dr. Robert E. Sallis, co-director of the Sports Medicine Fellowship at Kaiser Permanente.
“At best it might be described as weakly ergogenic, or performance enhancing,” Sallis says. “There are some pretty good studies that show modest improvements in things like time-to-exhaustion, that people perceive that exercise is not as difficult and that it’s a little bit of a stimulating effect that wakes you up and prepares you for a competition.”
Yet, evidence is emerging indicating that e-cigarette vapors might not be all that innocent.
“We don’t know what’s in [the e-cigarette vapors], because they are not regulated and the manufacturers are not yet required to tell what’s in the solution,” Edelman says.
Bad News for Your Lungs
E-cigs may not contain real smoke, but they can still do a number on your lungs. “They do cause an inflammation,” Edelman says. “It would be similar to smoking, only less…and you might get a chronic cough, or raise a little [mucus].”
While casual exercisers might not notice any difference in lung capacity, intense gym-goers might feel the effects of an e-cig. “For people who exercise to the [full] capacity of their lungs, then of course any decrease in lung function will impair your ability to exercise,” Edelman says.
“Lack of production oversight for any inhaled product raises a concern for impurities or contaminates,” says Dr. Andrew Nickels, Allergy and Immunology Fellow at the Mayo Clinic in Rochester, Minnesota. Though he has not yet had a patient complain of e-cig allergies, “From an allergy standpoint, additives such as flavors, could be a source of allergic reactions.”
Allergies release inflammatory chemicals called histamines, which can make it difficult to breathe during a tough workout, and could even induce the onset of asthma symptoms.
In or out of the gym, there’s more cause for concern: Early research on human cells has indicated that e-cigarette vapor may act on lung cells in a way similar to cigarette smoke, pointing to a potential link between vaping and an increased risk for lung cancer.
Harmful to Your Heart
Unsurprisingly, quitting smoking has been proven to improve health and, more specifically, increase an individual’s overall level of fitness, according to Edelman. “It’s not clear if it’s because the lungs are better [after quitting] or [blood] circulation is better, but the bottom line is: Smoking impairs fitness and we know because people stop smoking and fitness improves,” Edelman says. But whether this is true of e-cigs remains to be seen.
“Nicotine is a poison and you don’t have to smoke or inhale that much to get nicotine poisoning.”
If smoking’s impact on blood flow to the body’s muscles and heart is to blame for impeding fitness, nicotine may be at fault — and that’s an indicator that e-cigarettes could carry a similar physical burden. “E-cigarettes irritate the lungs less than regular cigarettes, but they deliver as much or more nicotine, and nicotine constricts blood vessels,” Edelman says.
Because the U.S. Food and Drug Administration does not yet regulate e-cigarettes, some brands are suspected to contain levels of nicotine significantly higher than what is found in an old-school pack of smokes.
“Nicotine is a poison and you don’t have to smoke or inhale that much to get nicotine poisoning,” Edelman says. “The fact that people may be using very high doses is a concern. It’s likely to have an effect on the circulatory system.”
On top of that, a study from Brown University recently discovered that prolonged exposure to nicotine may be linked to an increased risk for atherosclerosis, or a hardening of the arteries that can cause heart attacks.
In other words, perhaps we should think of smoking e-cigarettes the same way we think about eating cheeseburgers. Yes, they can be enjoyable. And sure, they aren’t linked as strongly to an increased risk of death as other tobacco products. But they’re linked to some potentially dangerous health problems that could affect you down the road.
A Call for More Research and Regulation
A recent study published in the journal Nicotine and Tobacco Research revealed that while secondhand exposure to e-cigarettes is likely less harmful than tobacco smoke, it still exposes bystanders to some levels of nicotine. Until more research can be done, organizations like the ALA are strongly urging the FDA to “move and move quickly” to regulate e-cigarettes the same way they do tobacco products, according to Edelman. In the meantime, he says he’ll continue to advise patients to steer clear of the e-cig.
“If they want to use it for smoking cessation I will say there are tested, FDA-approved products that are useful and why use something that hasn’t been tested?” Edelman says. And as for how e-cigs could impact fitness, “There are theoretical reasons to believe that e-cigarettes will impair performance in a manner similar to tobacco cigarettes, but that’s as far as we know at the moment.”