Are we going to need designated drivers for "vapers" now?
A new Yale University study finds that people who used a commercially available electronic cigarette liquid with a relatively high alcohol level had their motor skills significantly impaired — even though they didn't feel like they were "buzzed" from the vaporized booze.
E-cigs have become increasingly popular in recent years as users seek alternatives to traditional tobacco products, which cause cancer. The battery-operated e-cigs vaporize a liquid, which contains nicotine and often flavorings.
"They didn't actually know they were under the influence of alcohol," said Dr. Mehmet Sofuoglu, a professor at the Yale School of Medicine who co-authored the study published in the journal Drug and Alcohol Dependence. "It still influenced their performance."
Several of the study participants ingested enough alcohol via the e-cigs that metabolized booze was detected in their urine.
Sofuoglu said the findings are "worrisome," particularly on the heels of new data showing a dramatic upward spike in the number of middle school and high school students using e-cigarettes. There's also cause for concern, researchers said, because of the popularity among e-cig users of making their own vaping liquids — which can have higher alcohol levels than commercially sold liquids.
Sofuoglu said the study showed how e-cig users, even if they didn't end up having enough detectable alcohol in their urine to trigger a DUI charge, could end up being "intoxicated" and too impaired to drive because of how much "more quickly and efficiently" alcohol affected the brain after people inhaled vaporized booze compared to drinking it.
E-cig vapers who use liquids high in alcohol content may be on the track to "a faster level of dependence" on both alcohol and nicotine, Sofuoglu said.
Of 31 such e-liquids obtained by the Yale researchers for their study, about one-third didn't have any measurable alcohol in them, a paper on the study noted. Almost 40 percent had 0.75 percent or less alcohol content. And another 23 percent had alcohol levels of 1 to 3 percent.
One of the liquids, organic French vanilla, made by Virgin Vapor of California, had a whopping 23.5 percent alcohol content.
Researchers used that liquid to compare its effects with that of another e-liquid made by Virgin Vapor — organic naked vanilla — which had just a 0.4 percent alcohol content.
The 16 participants in the study, who all were traditional cigarette users and social drinkers, were tested on two separate days: one for each of the two different e-cig liquids.
When they were asked a series of questions after their puffing sessions, none of the participants indicated that they felt intoxicating effects from the higher-alcohol e-liquid, the study found. That was true after an initial five-minute session when they were asked to puff just 10 times, and even after a subsequent 20-minute session when they were allowed to puff as much as they wanted.
But the participants then were given a test designed to measure their motor skills. The test required putting a series of metal pins into holes. Participants were tested on placing the pins with their dominant hands, nondominant hands and then both hands, over 30-second periods.
Participants scored markedly worse when they vaped with the high-alcohol liquid than they did when they used the trace-alcohol liquid, according to the study.
And their scores "did get much worse after the [20-minute] free time," noted Sofuoglu.
He said that when people drink alcohol, they often are aware that they are becoming impaired. That doesn't appear to be the case, or is much less so, with vaping e-cig alcohol.
"In this study, they had motor impairment," he said, "but they didn't know they were intoxicated."
Annette Rogers, CEO of Virgin Vapor, said the company uses organic flavors, some of which "come in a base of organic ethyl alcohol as this is commonly used in the flavor industry when extracting flavor from organic base ingredients."
"When we first started our company in 2010, the only flavors available that were suitable for use in e-liquid were ones extracted using organic ethyl alcohol. Since that time and with the help of our chemist, Dr. Marc Foster, we have developed new and better flavors that do not require organic ethyl alcohol as an extraction method," Rogers said. "We prefer flavors that do not contain organic ethyl alcohol because we look to create a product with as few ingredients as possible."
"Due to our ongoing product development and innovation, we only have a few flavors that we still carry that are extracted using organic ethyl alcohol, because of their long-standing popularity but most do not. All of our ingredients are listed on every bottle of Virgin Vapor liquid, including organic ethyl alcohol when present," she said.
Last week, the federal Centers for Disease Control and Prevention released data showing a very large increase in the number of middle school and high school students using e-cigs, a rise that has tracked, and may be related to an explosion in advertising for the devices, according to the agency.
In 2011, the CDC said, ad spending on e-cigs stood at $6.4 million annually, and 280,000 middle and high school students reported having used the devices in the past 30 days.
As of 2014, the number of such students who reported using the devices had risen to 2.49 million — up from 800,000 in 2013. The ad spending on e-cigs had reached $115 million by 2014.
The CDC noted that "about 69 percent of middle and high school students were exposed to e-cigarette advertisements in retail stores, on the Internet, in magazines/newspapers, or on TV/movies."
"Exposure to e-cigarette advertisements may be contributing to increases in e-cigarette use among youth," the CDC said.