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The vaping and hearing loss controversy

Contributed by | Thursday, March 10th, 2016

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Everyone knows smoking is hazardous to your health. Some have turned to e-cigarettes, also known as vaping, as an alternative. But studies have shown smoking cigarettes can cause hearing loss, so could vaping be harmful to your hearing as well?

No smoking, biking or skateboarding sign on a building
Vaping has become a common substitute
for smoking. The side effects may include
hearing loss.

A recent article in the Sacramento Bee claimed just that. Unfortunately since the article didn’t present any study evidence to support the assertion, those in the vaping community were outraged. At Healthy Hearing, we took note of the controversy and decided to explore the issue further.

On one side of the fence, health experts at best urge caution when using e-cigarettes; at worst e-cigarettes are demonized as a health risk as bad as smoking. One the other side of the fence, you have those who already use e-cigarettes as well as those in the e-cigarette business, who (predictably) will tell you that e-cigarettes are perfectly safe. But does the truth lie somewhere in between?

To answer the question, Healthy Hearing decided to do its own exploration of some of the aspects of e-cigarettes, and leave the reader to decide for yourself whether vaping is a safe choice and just how it might affect hearing in the long term. There is much we don’t know, but here are some things we do know:

One of the problems we found is that since e-cigarettes are a relatively recent invention, they haven’t been on the market long enough to amass enough data as to their potential health effects. What that leaves us with is this:

  1. Anecdotal evidence such as one musician’s assertion that vaping caused his (temporary) hearing loss
  2. The potential for health threats based on the similarities to traditional cigarettes and,
  3. The unknown health risks from ingredients in e-cigarettes which are as yet unregulated and unchecked.

First, what are e-cigarettes? Put simply, e-cigarettes are devices that allow users to inhale a vapor containing varying levels of nicotine, along with other substances. They are battery operated and use a heating element to heat up a substance called e-juice, which is contained in a cartridge. The vapor is then released and inhaled by the user. There are more than 500 brands and 7,700 flavors of e-cigarettes currently on the market, yet no FDA regulations, oversight or safety checks determining what exactly is in them.

Because of this lack of oversight or regulation, at this point it is impossible for healthcare professionals or consumers to know what short term or long term affects e-cigarettes might have on certain aspects of your health, including hearing.

Let’s start with the nicotine, a substance also found in regular cigarettes. The problem is that although some e-cigarette cartridges contain no nicotine, others contain nicotine in varying amounts, from a little to a lot. Nicotine is an addictive substance that tightens your blood vessels, including the ones in your ears. This restricts the blood flow oxygen to the inner ear, which leads to damage in the tiny hair cells in the cochlea that translate sound vibrations into electrical impulses for the brain.

Another reason nicotine is also a major concern is the e-cigarettes give you the ability to “dial up” the level of nicotine. Vaping websites are full of tips and tricks on how to get the best “throat hit," or nicotine kick, and how to increase the amount of nicotine you are getting if you are not satisfied.

At this time there is no FDA regulation or oversight to ensure the level of nicotine reported on the cartridge label is accurate. As a matter of fact, a study done in 2014 found there was often a significant difference in the amount of nicotine present in the cartridge and what was presented on the label.

But you can always choose a zero nicotine option, which should be trouble free, right? Not necessarily.

Even if you go with the zero nicotine option, the e-juice bears examination. The e-juice is what gives the e-cigarette its “flavor”, and contains at the very least a mixture of flavorings, colorings, other unknown chemicals and a substance called propylene glycol.

Propylene glycol is an alcohol-based solvent that, while not having yet been studied in terms of its use in e-cigarettes, has been studied in relation to products such as ear drops. Research has proven that when used topically, propylene glycol is ototoxic (i.e. harmful to the inner ear).

Unfortunately the e-juice, with enticing flavors like Gummy Bear and Sweet Tart, is also what makes e-cigarettes appealing for young people.

And young people are taking up the e-cigarette habit at an alarming rate. The use of e-cigarettes among teens, more than tripled between 2013 and 2014, according to data published by the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration’s Center for Tobacco Products. And since studies have shown mechanisms within the hearing nerve are not fully developed until late adolescence, the hearing nerve pathways of teens are particularly vulnerable to any toxins such as nicotine.

Why are so many teens turning to vaping? In addition to slick marketing campaigns targeting the younger generation, the internet makes it all too easy for teens to access e-cigarettes. E-cigarettes are not legally allowed to be sold to anyone under the age of 18, yet anyone can go online and purchase e-cigarette products or equipment simply by checking a box claiming they are 18.

Some claim that e-cigarettes are a safer alternative to cigarettes, and can even help individuals stop smoking. The jury is still out on that as well. While we can’t tell you what to do, if you’re not already a smoker it may be best not to start using e-cigarettes in the first place, based on the potential for addiction. And don’t forget the other chemicals contained in them are as yet unregulated by the FDA. But if you do vape, and experience symptoms such as blockage, ear pressure, hearing loss or tinnitus, stop vaping immediately and consult an ENT or hearing healthcare professional.

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