Can I smoke or vape with interstitial cystitis?
It is an undeniable fact that the toxins found in cigarette smoke (tobacco) can be lethal. It contains more than 7,000 chemicals, including 69 known cancer-causing compounds, such as formaldehye, ammonia, cyanide, arsenic, acetone, lead, methanol, DDT (1) and several pesticides (2). These chemicals pass through the lungs, into the bloodstream and to the kidneys where they are collected in the urine. It comes as no surprise that tobacco use is the number one cause of bladder cancer. For IC patients, these chemicals are also well known to trigger bladder irritation and IC flares. Sadly, researchers have also these toxins in the urine of infants and children living in the homes of tobacco smokers. (3)
E-cigarette manufacturers may proclaim that they just produce “water vapor” and are less harmful than tobacco, but this is deceptive advertising. Studies have found that vapor from e-cigarettes may contain a variety of toxins, including 20 potential cancer causing chemicals, including: acetone, benzene, toluene, acrolein and several heavy metals, (4) Of course, e-cigs also contain nicotine, often compared with heroin for its addictive effect.
The big draw of vaping, though, are the thousands of flavors available. Unregulated and lacking basic safety studies, these flavors are often made with a focus on market appeal and profit rather than safety. And, unfortunately, some of these flavors can damage cells. Vapes that use a “butter” flavoring use a chemical that has been linked to “popcorn lung” though some dispute this finding. (5) Cherry, chocolate, candy, coffee, tea and tobacco flavors have been found to contain high levels of benzaldehydes. (6)
One study is quite alarming. Lung cells exposed to five Vapor Girl flavors (hot cinnamon candy, menthol tobacco, banana pudding, southern style, vanilla tobacco and koala) actually stopped reproducing and/or died.(7) Yes, they stopped growing and it is for this reason that I simply cannot endorse or support the use of e-cigarettes for the IC community.
One of the most frequent questions we receive from patients with IC is “Can I smoke or vape with IC?” Our answer is an unequivocal NO.
The interstitial cystitis bladder is structurally compromised with Hunner’s lesions and/or glomerulations as well as areas of general inflammation and irritation. As a result, toxins in urine penetrate more deeply into the bladder wall where they can cause IC flares, have the potential of triggering cancer growth, interfere with healing and, worse, potentially destroy healthy cells. Yes, this hasn’t been proven in a formal study (who would fund it?) but I believe that there is a clear and present risk.
Your goal as a patient is to create an environment that supports bladder healing and to avoid substances which can irritate the bladder wall. One study has found that some e-cig vape flavors reduce cell proliferation in the lungs. What happens when this chemical reaches the bladder wall?? Could it interfere with bladder healing? We simply don’t know. Are you willing to risk it?
– Jill Heidi Osborne MA
Updated (6:45PM PST) – I received some criticism from vaping advocates re: reference 4 and have adapted that paragraph appropriately. Thank you for your response.. all good info. The entire point of this article is that we have proof that the chemicals from tobacco smoke are the leading cause of bladder cancer. For the patient with IC who has a damaged epithelium, any kind of toxic chemical in urine can penetrate deeply into the bladder where it can provoke a variety of inflammatory and other reactions. As I say in the last paragraph… “What happens when this chemical reaches the bladder wall? Could it interfere with bladder healing? We simply don’t know. Are you willing to risk it.” For the patient suffering agonizing bladder pain, I don’t think inhaling either tobacco smoke or vapor is worth the risk. I’d love to see safety testing, especially of imports from China.
As to the identification of e-cig chemicals in urine, here is a formal study that is worth reading that cites three other urine studies. Yes, the authors correctly conclude that it is less toxic than tobacco but it also identifies a variety of chemicals in the urine of e-cig users and that the use of e-cigarettes could reverse the progress made in the regulation of indoor smoking. (9)
Update (8:20PM) – Getting LOTS of pushback from both Vape advocates and critics. I didn’t realize that this was such a flash point and I want to thank you for educating me. This is NOT an article about quitting smoking nor am I discouraging anyone from using e-cigs to help kick that habit. This is an article that asks an important question… if studies have found e-cig flavorings to be toxic to lung cells, including the reduction of cell proliferation, AND those same chemicals reach an IC bladder that is already struggling with cell proliferation, is the risk worth it? I don’t think it is. I’ve been asked if vaping is safe for IC and I can’t say it is. Yes, it’s less toxic than tobacco smoke but there are STILL some toxins in the urine of e-cig patients.
Update: (12:39 AM) – All right, really?? Someone via twitter suggests that this article is telling patients to smoke tobacco instead of e-cigs?? Are you kidding?? The entire first paragraph talks about the PROVEN danger of tobacco smoke and how it has caused both bladder cancer and IC flares. The last thing we would ever do is promote tobacco smoking. :::sigh::: Once you’ve spent time with anyone who has bladder cancer and can only pee through a catheter, as I have, you see the tragedy of tobacco in real time. The best defense is NO SMOKING at all and that is the entire point. We do NOT recommend any smoking for patients with an injured bladder wall (aka IC)…. FYI.. Medical marijuana in tincture form has helped quite a few patients with painful symptoms.
Update (1L59AM) – Just noticed that many of the critics of this piece are in the vape industry. Let me ask you a question. If a patient walked into your store with internal bleeding (bladder) and and no history of smoking… but they asked you “Is vaping safe for me?” How would you respond? Would you say “yes, it’s perfectly safe” or “no, the research is unclear at this point.” And, if you said “Yes”… are you willing to bear the burden of cost when this patient goes to the emergency room complaining of agonizing pain after they try it on your possible recommendation?? You’re thinking of this from the industry perspective… and I’m thinking of this from the patient laying in the fetal position in the middle of the night begging for the pain to go away.
There is NO DOUBT that vaping is much less risky than tobacco smoking… but to the patient above, it is still a risk that could cause terrible pain.
- What’s In A Cigarette. American Lung Association
- Pesticides Found in Cigarette Smoke. Live Science – April 2006
- Than K. Tobacco Smoke Found in Baby Urine. Live Science – May 2006
- Harmful Chemicals In Electronic Cigarettes. Group to Alleviate Smoking Pollution. 2013
- Hall N. Chemicals in Flavored E-Cigarettes Tied to ‘Popcorn Lung’ Disease. Newsweek. Dec. 8, 2015
- Kosmider L, et al. Cherry-Flavored E-Cigarettes Expose Users to the Inhalation Irritant, Benzaldehyde Thorax. Jan. 16, 2016
- Alfano A. Some E-Cigarette Varieties May Be More Harmful Than Others. Tech Times May 17, 2015
- Makris, N. E-Cigarette Flavorings Can Be Toxic to Lung Cells. Healthline. May 18, 2015
- Hecht, S. et al. Toxic and Cancer Causing Substances in the Urine of e-Cigarette Users vs. Smokers. Tobacco Research Programs and Masonic Cancer Center, University of Minnesota. Funding by the US National Cancer Institute.