E-Cigarettes: A Solution for Smokers or a Bunch of Hot Air? (Part 1)

Over the past couple of months I have seen more and more electronic cigarettes (e-cigarettes). For a non-smoker, I was curious about the health ramifications and how the FDA and other organizations treat e-cigarettes. Let’s be real, everyone knows smoking is bad for you, it kills about 480,000 people a year and is considered the single largest cause of preventable death in the United States. More Americans have died from smoking than all the wars America has fought. But despite all this, people smoke anyway. So why are people switching from cigarettes to e-cigarettes and are they better, worse or the same for you?

Electronic Cigarette

Electronic cigarettes, also known as personal vaporizers (PV) or electronic nicotine delivery systems (ENDS), are a battery powered device that produces a vapor instead of smoke. Some e-cigarettes contain a mixture of nicotine and flavorings, while others do not have nicotine. For those with nicotine, it is in a liquid that is heated to form a vapor (instead of smoke). In theory, e-cigarette allows the consumer to get nicotine and the sensation of bringing a cigarette to one’s mouth without the harmful substances like tar found in traditional cigarettes.

Originally e-cigarettes were disposable and looked like cigarettes. However, more and more of them are reusable gadgets that can be refilled with the liquid. The question is whether or not these will lead to the end of cigarettes or an increase in smoking?

Can E-Cigarettes End Smoking?

There are a couple of arguments and studies that suggest that e-cigarettes will potentially decrease the number of smokers. A team led by Riccardo Polosa in Italy studied 40 hardcore smokers. The study gave e-cigarettes to all participants. After six months, more than 50% of the participants had cut their regular consumption of traditional cigarettes by at least 50%. And almost 25% of the 40 people had stopped using regular cigarettes.

Another study from New Zealand found that after 6 months, about 7% of people given e-cigarettes had quit smoking, making it more effective than nicotine patches. In addition, Robert West, the director of tobacco studies at University College London, in response to an increase in people quitting, said, “It is impossible to know whether e-cigarettes drove the changes but we can certainly say they are not undermining quitting.”

Dr. Michael Siegel, a public health researcher at Boston University, argues that e-cigarettes could be the end of smoking in the United States. And Dr. Neal L. Benowitz, a professor of medicine at the University of California in San Francisco, says that, “nicotine may have some adverse health effects, but they are relatively minor”. Some people argue that nicotine is a lot like a caffeine addiction.

Or Will E-Cigarettes Make the Problem Worse?

Stanton A. Glantz, professor of medicine at the University of California, San Francisco, predicts that “the modern gadgetry will be a glittering gateway to the deadly, old-fashioned habit for children, and that adult smokers will stay hooked longer now that they can get a nicotine fix at their desks.” In addition, he argues that there is little evidence that people are switching from regular cigarettes to e-cigarettes, and if anything they allow people the opportunity to get a, “dose of nicotine at times when getting one from a traditional cigarette is inconvenient or illegal.” He also worries that smoking looks cool again. He’s got the fact that Julia Louis-Dreyfus and Leonardo DiCaprio used e-cigarettes at the Golden Globe Awards to back him up on that one.

According to David B. Abrams, executive director at Schroeder National Institute for Tobacco Research and Policy Studies at the Legacy Foundation, e-cigarettes, “need a little help to eclipse cigarettes, which are still the most satisfying and deadly product ever made.” But researchers worry that because e-cigarettes are so easy to acquire (they are sold on the internet) and come in appealing flavors (mango and watermelon) they will be attractive to both non-smokers and youth.

Risk of E-Cigarettes

Data has not truly caught up with e-cigarettes yet, since they have only been out on the market for about 7 years. However, studies analyzing their potential health effects are underway. Earlier this year a laboratory study reported that, “the nicotine-laced vapor generated by an electronic cigarette promoted the development of cancer in certain types of human cells much in the same way that tobacco smoke does.”   This data is based on preliminary findings – the study used specially treated human lung cells, not people. The researchers modified human lung cells to have genetic mutations that are correlated with an increased risk of cancer. They grew some of the cells in a liquid exposed for 4 hours to the vapor produced by e-cigarettes and grew other cells in a medium exposed to tobacco smoke. Both sets of cells exhibited changes that are normally associated with cancer. The team will be gathering more data before submitting their findings to a medical journal.

So What Does This Mean For Me?

Right now, people can smoke an e-cigarette anywhere (even right in front of you). The reality is that there is not enough data to support claims that e-cigarettes discourage or encourage smoking. There is also currently no data to support that e-cigarettes are less dangerous than traditional cigarettes or that they can cause cancer. There is simply not a lot that is known about them. The question of whether they are dangerous or safe will likely remain a hot issue while we wait for more solid evidence about the effects of e-cigarettes. It will be interesting to see where this technology goes and what will be the long term ramifications, if any, of e-cigarettes.