Over the past year I have had several patients approach me on whether or not e-cigarettes would help them quit smoking. You may have already seen the popular glowing sticks in mall kiosks, internet ads, and your favorite restaurant. They even made an appearance at this years Golden Globe Awards(Julia Louis Dreyfus at Golden Globes).
First introduced in China in 2004, the e cigarette has quickly emerged as a growing trend and cessation option for smokers. Currently a two billion dollar industry, the metallic tubes contain nicotine infused cartridges which the user blows out as vapor. The benefit of the e cigarette is that it does not have the tar and carbon monoxide of tobacco, which has been linked to cancer and other morbidities.
The cigarettes come in various nicotine levels, with the idea that smokers work their way down over time until they kick the habit. Despite their popularity, little is fully understood about the devices. Questions still not answered include long-term effects, second hand smoke dangers, and the potential for addiction. The Food And Drug Administration plans on creating regulations on the cigarettes in the near future, but several cities have already taken matters into their hands; creating proposals/bans against their use in public places. One of the biggest concerns with e cigarettes is their effect on underage smoking. There has been an in increase in teenage use of e cigarettes, creating a concern that they may become the new gateway drug towards regular tobacco use and other substances.
Results of a recent study by the Center for Tobacco Control Research & Prevention at UCSF argued that e cigarettes may in fact not help smoking cessation. The study looked at 949 smokers in their attempt at quitting with 88 of the participants using e cigarettes while the rest used various others methods (cold turkey, patches,chewing gums). The researchers concluded that smokers who used e cigarettes were no more likely to quit smoking after one year compared to smokers who did not use them. The validity of the study however has been under fire secondary to the small sample size of those who used e cigarettes ad well as the methods of the study.
Adding more fuel to the fire, just last week, the Center for Disease Control released their own study indicating the rapid increase in nicotine poisoning from e cigarettes. There has been a steady rise in the number of calls to poison control centers across the nation from poisoning by ingesting of the liquid nicotine within the cartridges or absorbing through the skin. Adverse effects include nausea,vomiting,and eye irritation. Ingestion has been particularly high in children, most likely because of the candy and fruit flavors appealing to children.
I support anyone trying to kick the habit of smoking. As a physician my biggest concern is always the safety of a particular means and its efficacy. The verdict is still pending on how the FDA will regulate e cigarette use but we know they are here to stay. I would recommend their use only after someone is aware of the lack of long term evidence for their benefit and possible harm. One thing is for sure, tobacco use is a public health concern and if someone wants to be tobacco free, any means is far better than no means at all.
I never thought smoking was cool, but those e-cigarettes look like a new accessory. Thanks for linking up this topic with Medical Mondays!
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