Electronic Cigarettes — Risky Business?

Have you seen the ads or mall kiosks marketing these new and so-called “fantastic, risk-free, clean, and absolutely amazing” products that let people continue to “smoke” without all the dangers of smoking? The electronic cigarette (e-cigarette) manufacturers are marketing their product as if it’s a miracle. They often publicize their product as the first healthy cigarette, free of the harmful chemicals and tar typically found in tobacco products. Some companies are even calling them green and natural, and marketing them as a wholesome alternative to standard cigarettes. But do we have all the facts about e-cigarettes?

An electronic cigarette contains liquid nicotine, which is highly addictive. In fact, research shows nicotine is as addictive as heroin.¹ When the user inhales an e-cigarette, a battery warms liquid nicotine stored in a plastic filter. The nicotine is dissolved in propylene glycol, the liquid that is vaporized in nightclub and stage show smoke machines. The combination of heat and liquid creates the vapor or “smoke” puff when exhaled. The nicotine may be masked by “flavors” such as chocolate, fruit, candy, and waffle, causing concerns about e-cigarettes’ appeal to children.

According to Elicko Taieb, CEO of Smoking Everywhere, one of the largest distributors of electronic cigarettes, “Our product is comparable to the nicotine patch except people still get the oral fixation, which they love.”

But public health officials are skeptical. If you are thinking about using e-cigarettes as an alternative to smoking, or to help you stop smoking, it’s important to know that these nicotine delivery devices are not FDA approved for effectiveness or safety. There are proven and safe alternatives for nicotine replacement therapy to help you stop smoking, such as the patch and gum, both of which are FDA approved and safe when used according to directions. There are also FDA-approved nicotine inhalers which work differently and deliver consistent doses of nicotine without safety questions. You can learn more about safe and thoroughly tested medications to help you quit smoking, and then discuss with your physician which may be best for you.

Taieb of Smoking Everywhere said, “There are no ingredients in our e-cigs that can cause cancer. However, it is a pretty new product, so we are not 100 percent sure of the side effects at this point. But we haven’t heard of any negative side effects yet, but we are pretty sure they are safe.”²

Pretty sure? Is “pretty sure” that a product is safe good enough for you, or for your family? If it’s a product that you inhale or ingest, “pretty sure” just does not cut it.

“If the marketers of the electronic cigarette want to help smokers quit, then they need to conduct clinical studies and toxicity analyses and operate within the proper regulatory framework,” said Douglas Bettcher, Director of the World Health Organization’s (WHO’s) Tobacco Free Initiative. “Until they do that, WHO cannot consider the electronic cigarette to be an appropriate nicotine replacement therapy, and it certainly cannot accept false suggestions that it has approved and endorsed the product.”³ WHO officials are taking a firm stance, calling for marketers to immediately remove any suggestion that WHO considers e-cigarettes to be a safe and effective smoking cessation aid from Web sites or other materials.

The FDA also has chimed in regarding those who say that an electronic cigarette is no different than an approved nicotine inhaler. “The Nicotrol inhaler is an approved smoking cessation device,” said FDA spokesperson Rita Chapelle. “Because these e-cigarette products haven't been reviewed by the agency, their labeling has to be reviewed, their intended use has to be reviewed, and all of their ingredients and components have to be reviewed.”⁴ Jonathan Scott, MD, Director of the Institute for Global Health at the University of Southern California warns that e-cigarettes are “nothing like FDA-approved nicotine delivery devices” such as the inhaler, patch, gum and lozenge which have demonstrated safety.

The FDA tried to block e-cigarettes from being imported as an unapproved combination drug and delivery device. A federal district court ruled that the FDA did not have this authority as long as the manufacturer did not claim that e-cigarettes were a form of therapy. However, the FDA can and will regulate them as tobacco products. ⁵

Those who try to convince you to spend your hard-earned money on these and other products probably do not want you to look too closely at the scientific evidence. Those who promote e-cigarettes may not have your best interests at heart. But we do, and so do many physicians and scientists whose job it is to keep you safe and healthy. Noting that inhaling pure nicotine may be dangerous, Dr. Steven Schroeder, a physician and smoking cessation expert at the University of California, San Francisco Medical Center said, “We have no clue what the health effects could be.”⁶

The clear purpose of the e-cigarette is to provide an inhaled dose of an addictive substance, nicotine, to you, its user. The result may be to foster your addiction and cause you to buy more e-cigarettes. There is nothing good about that. You’re too important to your family, your unit, and your country to use e-cigarettes. When you are ready to quit, we’re here to help. Quit Tobacco—Make Everyone Proud.

References

¹ The Health Consequences of Smoking: Nicotine Addiction; A Report of the Surgeon General, 1988.

² http://www.cnn.com/2009/HEALTH/03/13/ecigarettes.smoking/index.html

³ http://www.who.int/mediacentre/news/releases/2008/pr34/en/index.html

⁴ http://www.webmd.com/smoking-cessation/features/ecigarettes-under-fire?page=2

⁵ http://www.cnn.com/2009/HEALTH/03/13/ecigarettes.smoking/index.html

⁶ http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm172906.htm