Electronic
cigarettes come in a variety of shapes and models, but most consist of a
battery, a heating element, and a liquid that contains nicotine, propylene
glycol and flavorings. The heating element warms and aerosolizes the liquid,
turning it into a vapor the user inhales. Smoking an e-cigarette (called
"vaping"), gives users a nicotine hit without exposing them, or those
around them, to tobacco smoke. The lack of odor is one of the biggest selling
points, says Craig Weiss, chief executive of NJoy electronic cigarettes.
Though
e-cigarette makers do not make safety or health claims, many users assume that
eliminating the smoke of burning tobacco also eliminates the harm.
"There's no
question that e-cigarettes deliver fewer 'toxic substances' than conventional
cigarettes, but the question of how much less is still not clear," says
Stanton Glantz, director of the Center for Tobacco Control Research and
Education at the University of California at San Francisco. Though sales of
e-cigarettes are expected to reach $1 billion this year, with many different
brands available, vaping is new enough that there haven't been many studies
done yet — certainly none of the large-scale, randomized trials that would be
necessary to offer conclusive answers about the safety of e-cigarettes, Glantz
says.
While there's
little doubt that electronic cigarettes expose users to far fewer carcinogens
and irritants than conventional cigarettes, the ingredients found in the
liquids can vary greatly from product to product, says behavioral scientist
Alexander Prokhorov at the University of Texas MD Anderson Cancer Center.
"The companies improvise to come up with new flavorings and every time
they introduce a new flavor, you don't really know what's in it," he says.
An analysis by
researchers at the FDA found very low levels of nitrosamines, ethylene glycol
and diethylene glycol — chemicals associated with cancer and other health risks
— in some electronic cigarette products, but the levels were a tiny fraction of
what a smoker would get from a tobacco cigarette.
Unlike tobacco
cigarettes, electronic cigarettes aren't currently subject to regulation in the
United States, which means their ingredients aren't standardized. The FDA is
working on a proposed rule to regulate the devices, wrote agency spokesperson
Jenny Haliski in a prepared statement. Though the FDA did not provide a
timeline for regulation, Glantz suspects political pressure makes regulation
unlikely to happen anytime soon.
For now,
researchers are trying to get a handle on the risks and benefits of
e-cigarettes.
"It's a new
product, and there's still a lot we don't know," says Pallav Pokhrel, a
public health scientist at the University of Hawaii Cancer Center.
For instance,
it's unclear what effects electronic cigarettes may have on smoking initiation
among youth or cessation among current smokers.
Some electronic
cigarettes allow users to adjust the amount of nicotine they're getting, and
even adjust it down to zero over time, and it seems plausible that a device
that lets people reduce the amount of nicotine they're consuming could help
them cut their dependence, Prokhorov says. However, right now there aren't good
studies to show that they outperform existing nicotine cessation products, nor
are they FDA-approved for this purpose.
Lauren Odum, a
pharmacist at the University of Missouri at Kansas City, recently published a
review of the scientific literature on using e-cigarettes to quit smoking.
"We came up with a lot of anecdotal evidence from patients saying that
these are very helpful, but it's mostly surveys and the data is skewed, because
people who have a positive experience are more likely to report back," she
says. "The ones who weren't able to quit smoking were probably less likely
to respond these surveys."
Odum works at a
smoking cessation clinic and says that patients have told her that e-cigarettes
helped them quit or cut back on regular cigarettes. "One of the reasons
people like them is that they don't have to stop the smoking habit," she
says. "They still get the hand-to-mouth motion and they still get the
nicotine, which is the addictive component."
Nick Capodice
never wanted to stop smoking: "I really loved smoking. I loved the act of
it, the taste of it — everything" says the Brooklynite. He had no
intention of quitting. But after his father was diagnosed with cancer, Capodice
spent three "miserable" months attempting to give up cigarettes,
before giving up. He didn't try vaping in hopes of quitting smoking altogether,
but after a few e-cigarettes, he lost his urge for tobacco. He hasn't smoked in
more than 16 months and has tapered down the amount of nicotine he's using in
his e-cigarettes to zero.
But not everyone
who uses e-cigarettes stops smoking — NJoy's Weiss says that most of his
company's customers also use tobacco cigarettes — and some public health
researchers worry that vaping may actually prevent some people from kicking
their nicotine habit if it allows them to get their fix in circumstances where
they can't smoke.
Another concern
is that e-cigarettes might be a gateway to traditional cigarettes for kids,
getting them hooked on nicotine, Prokhorov says. (A report last week by the
Centers for Disease and Control found that use of e-cigarettes among middle and
high schoolers doubled between 2011 and 2012, with about 1.78 million students
having tried them, among whom 160,000 had never used conventional cigarettes.)
Finally, people
who would never smoke a regular cigarette might take up the habit if they think
that electronic cigarettes are safe, says Odum.
But Richard
Carmona, who crusaded against tobacco during his term as U.S. surgeon general
from 2002 to 2006, views e-cigarettes as a potential tool for improving public
health. About 20 percent of Americans smoke, and the number of smokers has hit
a plateau, Carmona says. "We still need to do more research," he
says, but "this is the first thing I've seen in years that has promise for
decreasing tobacco use in our country." Carmona, who recently joined the
NJoy board (it's a paid position), says that the company is committed to
conducting and publishing the research necessary to answer the important
scientific questions that remain about e-cigarettes.
Article Credit: http://www.capecodonline.com
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