Electronic cigarettes - not as harmless as some may think

I'm not a proponent of electronic cigarettes, or e-cigarettes. While I concede that they may be the lesser of two evils, smoking a combustible cigarette or an e-cigarette, I still believe they are dangerous and should not be promoted.

I wrote a piece about e-cigarettes for Forbes.com last year (What Are Electronic Cigarettes and How Safe Are They?), for which I interviewed a physician and someone in the e-cigarette industry. The physician felt much like I do; he'd rather no one use them, but if they were truly being used by someone who would ordinarily be smoking regular cigarettes, then this would be better. The pro-electronic cigarette person denied that there were any risks at all and vehemently denied my questions as to whether the manufacturers were trying to get teens and children to use them. I might have believed him if the e-cigarettes didn't come in flavors clearly designed to appeal to children.

Those who advocate for electronic cigarettes make the following claims:

• They are not addicting as are traditional cigarettes
• You aren't "smoking," you're "vaping," because you aren't inhaling smoke, which is an irritant to the lungs
• You aren't inhaling many of the traditional cigarette ingredients/pollutants
• E-cigarettes can be a smoking cessation tool, helping people quit smoking traditional cigarettes.

Those opposed to the new cigarettes say:

• E-cigarettes are not effective as a smoking cessation tool because they don't rid the person of the hand-to-mouth and time-of-smoking habits, they just transfer them from traditional cigarette to e-cigarette form
• While you aren't inhaling smoke, you are inhaling vapor, which is not meant to go into your lungs. You are still inhaling substances that are not meant to be inhaled.
• Children and teens are drawn to them because of the marketing and flavors

Interestingly, the Centers for Disease Control (CDC) issued a press release on April 3, 2014, to notify the public of a significant increase in calls to poison control centers across all states in relation to e-cigarette use.

"The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014, according to a CDC study published in today’s Morbidity and Mortality Weekly Report. The number of calls per month involving conventional cigarettes did not show a similar increase during the same time period."

Research has been ongoing since the introduction of e-cigarettes as doctors and regulators try to sort out the truth from the claims. The most recent study was just published last month. According to the study, undertaken by RTI International:

Electronic cigarette “vapors” are made of small particles containing chemicals that may cause or worsen acute respiratory diseases, including asthma and bronchitis, among youth, 

Although the FDA does regulate the sale of cigarettes and tobacco (both smoking and smokeless), it doesn't control the sales of e-cigarettes unless they are specifically marketed for therapeutic purposes. The FDA has proposed that it should cover "additional products that meet the legal definition of a tobacco product, such as e-cigarettes."

The FDA is encouraging people to submit their thoughts on e-cigarettes: Extending Authorities to Additional Tobacco Products.

As with regular cigarettes, I believe that as long as they are a legal product, if someone chooses to smoke that is their decision. I feel the same way about electronic cigarettes. If people choose to use them, that is their decision. However, I do feel it important to sort out what is true. Are they really harmless? Are they really effective smoking cessation products? It's not the use I am debating, it's the claims.

What do you think? Is there a place for e-cigarettes? What about the argument from the industry that they are not marketing it towards children and teens? What do you think?

The words we use to describe mental illness - how they matter

We hear the words often - words that imply that a person is a disease and the disease is a person. For example, we may say that someone is a diabetic or a hypertensive. But that's not right. The diabetes and the hypertension (high blood pressure) don't define the person. The person lives with or has diabetes or hypertension. Do you see the difference?

This use of words is particularly important when it comes to mental health. Someone may say that a sibling or coworker is a schizophrenic or that someone committed suicide. The first is wrong for the same reason that saying someone is diabetic is wrong. But what is wrong with "committed suicide?" A lot really, because people commit crimes - and suicide isn't a crime. 

Someone I love killed himself. I don't say he committed suicide. I say he killed himself or he took his life. He didn't commit a crime and by implying it with the words, his death is stigmatized even more.

How we use words evolves over time and writers and journalists play a role in how this happens. If writers repeat hurtful or incorrect terminology or phrases, the readers begin to think that this is normal and what they should be using too. Because of this, I was glad to see that the Canadian Journalism Forum on Violence and Trauma partnered last year with CBC News (the Canadian Broadcasting Corporation), to put together a comprehensive guide on writing about mental health. Mindset - Reporting on Mental Health was compiled to help Canadian journalists navigate the waters of reporting on mental illness. The English version was launched last week, April 24, and is now available for download.

While it was written for Canadian journalists, there is no reason why English-speaking writers and journalists from around the world can't use the guide. It addresses issues about how not all mental illness can be put into one category, how the majority of people with mental illnesses don't commit crimes, interviewing techniques, and mental illness and the law - among other things.

It's an interesting read for students who will be working in social fields, such as psychology, teaching, policing, social work, law, and so many other professions. It's also interesting for the general public, because it gives some context to the issue of mental illness and how we talk about it. 

Think about it - how do you talk about mental illness? I know that I learned quite a bit from just browsing the document. 

Yes, vaccines do save lives

I encourage vaccinations. My three children received all recommended vaccinations. As an adult, I have received all recommended vaccinations and I try to keep them up-to-date. I did so and I continue to do so because they save lives. I refuse to watch or listen to celebrity moms who have become "experts" on any health issues, particularly the anti-vax celebrity moms.

When my children were young in the late 80s and early 90s, before anti-vax publicity really took hold, I remember saying to my husband that there was going to be trouble. While he and I remember what it was like to know children who did get the childhood diseases - or we got them ourselves - the fully vaccinated generation was heading into parenthood and they would probably not have seen the devastation that these diseases can cause.

It's unlikely that they'll meet a person who is hearing impaired or completely deaf because his or her mother was exposed to rubella (German measles) when she was pregnant with that child. It's unlikely that they know of children who were severely affected by the so-called "harmless" childhood illnesses. It's unlikely they know of someone who has lost a sibling or child to a preventable illness. And as such, many have no clue as to the damage these illnesses can actually do. I had mumps when I was a child. It was awful. I got through it without any lasting effects, but the boy I passed the mumps on to was not that lucky. He developed serious and painful complications that could have been avoided. My children all had the chicken pox when my five-year-old brought them home from kindergarten and then passed them to my three-year-old and one-year-old. The vaccine wasn't available yet. They were miserable and one was particularly ill. Why would anyone wish that on their child?

Autism is not something you want for your child. But with all the mounting evidence that the vaccines do not cause it, you would think that this myth would die down instead of keep growing. Are vaccines fool proof? No, they're not - and they don't claim to be. Some people who are vaccinated still may become ill, but often it is not as severe as it may have been otherwise. Do people have side effects? Yes, there are a few people who do experience side effects. But the number of lives saved by vaccines far, far, far outnumbers those who are affected by side effects.

I read of a pediatrician who does not recommend vaccines because she said it interferes with nature. Really? But then so does removing a ruptured appendix or a tumor. In vitro fertilization, pulling teeth, taking antibiotics - those are all "interfering with nature" if you're going to follow this physician's way of thinking.

I attended a health journalist conference in March, where the key note speaker, a physician, told us of a toddler in his ICU who was admitted just the week before. This toddler had not been vaccinated for childhood diseases. The parents rushed their child to the emergency room because she caught one of the "harmless childhood disease viruses." The child was saved, but was so brain damaged that she will likely never wake up.

Vaccinations are not a government plot to control everyone. They are not a pharmaceutical plot to make money (if so, they'd make you take more than one or two doses in your lifetime). They are lifesaving tools that aren't perfect. But they are what we have right now.