Thursday, May 8, 2014

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 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?


Tim Triple said...

I'm afraid you seem to have fallen for the full Stanton Glantz propaganda against e-cigarettes. Never mind the few misleading studies coming out against e-cigarettes that have been adequately debunked elsewhere, please look out the quality research and informed opinion by scientists and others that know what they are talking about, such as Dr Farsalinos, Robert West and Professor John Britton in the UK, as well as the recent ASH UK study.

Be honest, the real reason you are so much against e-cigarettes is because you hate smoking with a passion. You will never give them a fair hearing as you are clearly ideologically opposed to tobacco and nicotine. You give this away by your talk of 'hand to mouth actions'. What on earth has that got to do with the effectiveness of e-cigarettes as a harm reduction measure?

The plain fact of the matter is that these devices are at least 99 percent safer than smoking tobacco (a widely accepted figure by proper scientists in the field) and they will save thousands and, ultimately, millions of lives if they are allowed to. People who stand in their way by spouting baseless nonsense will be be harshly judged by our children and their children, as letting needless deaths occur.

Please open your eyes and give all the evidence a fair hearing.

You owe it to the children.

Marijke Vroomen-Durning said...

Wow - you're a mind reader who can tell me what I think before I think it. Great skill. Wish I had it.

Since the hand-to-mouth motion is a habit that develops because of smoking (hence the strong desire to constantly put something in your mouth), as long as the motion is encouraged, then the addiction will be harder to break.

I never said that e cigarettes should be banned and if you took the time to read, I did say that they are the lesser of two evils. I never said get rid of e cigarettes and promote combustible cigarettes - as you allude to in all the needless deaths that our children will blame all on me. However, some people feel threatened by such statements, as evidenced by your attack of claiming to know how I think.

Rob said...

From the press release on the RTI 'study' - " The system is attached to an e-cigarette to uniformly generate and capture the vapor emissions. The system is flexible to be representative of realistic smoking patterns among adolescents and adults." Without reading the paper to discover just how this system works I can only speculate, but these machines have no sense of taste, so can't tell if the e-cigarette is giving dry-hits, that's where the wick dries out and the liquid is effectively burnt rather than vapourised. A human will stop vaping immediately as this tastes disgusting - it's likely that this machine will just carry on regardless. If this is the case then any experimental data collected would be invalid.

As far as the hand-to-mouth action goes, that's one of the reasons why it's relatively easy for smokers to switch to becoming vapers.

The second reason is the production of vapour - a simple experiment that many of us have tried is to vape with eyes closed; not being able to see the vapour means that it's less satisfying for many if not most vapers.

The third reason is the range of flavours, from the tobacco and menthol flavours that many of us start with, to the fruit and dessert and occasionally drink based flavours (e.g. coffee, tea and alcholic drink flavours). I can only assume that most of the anti-ecig people had their tastebuds surgically removed after they reached 18, since they seem to think that adults don't like sweet flavours. Once you've switched to a sweet flavour then real tobacco smoke tastes revolting - I'm sure it always did.

When it comes to any study - particularly on e-cigs, it's important to know who funds the research. The press release doesn't say, but a quick scan through the Clients and Funding Agences page on the RTI website does come up with Robert Wood Johnson Foundation. Johnson & Johnson, Pfizer and, oh look, Novartis. All of whom either manufacture NRT or other smoking cessation products (I probably missed some other similar companies from the list). Now tell me that this would have absolutely no bearing whatsoever on the quality of the research, or the spin placed on it.