The topic, though, remains as polarizing a health issue as sex education or diet sodas.
An e what?
The e cigarette was actually developed by a pharmacist in China.
The pharmacist, Hon Lik, was a three pack a day smoker. That was nothing unusual more than 300 million people in China are regular smokers. But when Lik’s father, who was also a heavy smoker, died of lung cancer, Lik decided he had to come up with an alternative that wouldn’t kill him.
Most scientists believe nicotine itself, while highly addictive, is not what causes cancer for smokers or for the people around them who breathe their second hand smoke. Instead, it’s the toxic chemicals that are created when tobacco and filler products burn that are dangerous.
If there was a way to get nicotine addicts their fix without the burn, you just might avoid the health problems. Nicotine then becomes as harmless as any other addictive substance, such as caffeine, some experts say.
So Lik developed an e cigarette a device that uses a small battery to atomize a pure liquid solution of nicotine. Nothing is burned. There is no ash. There is no smoke. There is nicotine, and then there is flavoring added for taste.
Essentially the person using these inhales a kind of vapor that looks like fog from a fog machine. A recent review of all the scientific research done on e cigarettes by Drexel University professor Igor Burstyn concludes “current data do not indicate that exposures to vapors from contaminants in electronic cigarettes warrant a concern.”
In plain language, Burstyn concludes “It’s about as harmless as you can get.”
“I wouldn’t worry at all if someone was smoking one of these by my kids,” Burstyn said. “From a pure health perspective, these are not as bad as a cigarette.”
E cigarettes came to the U.S. market around 2009. The CDC now estimates about one in five American smokers have tried an e cigarette that’s about 6% of all adults.
There are e cigarette stores, but now you can also buy them online or in convenience stores. Some look like regular cigarettes some look like pens or thumb drives.
First you buy a starter kit, which costs between $40 and $130. In the kit is the e cigarette, a charger and a few cartridges. The cartridges typically last as long as a 20 pack of cigarettes and sell for around $10. You can also buy a bottle of e liquid to refile the cartridge yourself.
The anti e cigarette camp
Critics point out e cigarettes come in kid friendly flavors such as gummy bear, atomic fireball candy and cookies and cream. It makes them worry that e cigarettes will become a gateway to encourage kids to develop a lifelong nicotine addiction or worse, try the real thing.
Only about 20 states specifically forbid the sale of e cigarettes to children.
Tobacco use has been on the decline with kids it’s about half what it was in the mid 1990s. But the latest CDC study shows a growing number of middle and high school students have tried e cigarettes.
One in 10 high school students surveyed said they had tried e cigarettes last year. That’s double the number from 2011. One high school in Connecticut banned them after the principal said administrators dealt with at least one incident involving e cigarettes every day.
CDC director Tom Frieden characterized this trend as “deeply troubling.”
But as far as risky behavior goes, it’s still a tiny fraction of students. The survey showed about 3% of these kids said they had used one in the last 30 days. By contrast, 39% of students said they drank some amount of alcohol in the past 30 days, 22% binge drank and 24% rode with a driver who had been drinking.
The real problem is that 88% of adult smokers who smoke daily said they started when they were kids, according to the CDC. Kids who start down the path to using e cigarettes may stick with them for life.
“So much is unknown about them and what the long term complications could be with their use,” said the American Lung Association’s Erika Sward. “Bottom line, we don’t know what the consequences of using them are, and we are very troubled that kids would find them attractive.”
E cigarettes are unregulated in the United States no laws make manufacturers tell you what you are actually inhaling. The unknown is one of the many qualities of e cigarettes that the American Lung Association doesn’t like.
It’s “a complete unregulated Wild West,” Sward said. She wants the FDA to move quickly with regulatory oversight, which she says would make manufacturers disclose what the actual ingredients are in each of the 250 or so brands available.
In 2009, a FDA test on a small number of e cigarette samples found “detectable levels of known carcinogens and toxic chemicals to which users could potentially be exposed.” They found diethylene glycol in one cartridge at a 1% level this is an ingredient used in antifreeze and can be toxic to humans in large quantities. Diethylene glycol is also found in some dental products and in some pharmaceuticals.
After that study, the FDA banned the sale of e cigarettes. They warned e cigarette smokers that they were inhaling “toxic” and “harmful” chemicals. However, in 2010, a court ruled that “the FDA had cited no evidence to show that electronic cigarettes harmed anyone,” and stores could go on selling them.
The early e adopters
On the other side of the debate are the passionate supporters of e cigarettes. Many who use them say it is the first thing that has helped them stop using cigarettes something more than 90% of smokers fail to do with any of the existing FDA approved methods. There are blogs and message boards dedicated to them. And there are countless impassioned testimonials from the people who use them.
Florida resident Craig Lashley says they’ve changed his life.
“I got tired of being like that little kid in ‘Peanuts’ who had the cloud of smoke following him all the time,” Lashley said. “I didn’t like the way I smelled when I smoked, and I didn’t like what smoking said about me, especially to kids.”
He discovered the e cigarette about a year ago and hasn’t smoked a regular cigarette since.
He says he smells better, feels better and spends a lot less about $10 a week on e cigarettes. He used to spend about $45 a week on regular cigarettes.
“I like the feel of blowing smoke,” Lashley said. “It seems to me like (e cigarettes are) a healthier alternative.”
A growing number of respected physicians and scientists agree, and they say these products could end a major health problem.
“Electronic cigarettes and other nicotine containing devices offer massive potential to improve public health, by providing smokers with a much safer alternative to tobacco,” the Royal College of Physicians says. “They need to be widely available and affordable to smokers.”
The latest study, published in the British journal the Lancet, examined whether people who used them as an alternative to smoking would abstain from using regular cigarettes.
The New Zealand authors studied the behavior of 657 people who were trying to quit. One group got nicotine patches, another got nicotine e cigarettes and others got placebo e cigarettes without the nicotine.
Over a period of six months, only a tiny fraction of the people in the study actually quit smoking.
People using the nicotine e cigarettes quit at a slightly better rate compared with those using the patch, though. Some 7.3% using the e cigarettes abstained from smoking traditional cigarettes compared with the 5.8% who stopped with the patch. About 4.1% stopped with just the placebo e cigarettes.
It was such a small number of people who quit that the authors concluded “more research is urgently needed to clearly establish their overall benefits and harms at both individual and population levels.”
Dr. Michael Siegel, a physician who has spent the past couple decades
working on tobacco control initiatives, has been surprised by the negative reaction to e cigarettes from so many people in the public health sector. Siegel says the studies he’s done have shown e cigarettes are a help.
“True we don’t know the long term health effect of e cigarettes, but there’s a very good likelihood that smokers are going to get lung cancer if they don’t quit smoking,” he said. “If they can switch to these and quit smoking traditional cigarettes, why condemn them?”
Siegel theorizes the e cigarettes might look too much like smoking.
“It’s ironic the very thing that makes them so effective … drives the anti smoking groups crazy. But what makes them so effective is it mimics the physical behaviors smokers have, which is something the patch can’t do.”
Siegel does believe there is an urgent need for more regulations.
Ray Story, founder of the Tobacco Vapor Electronic Cigarette Association, agrees. He says his association has also pushed for age verification legislation.
“When you have these companies trying to promote these as something they are not, and you have stores that sell them in the candy aisle, you are going to have a problem,” Story said. “If they are officially categorized as a tobacco product, you get an automatic age verification put in place.
“Nicotine is addictive, and we want the federal government to create guidelines and a structure that will confine these to being sold as adult products.”
Lashley says no matter what the debate, he will continue to spread the e cigarette gospel to his fellow adults.
So far, his co workers have been receptive to the idea. He used to be the only one with an e cigarette on smoke breaks. Now he says he’s got more than a dozen colleagues doing the same.
One colleague, though, complained about it.
“He said ‘I’m sick of all these people smoking electronic cigarettes,” Lashley said. “When I asked him why he said. ‘Simple, now I can’t bum any off of them.’ “
Who
Call to arms on e-cigarettes in the european parliament (updated) В« the counterfactual
What are electronic cigarettes?
Electronic cigarettes or ENDS (electronic nicotine delivery systems) are devices whose function is to vaporize and deliver to the lungs of the user a chemical mixture typically composed of nicotine, propylene glycol and other chemicals, although some products claim to contain no nicotine. A number of ENDS are offered in flavours that can be particularly attractive to adolescents. Electronic cigarettes (e cigs) are the most common prototype of ENDS.
Each device contains an electronic vaporization system, rechargeable batteries, electronic controls and cartridges of the liquid that is vaporized. The manufacturers report that the cartridges typically contain between 6 and 24 mg of nicotine, but sometimes can contain more than 100 mg. In the form of tobacco products, nicotine is an addictive chemical that in excessive amounts can be lethal (0.5 1.0 mg per kg of weight of the person).
Most ENDS are shaped to look like their conventional (tobacco) counterparts (e.g. cigarettes, cigars, cigarillos, pipes, hookahs or shishas). They are also sometimes made to look like everyday items such as pens and USB memory sticks, for people who wish to use the product without other people noticing.
Are electronic cigarettes (ENDS) safe?
The safety of ENDS has not been scientifically demonstrated.
The potential risks they pose for the health of users remain undetermined. Furthermore, scientific testing indicates that the products vary widely in the amount of nicotine and other chemicals they deliver and there is no way for consumers to find out what is actually delivered by the product they have purchased.
Most ENDS contain large concentrations of propylene glycol, which is a known irritant when inhaled. The testing of some of these products also suggests the presence of other toxic chemicals, aside from nicotine. In addition, use of these products when they contain nicotine can pose a risk for nicotine poisoning (i.e. if a child of 30 Kilos of weight swallows the contents of a nicotine cartridge of 24 mg this could cause acute nicotine poisoning that most likely would cause its death) and a risk for addiction to nonsmokers of tobacco products. Nicotine, either inhaled, ingested or in direct contact with the skin, can be particularly hazardous to the health and safety of certain segments of the population, such as children, young people, pregnant women, nursing mothers, people with heart conditions and the elderly. ENDS and their nicotine cartridges and refill accessories must be kept out of the reach of young children at all times in view of the risk of choking or nicotine poisoning.
As ENDS do not generate the smoke that is associated with the combustion of tobacco, their use is commonly believed by consumers to be safer than smoking tobacco. This illusive safety of ENDS can be enticing to consumers however, the chemicals used in electronic cigarettes have not been fully disclosed, and there are no adequate data on their emissions.
Is use of electronic cigarettes (ENDS) an effective method for quitting tobacco smoking?
The efficacy of ENDS for helping people to quit smoking has not been scientifically demonstrated.
ENDS are often touted as tobacco replacements, smoking alternatives or smoking cessation aids. But we know that for smoking cessation products to be most effectively and safely used, they need to be used according to instructions developed for each product through scientific testing. There are no scientifically proven instructions for using ENDS as replacements or to quit smoking. The implied health benefits associated with these claims are unsubstantiated or may be based on inaccurate or misleading information. When ENDS are used as cessations aids, they are intended to deliver nicotine directly to the lungs. None of the approved, regulated cessation aids, such as nicotine patches and chewing gum, delivers nicotine to the lungs. Therefore, the biological mechanism by which smoking cessation might be achieved by delivery of nicotine to the lungs and its effects are unknown. Delivery to the lung might be dangerous. Therefore, independently of the effects of nicotine, it is of global importance to study lung delivery scientifically.
The dose of delivered nicotine is also unknown. It is suspected that the delivered dose varies notably by product, which contain nicotine in various quantities and concentrations.
Conclusion
Until such time as a given ENDS is deemed safe and effective and of acceptable quality by a competent national regulatory body, consumers should be strongly advised not to use any of these products, including electronic cigarettes.