When a colleague introduced me to the electronic cigarette, I thought it
was an ingenious idea. Also known as an e-cigarette, it’s a battery-powered
device capable of creating a chemical vapor that is said to deliver nicotine
in a less harmful way. My colleague, a smoker for over 20 years, said
this was the answer she had been waiting for to help her quit.
After my entrepreneurial brother asked me for my medical opinion on the
device, I decided to do some more research. The e-cigarette industry has
flourished into a $1.7 billion market with more than 200 companies in
the United States, and he was considering an investment in this blooming field.
Delving a little deeper into the e-cigarette trend, I found the device’s
safety claims might just be smoke and mirrors.
Advocates for e-cigarettes claim that the devices are a healthier alternative
to cigarettes, as they cut down on dangerous ingredients found in tobacco.
However, the FDA discovered the delivery cartridges contained impurities,
some of which are known cancer-causing agents. No evidence exists that
the chemicals are harmful in the amounts found, but long-term studies
have yet to be done.
The device itself is suspicious. The e-cigarette is not classified as a
medical device, so the product is not held to the same rigorous standards
as other devices, such as nebulizers. In 2012, a man was horribly injured
by his device when it exploded in his mouth, causing the loss of several
teeth and part of his tongue. In 2013, an e-cigarette exploded while it
was connected to its car charger. The hot coil landed in a car seat, causing
a fire and second-degree burns to a three-year-old passenger.
While studies found e-cigarettes helped a small percentage of people remain
cigarette-free after six months, the device did very little overall to
help smoking cessation. In addition, there is concern that it can lure
non-smoking consumers because of its benign appearance. E-cigarette manufacturers
have come under scrutiny for selling devices with appealing flavors, such
as cherry and chocolate, and for using celebrities in their marketing
Teens could be particularly vulnerable, as there are inconsistent regulations
limiting sales to minors nationwide. The National Youth Tobacco survey
revealed 10% of high school students have tried e-cigarettes. Opponents
of the device say it is nothing more than a pathway toward addiction,
since nicotine has a notoriously high addiction potential due to stimulation
of the brain’s reward system.
The future of the e-cigarette industry in the United States remains uncertain.
The New York City council recently passed a bill banning use in public
areas. Several states have imposed indoor e-cigarette bans, and other
states, including California, are considering it. The FDA has yet to impose
legislation on the device, leaving both advocates and opponents in anticipation.
As a physician who treats patients of all ages, including curious adolescents
transitioning into adulthood, I find that my patients want to know more
about e-cigarettes. I endorse what I feel is best for my patients, and
e-cigarettes do not fall into this category. Until further research is
performed that validates their use, I will encourage my patients and entrepreneurial
family members to steer clear of them.