E-Cigarettes Too E-Z to be True

As published in the Seattle Times

Electronic cigarettes (e-cigarettes) have become increasingly popular over the past few years. The Centers for Disease Control and Prevention said that in 2011, 21 percent of U.S. adult smokers had tried e-cigarettes, a 50 percent increase from 2010. Even celebrities like musician Bruno Mars have publicly endorsed e-cigarettes as an alternative to smoking. The rapid rise of e-cigarette use has my patients asking me what the health risks of using e-cigarettes are and if they are safer than smoking regular cigarettes.

E-cigarettes vaporize a liquid solution (usually containing nicotine and flavoring), which users of the product commonly refer to as “vaping” to mimic the experience of smoking a traditional cigarette. The vaporized liquid means that e-cigarettes do not produce secondhand smoke and can therefore be used without inconveniencing people nearby. While this might seem like good news for consumers, the reality is that e-cigarettes are not regulated by the Food and Drug Administration, and so we have no way of knowing exactly what is in the solution and what the health risks might be.

E-cigarettes, often marketed as a healthier alternative to traditional cigarettes, are said to help smokers quit, be safer for long-term health and be less harmful to others as they do not emit secondhand smoke. But are e-cigarettes really a move in the direction of harm reduction? Do we need a new unregulated nicotine-dispensing device to help us be healthier?

It is clear that traditional cigarettes are harmful to health, but the health risks of e-cigarettes have yet to be exposed since they are unregulated. E-cigarettes differ from traditional cigarettes in that they do not give off harmful secondhand smoke or contain carcinogens such as arsenic and vinyl chloride. However e- cigarettes do contain nicotine, which can increase blood pressure and lead to addiction, coronary heart disease and cardiovascular issues later in life. Since e-cigarettes are unregulated, manufacturers do not have to disclose how much nicotine is in the solution. Additionally, many of the components of the liquid used in e-cigarettes may never have been studied for use as a vapor into the lungs, which could have unforeseen health risks.

E-cigarettes have also been marketed as an alternative to help quit smoking, but my patients who use them have said they make it easier to “smoke” while at work and home due to the discretion e-cigarettes provide. Also, the rapid nicotine surge they provide is less likely to help in smoking cessation than traditional nicotine gum and patches. Of course, e-cigarettes are not only promoted to those looking to quit smoking; they are also targeted at a whole new generation of “starters” who may be drawn to the ease of use, lack of smell, candy flavors and misplaced understanding that if e-cigarettes are safer, they are implicitly not as addictive.

Despite no secondhand smoke being emitted from e-cigarettes, they still pose a safety threat to others, especially children. According to the Centers for Disease Control and Prevention, 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. Some of the refill options available for e-cigarettes could be fatal at just two teaspoons for a child, and since e-cigarettes are unregulated, they are not required to be child resistant and tamper proof.

Though e-cigarettes may be used to replace a cigarette habit and could be a tool to help lifelong smokers kick the habit, I advise my patients not to use e-cigarettes until they are regulated and their health risks are fully understood. If you are trying to kick the cigarette habit and improve your health, visit your primary care physician who can help you develop a plan to quit smoking and build a healthier lifestyle.

Ari Gilmore, MD, practices family medicine at the Pacific Medical Center Beacon Hill clinic. He earned his medical degree from the University of Washington and certification from the American Board of Family Medicine. Click here to learn more about Dr. Gilmore.

Ari Gilmore, MD

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