E-Cigarettes Lack Evidence of Health Benefits

Thursday, August 14, 2008 11:20 AM by kenw
Ken Wassum, Senior Product Manager:

 

Is that person over at the corner table at your favorite smoke-free restaurant smoking? Maybe yes…maybe no.

A new product on the market is the electronic cigarette. Here’s how they work. Each unit has a cartridge containing nicotine and water, a heating element, and a battery. Most look pretty much like a real filtered cigarette. When you puff on the filter, the element vaporizes the water/nicotine solution and you take that into your lungs. Nicotine delivered to the lungs gets to the brain very quickly. It supposedly tastes like a real cigarette, but has no smoke – only vapor with nicotine. In essence, it is a nicotine delivery system.

So are they safe? Can they help people quit smoking actual cigarettes? How much nicotine do they deliver at each puff? Can a user become addicted to the e-cig? These are all good questions, but there are no good answers. Why? The answer is that these products are not regulated in any way. Not by the Federal Drug Administration. Not by the Federal Trade Commission. Not by anybody. We have only the word of the manufacturer to go by.

One could presume they are safer than a real cigarette, with its 4,000 chemicals and over 60 carcinogens, because the e-cigarette purportedly has no smoke—only water vapor with nicotine. But, we really don’t know if they are safe or not. Since they do contain nicotine, they undoubtedly have some addiction potential, but we don’t know how addictive they might be.

Can they help people quit smoking? The manufacturer of Safesmoke E-Cigarette says they can. But, their claims not based on any data from external evaluators or any studies. So, in fact, we have no idea if they can help someone quit smoking.

E-cigs are being made by a number of manufacturers, mainly in Asia. These include the Smoke Everywhere E-Cig, the Safesmoke E-Cigarette, the Ruyan E-Cigarette, along with several others. They sell for somewhere between $50 and $150. Cartridges containing water and nicotine sell for about $2 each. Safesmoke claims that you get around 300 puffs from each cartridge.

One thing is clear. Most of these products are being marketed to smokers to use “where smoking is not allowed.” With more and more states implementing smoke-free indoor air regulations, the market could be significant. A big question is whether these products are actually allowed to be used in smoke-free areas. Is a restaurant owner going to allow someone to use something that looks like it is putting out smoke and risk a big fine? Or, risk losing business to patrons who do not want to be exposed to this “smokeless cigarette”?

Free & Clear cannot recommend these products to smokers. With no scientific studies examining their safety or proven ability to help smokers quit, we can only remain suspect. Since there are clinically and scientifically validated ways to help smokers quit (Clinical Practice Guidelines), we see no place for this product in the field of tobacco dependence treatment at this point in time.

We will be watching these products closely and post an update when there is more information.

Actions: Permalink | Comments (8)

Comments

Jeremy H us

Friday, August 15, 2008 6:16 AM

This reminds me of the Nicotine Water debacle:
www.cbsnews.com/.../main514046.shtml

In the nicotine water situation, the FDA did get itself involved in shutting down the distributor. I noticed the company has shifted it's focus to marketing the product in other countries but will not sell it in the United States.

While we are always looking for a more comfortable or "easy" way to quit, it still stands that the tried and true methods for quitting (as outlined by Ken in the Clinical Practice Guidelines) are what are the keys to success. While it's encouraging to see new and evolving methods, NOW is always the best time to quit and be free!

Scott us

Saturday, August 16, 2008 2:16 AM

I bought one of these (4 weeks ago)and have not smoked a cigarette in 4 weeks

Kristine Carabeo us

Friday, August 22, 2008 10:29 AM

In our tech hungry world, I'm not surprised at the creation of the e-cig. I wouldn't be surprised if something like an iCig is created by Apple that gives you your nicotine boost while listening to a smoking play list.

But I like your point about what implications might come if a product like this were to be used in places that don't allow smoking. For people who are trying to quit or who have quit, they often find solace in places where people don't smoke. What would happen if they see people recreating that smoking experience with an e-cig?

Laurie us

Wednesday, October 08, 2008 12:39 AM

43 years of smoking 1.5 to 2 packs a day of increasingly expensive cigarettes. Then standing outside in blizzards and hurricanes, I switched in ONE DAY to e cigs. They cost less (4-5 cartons a month - $150 a month vs. e-cig intial purchase including 50 "refills for $98 and now all I need to buy is the "juice"). Someone brought a case into court in nevada and the e-cig won. I'm sure the anti-smoking bullies will lauch an attack... but for now I'm a happy "ex" smoker. No ashtrays, no butts, no smoke smell... It's a good thing.

Rosemarie us

Sunday, October 19, 2008 8:56 PM

Like Laurie, I've smoked for 40 years and was able to stop smoking the first day with my mini e-cigarette. This wasn't the case with patches and gum - I would light a cigarette while wearing the patch. So this is a miracle-find for me... absolutely the BEST invention!

Tony us

Thursday, October 30, 2008 8:03 PM

E-Cigs were not meant to stop smoking...they are for smoking a little bit healthier and a whole lot cleaner. My house and car don't stink. My aunt will sit with me at the kitchen table for coffee. My children don't need to worry about any fire issues. I can live in a high rise senior apartment and still be considerate of my neighbors. I like to smoke, don't want to quit..I just switched to electronic cigs. www.torchcigarettes.com

JJ gb

Saturday, November 01, 2008 10:33 PM

What on earth is wrong with non/ex smokers, is there a general intellegence problem, do they enjoy moaning for the sake of it or are they just opposed to personal freedom of choice. These products release hot water vapour for goodness sakes. The original argument for the smoking ban was passive smoking, that is not an issue with this product. If someone chooses to ingest nicotine and that person is an adult what earthly business is it of anyone else, just as it is no one elses affair when people choose to ingest caffiene while the steaming water vapour from that drug of choice also wafts into public spaces.

Ken Wassum us

Friday, November 14, 2008 5:46 PM

While Free & Clear cannot recommend these products due to a lack of empirical data on their safety, I can offer my personal perspective. Tobacco smoke has a host of dangerous chemicals and toxins that are very damaging to a smoker's health. Tobacco smoke also contains nicotine, and while addictive, it is "relatively" harmless. To the best of our knowledge it does not cause smoking related cancer and other diseases of the lung, such as emphysema.

These electronic cigarettes have been designed to allow smokers to choose a "safer" mechanism to ingest nicotine. If they prove to be safe, then these products may very well be a viable alternative to smoked tobacco, or to use when a person cannot smoke tobacco, such as a smoke-free restaurant. And since the nicotine is delivered in a vapor to the lungs it is absorbed much more quickly than nicotine from the nicotine patch, gum, or lozenge. As such, it is probably much more satisfying to the user than FDA approved nicotine replacement products.

These products need more testing to assess their safety. We are told by the manufacturer that they deliver only water vapor and nicotine. The problem is that they do not fall under the the oversight of the FDA or other regulatory agencies, so they are not subject to further scrutiny. I do hope that they prove to be a safe alternative to smoked tobacco.


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Thursday, November 20, 2008 1:30 AM