Ken Wassum, Senior Product Manager, Tobacco:
Does the electronic cigarette, commonly called the E-cig, hold promise for a healthier alternative to smoked tobacco? Or, is it potentially dangerous? There is a lot of fuss about this product. Some of it is justified and some of it is a little silly –well intentioned, but still silly.
Those who support the E-cig say it provides a safe alternative to smoked tobacco, and they could be right. They argue that since the product delivers nicotine in the absence of the other 4,000 chemicals and carcinogens in tobacco smoke, it has to be safer. And while we know that nicotine can be addictive, it is not a known carcinogen nor does it cause serious health problems. No argument there.
So what’s the problem? The problem is that there is to date no safety data from an independent evaluator. It follows that if this product simply delivers nicotine in a vapor (not smoke) in dosages similar to that of a cigarette, it very well could be as safe as FDA approved over-the-counter nicotine replacement products like the patch, gum, and lozenge. But, again, until we have reliable safety data, it is all speculation.
As someone who has delivered treatment for tobacco use dependence for over 16 years I have encountered many who firmly believe that helping people become nicotine-free is as important as helping them become smoke-free. Very early in my career I might have agreed with them, but my experience has taught me that this is a bit extreme, and in fact, may not be in the best interest of those trying to quit smoking. Some former smokers remain on nicotine replacement therapy long-term with no known adverse consequences. Without question, long-term use of NRT is to be preferred over any level of smoking.
However, those who fall into the nicotine-free school of thought fear that those who continue to use nicotine long-term in the form of patch, gum, lozenges, or the E-cig, will eventually return to smoking, because of their dependence on nicotine. It is a legitimate concern. The problem is that there is no empirical data to support their position. And without empirical data, anybody’s guess is as good as another’s.
So, until we have such data, the E-cig needs to be viewed cautiously, but with an open mind. The stakes are too big. If indeed the product is safe and is successful in the market it could (and I am saying could), be another tool of harm reduction tactics that might reduce disease and death related to smoked tobacco. If it turns out not to be safe then we have another nicotine delivery system and subsequent addiction to deal with.
If the FDA would simply step up to the plate with a thorough analysis of the E-cig we might have some answers. Such analysis is long overdue.