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If you are considering trading your tobacco addiction for “something less toxic” you might be looking at electronic cigarettes as one of your options. E-cigarettes are battery-powered devices that heat a liquid nicotine solution in a disposable cartridge to create a vapor that’s inhaled, a practice known as “vaping.”
They’re sold at grocery and specialty stores, online, and are marketed to consumers — including minors — as being safer than traditional tobacco smokes.
Since being introduced to consumers in 2003, e-cigarettes have proven wildly popular, particularly among smokers trying to get off tobacco. So little was known about this new smokeless nicotine-delivery system that scores of studies have been initiated to figure out what, if any, benefits and risks the products pose to users.
Emerging research suggests that trading your tobacco products for e-cigs is probably a less toxic choice but the vapor devices' benefits still pale in comparison to smoking cessation. A panel of experts concurred, speaking at a press conference this week as part of the annual Frontiers in Cancer Prevention Research conference sponsored by the American Association for Cancer Research (AACR).
The e-cigarette market, and the devices themselves, are changing so rapidly, science is having a difficult time keep pace, said Dr. Scott Leischow, Ph.D., co-lead of the Cancer Prevention and Control Program at the Mayo Clinic in Scottsdale, Ariz. This presents numerous challenges to public health experts in determining whether or not the products are safe and effective.
“We’ve found the amount of nicotine people are getting from E-cigarettes does depress withdrawal symptoms, such as cravings, and individuals have reported it functions as a reasonable substitute for tobacco cigarettes,” Leischow said.
But it’s still unclear whether using the products for smoking cessation actually works, what the relapse rate might be, and whether or not e-cigarettes will ultimately reduce disease risk in smokers or produce new risks, he said.
The e-cigarette market is currently unregulated which means the devices, liquid and how and where they are marketed to consumers varies enormously. It also means they are not taxed the same way traditional tobacco products are. But that could change later this month.
The Food and Drug Administration (FDA) is set to decide within a few weeks whether to lump e-cigarettes in with conventional smokes as part of its oversight of the $90 billion U.S. tobacco market. Regulating e-cigs would likely pose greater restrictions on production, flavorings and where they’re sold and advertised. It’s even possible that states could consider restricting where the novel devices are used under the Clean Air Act.
In the last few years e-cigarettes have skyrocketed in popularity, with sales projected to approach $2 billion in 2013. While this sounds astronomical, electronic cigarette sales are still dwarfed by their analog cousins, whose sales are netting about $80 billion annually according to Wells Fargo Securities Analyst Bonnie Herzog in a report released in August.
However, Herzog forecasts that by 2021 e-cig sales will surpass tobacco as more smokers shift to healthier options.
E-cigs' phenomenal popularity offers scientists the rare opportunity to participate in real-time health, social and economic global research. Vapor users are in effect guinea pigs in a real world experiment that is being played out in a way that has not been available to researchers in the past.
Peter Shields, M.D., deputy director of the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and a professor at the Ohio State University College of Medicine in Columbus, said that in as little as two to five years, scientists will have definitive answers to some of the easier questions about the electronic devices.
In addition to safety and smoking cessation efficacy questions, researchers are also determining if the devices pose a risk as a “gateway” to traditional tobacco products for young people. One study presented at the conference suggests that’s unlikely.
“There is a lot of public health research that’s looking at E-cigarettes. We are often accused of being stuck in the tobacco wars, but most researchers are embracing the idea that if we have something that is helpful we want it as much as anyone else. But first we have to figure out if we are playing with fire here.”
Preliminary research conducted by the Roswell Park Cancer Institute in Buffalo, N.Y., suggested that e-cigarettes should be considered a harm-reduction tool.
Maciej Goniewicz, Pharm.D., Ph.D., assistant professor of oncology at Roswell conducted the preliminary study which showed that e-cigs deliver less harmful substances to users compared to tobacco cigarettes. However none of the panelists would go so far as to suggest e-cigarettes are “safe.”
“The whole idea behind e-cigarettes is that if we can provide a product that can deliver the nicotine without the other toxic substances, smokers can benefit by reducing their risk to cancer or cardiovascular disease. The idea is that the vapor released from the electronic version would be free of any toxins. Unfortunately, there are toxic substances generated from the products, including carcinogens,” Goniewicz said.
Some current research is focused on propylene glycol glycerin, an organic compound that’s in some e-liquids as well as in cough syrup, mouthwash and some skin and hair products. Some e-cigarette users report that inhaling the chemical provides a strong “throat hit” similar to traditional cigarettes.
“The industry will say Propylene glycol glycerin is generally recognized as being safe by the FDA. What they are talking about is what happens when it is put on your skin. We don’t know what happens when you inhale it, especially after it gets heated,” said Shields. “Those studies are harder to do and results may not be available for decades.”
The experts say that smokers who want to quit are better off using one of the already FDA-approved smoking cessation drugs than switching to e-cigarettes, at least until more information is known about electronic products.
Lynette Summerill is an award-winning writer and Scuba enthusiast who lives in San Diego with her husband and two beach loving dogs. In addition to writing about cancer-related issues for EmpowHER, her work has been seen in publications internationally.
Sources:
AACR Frontiers in Cancer Prevention Research Press Conference. “E-cigarettes and Their Impact on Health. 29 Oct. 2013.
V2 Cigs and National Tobacco Company Announce Strategic Partnership. Press release via Marketwired 23 April 2013.
http://www.marketwired.com/press-release/v2-cigs-and-national-tobacco-company-announce-strategic-partnership-1781533.htm
E-cigarette sales are smoking hot, set to hit $1.7 billion. Dan Mangen, CNBC.com. 28 Aug. 2013.
http://www.cnbc.com/id/100991511
Electronic Cigarettes (e-Cigarettes). U.S. Food and Drug Administration.
http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm172906.htm
Reviewed October 31, 2013
by Michele Blacksberg RN
Edited by Jody Smith
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