A Boston University School of Public Health (BUSPH) researcher is bucking concerns raised by the United States Food and Drug Administration (FDA) regarding electronic cigarettes, saying they are much safer than the real deal and show real promise in the fight against tobacco-related diseases and death.
Michael Sigel, professor of community health sciences at BUSPH and colleagues were the first to comprehensively examine scientific evidence about the safety and effectiveness of electronic cigarettes. The battery-powered devices, also known as e-cigarettes, provide tobacco-free doses of nicotine in a vaporized solution. The review is published early in the December 9, 2010 online edition of Journal of Public Health Policy.
“Few, if any, chemicals at levels detected in electronic cigarettes raised serious health concerns,” the authors said. “Although the existing research does not warrant a conclusion that electronic cigarettes are safe in absolute terms and further clinical studies are needed to comprehensively assess the safety of e-cigarettes.”
Siegel said available evidence shows the electronic device to be much safer than tobacco cigarettes and comparable in toxicity to conventional nicotine replacement products.
Siegel’s report reviewed 16 lab studies that identified the components in e-cigarettes liquid and vapor. The authors found the level of cancer-causing ingredients in electronic versions are up to 1,000 times lower than in traditional cigarettes.
“The FDA and major anti-smoking groups keep saying that we don’t know anything about what is in e-cigarettes,” Siegel said. “The truth is, we know a lot more about what is in e-cigarettes than regular cigarettes.”
E-cigarettes have proven controversial since debuting in the United States three years ago. The FDA has threatened to ban the sale of e-cigarettes and six national anti-smoking groups — The American Cancer Society, American Heart Association, American Lung Association, Campaign for Tobacco-Free Kids, American Legacy Foundation, and Action on Smoking and Health — have called for e-cigarettes to be removed from the market.
The anti-smoking groups cite concerns that the FDA has not evaluated any e-cigarettes for safety and effectiveness, and that the devices contain dangerous chemicals marketed toward children.
“The only ones who would be protected by a ban on e-cigarettes are the tobacco companies, as these new products represent the first real threat to their profits in decades," Siegel said.
In December 2010, The U.S. Court of Appeals for the D.C. Circuit ruled the FDA could only regulate e-cigarettes as tobacco products, not as drug-delivery devices. The Associated Press reported Dec. 7. that the court said it in its ruling that the Federal Food, Drug, and Cosmetic Act does not give the FDA authority to regulate e-cigarettes under the same rules as nicotine gum or the nicotine patch.
The ruling prevents the FDA from requiring e-cigarette manufacturers to conduct stringent clinical trials to prove the products safety and effectiveness as an aid to quit smoking, even while new research is emerging on the product.
Investigators at the Schroeder Institute for Tobacco Control and Georgetown University’s Lombardi Center reported this month that they lab-tested different brands of e-cigarettes and found that the amount of nicotine delivered varied greatly, depending upon the maker of the device, the cartridge used, and “even from puff to puff.”
“This inconsistency suggests poor quality control measures, which contributes to the list of unknowns about [e-cigarettes] and adds to the public health community’s skepticism surrounding the products,” said the study’s lead author, Nathan Cobb, MD, Research Investigator at the Schroeder Institute.
Cobb and his colleagues said that although manufacturers claim that e-cigarettes may reduce the harm associated with cigarette smoke, the devices also present risks not associated with tobacco. The full effects of e-cigarette use may not be known for years.
However, Siegel, who has 25 years of experience in the field of tobacco control and claims no financial interest in e-cigarettes, believes removing e-cigarettes from the market would force thousands of users to return to traditional cigarette smoking.
In his report, Siegel cited preliminary evidence that e-cigarettes can be effective in suppressing the urge to smoke, largely because they simulate the act of smoking a real cigarette. He argued that smoking-related stimuli alone have been found capable of suppression tobacco abstinence symptoms for long periods of time.
The Cobb study, “Novel Nicotine Delivery Systems and Public Health: The Rise of the ‘E-Cigarette,’” appeared in the December 2010 issue of the American Journal of Public Health.
Lynette Summerill is an award-winning writer who lives in Scottsdale, Arizona. In addition to writing about cancer-related issues for EmpowHER, she pens Nonsmoking Nation, a blog following global tobacco news and events.