Can E-cigarettes Really Help You Quit Smoking? Our Tobacco Treatment Specialist Weighs In

Northwestern Medicine
Pulmonology September 18, 2013
Tabacco Treatment Specialist Carol SouthardA study just released by the Centers for Disease Control (CDC) found that the percentage of middle and high school students who use electronic cigarettes more than doubled from 2011 to 2012. Unfortunately, the long-term effects of electronic cigarettes are unknown.

Here’s how they work: Electronic cigarettes, or e-cigarettes, are battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol. Many electronic cigarettes look remarkably like the real thing and include a red light at one end to mimic the burning embers of a cigarette. It has a chamber for storing liquid nicotine, which is heated to a mist and inhaled into the lungs.

They are currently unregulated by the Food and Drug Administration (FDA). While the FDA has announced that it intends to expand its jurisdiction over tobacco products to include e-cigarettes, it has not yet issued regulatory rules. Because e-cigarettes are unregulated, the agency does not have good information about them, such as the amounts and types of components and potentially harmful constituents.

While the products have not been fully evaluated for safety, quality and efficacy, a 2009 FDA analysis of e-cigarettes from two leading brands found that the samples contained carcinogens and other hazardous chemicals, including diethylene glycol, which is found in antifreeze. Last year, a report from Greek researchers found that using e-cigarettes caused breathing difficulties in both smokers and non-smokers. This year, a French based research group found that e-cigarettes contain “potentially carcinogenic elements”. The British Medical Association and the World Health Organization have each issued warnings about the dangers that may be associated with the smoking devices. Many countries have already banned sale – including Canada, New Zealand and Australia. All of the US airline companies ban use in-flight.

Although some e-cigarettes have been marketed as smoking cessation aids, there is no conclusive scientific evidence that e-cigarettes promote successful long-term quitting. Like any product with nicotine - which is more addictive than heroin, cocaine or alcohol - many who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and inevitably turn to conventional cigarettes. And there is some evidence that current smokers are using e-cigarettes as a way to ingest nicotine in places where smoking is restricted. This may cause some smokers to delay or even avoid quit attempts altogether.

Perhaps the most potent argument against use is that American Tobacco companies are now manufacturing electronic cigarettes. Although electronic cigarettes are marketed as a safer alternative to conventional tobacco products, once Big Tobacco starts to refine electronic cigarettes, they will no doubt become even more dangerous – as happens with all their products.

For all the above reasons, I do not recommend use of electronic cigarettes in my highly successful Tobacco Cessation Program offered at Northwestern Memorial Hospital. While electronic cigarettes are probably “harm reduction” when compared to traditional tobacco products, health benefits only truly occur by stopping use of all tobacco and inhaled products. Moreover, there are proven safe and effective cessation strategies and treatments, including counseling and FDA-approved cessation medications.

Carol Southard, NRN, MSM
Tabacco Treatment Specialist
Northwestern Integrative Medicine
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