Electronic Cigarettes

Electronic Cigarettes

After watching a few hours of local TV, I was impressed about the number of commercials dedicated to a new store that specialized in electronic cigarettes (aka a “vape shop”). I have also had quite a few patients answer the question, “Do you use tobacco?” with “Not anymore, I have switched to e-cigs”. In fact, according to the Center for Disease Control and Prevention (CDC), electronic cigarette use doubled among middle and high school students in the past year. This has encouraged me to investigate electronic cigarettes, or “vaping”, a little more closely.

The electronic cigarette has a few parts: a rechargeable battery, a canister of nicotine liquid (with or without added flavor), and a heating device. The nicotine liquid is heated into a vapor and the user can inhale this vapor to receive a similar sensation to smoking a cigarette.

Why would someone choose an electronic cigarette over a traditional cigarette? The people who advertise electronic cigarettes state that the advantage is that the user does not receive all the toxins, like tar, arsenic, formaldehyde, and the thousands of other poisons found in cigarettes. They also decrease exposure to secondhand smoke and may decrease the other side effects of smoking cigarettes, like yellow hair and teeth and bad smelling clothes. However, nicotine, one of the most addictive chemicals around, itself is a toxin that formerly was used as an insecticide. And with electronic cigarettes, you may be getting even more of the addictive substance. According to a local store’s website, for every 18-26mg of nicotine vaporized, 10-18mg of nicotine will be delivered (which is over 10 times the amount of nicotine delivered by smoking a traditional cigarette). Nicotine can cause harm to people other than the “vapers” as well.

The American Academy of Pediatrics acknowledged last month that over half the calls to Poison Centers ever the past few years were related to electronic cigarettes. Poisoning from traditional cigarettes is usually from children eating them, but poisonings from e-cigarettes are due to the nicotine liquid being ingested, inhaled or absorbed through the skin or eyes. “E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children,” CDC director Tom Frieden, M.D., M.P.H., said in a press release.
The Food and Drug Administration (FDA) is looking further into how to handle the electronic cigarette situation. There have not been robust studies analyzing the safety of electronic cigarettes, their success in smoking cessation (akin to the nicotine patch or gum, one of the marketing strategies), or if they pose a threat as a gateway drug to nicotine addiction.

The FDA proposed last month to regulate electronic cigarettes similar to the regulation of tobacco products, by prohibiting sales of electronic cigarettes to youth under the age of 18, as well as preventing the distribution of free samples. Read the full FDA proposal and submit any formal comments. The public can comment until 7/9/14.

As the FDA decides on how to regulate electronic cigarettes, share your opinion with us by leaving a comment.

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