Published Mar 6, 2014
Last week, a patient of mine who has lung cancer told me that our recent heart-to-heart discussion about her need to quit smoking cigarettes had actually worked: After 42 years of the nasty habit, she had stopped. The tears that started to well up in my eyes quickly began to dry, however, as he went on to explain that she had replaced her Marlboros with electronic cigarettes.
Like most non-smokers, I did not know much about electronic cigarettes, or e-cigs, as theyre commonly called, except that they have been frequently mentioned in the news recently because of their rapidly growing popularity (U.S. sales of them are expected to double this year, to over $1 billion) and the fact that little is known about their health effects.
I view anything with the word cigarette in it as negative. I dont even like candy cigarettes, because they introduce the idea of smoking to kids, who often pretend to smoke them, and make cigarettes seem familiar and maybe even fun.
Cigarette smoking is known to cause 30% of all cancer deaths and 87% of all lung cancer deaths. It can also cause cancers in the nasopharynx, mouth, lip, tongue, and bladder. Tobacco smoke is known to contain thousands of chemicals that are potentially dangerous to the lungs and body icyanide, tar, carbon monoxide gas, benzene, formaldehyde, methanol, acetylene, and ammonia, to name a few. In addition to all of the smoking-related cancers, smoking also leads to diseases such as emphysema, COPD, vascular disease, stroke, heart disease, and others, many of which can be as incapacitating as cancer. So we know that people should not start smoking, and if they do already smoke, they need to stop.
I decided to do a little research about e-cigarettes. Here is what I found out:
- E-cigarettes are basically plastic tubes that light up and turn the liquid they contain into water vapour that can be breathed in, providing the nicotine, sensation, and appearance of smoking. Most of them are made in China.
- E-cigarettes are battery operated, so dont require matches or lighters, and dont produce the litter of cigarette butts. Since e-cigs dont really give off smoke, theyre allowed in more places, which is a large part of their appeal.
- In addition to the extremely addicting nicotine, e-cigarettes deliver flavoring (bubble gum, cherry, chocolate, and others) and other chemicals, such as acetylaldehyde and benzene.
- E-cigarettes do not, apparently, contain the tar and tobacco carcinogens that have been so intrinsically linked to the development of lung cancer, emphysema, and COPD in cigarette smokers.
- Although they require an upfront investment for the charging kit and cartridges, over time e-cigarette smoking is touted as less expensive because the disposable liquid is less expensive than a cigarette. Of course, this could change if the products become taxed like cigarettes.
- Although many of the early e-cigarette companies have been small startups, big tobacco is now getting into the business in a big way. Lorillard and Altria have acquired e-cigarette makers, and the others will soon get into this rapidly growing segment, spending big bucks on marketing and distribution. Since e-cigarette ads are not banned by the FCC, we will soon see advertisements for cigarettes on TV for the first time in decades. Although no major networks have yet agreed to carry them, cable networks are lining up to take tobaccos money.
- Much to the dismay of parents, E-cigarettes are being successfully marketed to teens. According to the CDC, the number of middle and high school students experimenting with e-cigarettes doubled between 2011 and 2012 to an estimated 1.8 million students. 10% of high school students last year claimed they had tried e-cigarettes, up from 4.7% the year before. Many of the e-cigarette experimenters had never tried conventional cigarettes.
In some of the more sophisticated and expensive e-cigarette varieties, you can adjusted the amount of nicotine delivered per smoke, using it to taper nicotine intake over time and wean the smoker off the habit, in a way similar to that of the nicotine patch.
If e-cigarettes can help smoking cessation, then perhaps there is a glimmer of hope here. The problem is that we dont really know enough about e-cigarettes to deem them safe. They are not yet regulated by the FDA, but that is about to change, reportedly.
Although I would not feel comfortable recommending that my lung cancer patients switch from tobacco to electronic cigarettes, I do feel that getting them to stop inhaling the thousands of chemicals in cigarette smoke is a good thing.
Futhermore, anything that helps reduce the amount of second-hand smoke in the home, on the street, or in the car exposing other people to dangerous second-hand smoke is a step in the right direction as well.
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