FRIDAY, Jan. 3, 2014 (HealthDay News) -- It's the new year, a
time when a smokers' thoughts often turn to quitting.
Some people may use that promise of a fresh start to trade their
tobacco cigarettes for an electronic cigarette, a device that
attempts to mimic the look and feel of a cigarette and often
Here's what you need to know about e-cigarettes:
What is an e-cigarette?
The U.S. Food and Drug Administration (FDA) describes an
e-cigarette as a battery-operated device that turns nicotine,
flavorings and other chemicals into a vapor that can be inhaled.
The ones that contain nicotine offer varying concentrations of
nicotine. Most are designed to look like a tobacco cigarette, but
some look like everyday objects, such as pens or USB drives,
according to the FDA.
How does an e-cigarette work?
"Nicotine or flavorings are dissolved into propylene glycol usually, though it's hard to know for sure because they're not regulated," explained smoking cessation expert Dr. Gordon Strauss, founder of QuitGroups and a psychiatrist at Lenox Hill Hospital in New York City. "Then, when heated, you can inhale the vapor."
The process of using an e-cigarette is called "vaping" rather
than smoking, according to Hilary Tindle, an assistant professor of
medicine and director of the tobacco treatment service at the
University of Pittsburgh Medical Center. She said that people who
use electronic cigarettes are called "vapers" rather than
Although many e-cigarettes are designed to look like regular
cigarettes, both Tindle and Strauss said they don't exactly
replicate the smoking experience, particularly when it comes to the
nicotine delivery. Most of the nicotine in e-cigarettes gets into
the bloodstream through the soft tissue of your cheeks (buccal
mucosa) instead of through your lungs, like it does with a tobacco
"Nicotine from a regular cigarette gets to the brain much quicker, which may make them more addictive and satisfying," Strauss said.
Where can e-cigarettes be used?
"People want to use e-cigarettes anywhere they can't smoke," Strauss said. "I sat next to someone on a plane who was using an e-cigarette. He was using it to get nicotine during the flight." But he noted that just where it's OK to use an e-cigarette -- indoors, for instance? -- remains unclear.
Wherever they're used, though, he said it's unlikely that anyone
would get more than a miniscule amount of nicotine secondhand from
Can an e-cigarette help people quit smoking?
That, too, seems to be an unanswered question. Tindle said that
"it's too early to tell definitively that e-cigarettes can help
A study published in
The Lancetin September was the first moderately sized,
randomized and controlled trial of the use of e-cigarettes to quit
smoking, she said. It compared nicotine-containing e-cigarettes to
nicotine patches and to e-cigarettes that simply contained
flavorings. The researchers found essentially no differences in the
quit rates for the products after six months of use.
"E-cigarettes didn't do worse than the patch, and there were no differences in the adverse events," she said. "I would be happy if it turned out to be a safe and effective alternative for quitting, but we need a few more large trials for safety and efficacy."
Strauss noted that "although we can't say with certainty that
e-cigarettes are an effective way to quit, people are using them"
for that purpose. "Some people have told me that e-cigarettes are
like a godsend," he said.
Former smoker Elizabeth Phillips would agree. She's been
smoke-free since July 2012 with the help of e-cigarettes, which she
used for about eight months after giving up tobacco cigarettes.
"E-cigarettes allowed me to gradually quit smoking without completely removing myself from the physical actions and social experience associated with smoking," Phillips said. "I consider my e-cigarette experience as a baby step that changed my life."
Are e-cigarettes approved or regulated by the government?
E-cigarettes are not currently regulated in a specific way by
the FDA. The agency would like to change this, however, and last
April filed a request for the authority to regulate e-cigarettes as
a tobacco product.
The attorneys general of 40 states agree that electronic
cigarettes should be regulated and sent a letter to the FDA in
September requesting oversight of the products. They contend that
e-cigarettes are being marketed to children; some brands have fruit
and candy flavors or are advertising with cartoon characters. And,
they note that the health effects of e-cigarettes have not been
well-studied, especially in children.
Are e-cigarettes dangerous?
"It's not the nicotine in cigarettes that kills you, and the nicotine in e-cigarettes probably won't really hurt you either, but again, it hasn't been studied," Strauss said. "Is smoking something out of a metal and plastic container safer than a cigarette? Cigarettes are already so bad for you it's hard to imagine anything worse. But, it's a risk/benefit analysis. For a parent trying to quit, we know that secondhand smoke is a huge risk to kids, so if an electronic cigarette keeps you from smoking, maybe you'd be helping kids with asthma or saving babies."
But on the flip side, he said, in former smokers, using an
e-cigarette could trigger the urge to smoke again.
The other big concern is children using e-cigarettes.
"More and more middle and high school kids are using e-cigarettes," Tindle said. "Some are smoking conventional cigarettes, too. The latest data from the CDC found the rate of teens reporting ever having used an e-cigarette doubled in just a year. We could be creating new nicotine addicts. We don't know what the addictive properties of e-cigarettes are," she added.
"It's shocking that they've been allowed to sell to minors," Tindle said.
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