Are Electronic Cigarettes Safe? Dr. Michael Fiore

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• Electronic Cigarettes Are The Latest Development For Smokers

  While cigarettes and other tobacco products have been more or less unchanged for decades, there is a new product on the market for smokers. Whether it is safe or not is hotly contested.

  The Food and Drug Administration describes electronic cigarettes, also known as e-cigarettes, as “battery-operated products designed to deliver nicotine, flavor and other chemicals. They turn nicotine – which is highly addictive – and other chemicals into a vapor that is inhaled by the user. While some actually look like cigarettes, cigars, or pipes, others are more like a pen, or even a USB key.

  Dr. Michael Fiore is a professor of medicine at the University of Wisconsin School of Medicine and Public Health. He is also the director of the UW Center for Tobacco Research and Intervention (UW-CTRI). According to Fiore, electronic cigarettes “have become incredibly popular, and not surprisingly, a big part of that is that the tobacco industry has decided that there are profits in e-cigarettes and they’ve bought some of the brands, and they are heavily marketing their products. So they’ve become ubiquitous.” The rate of use has increased rapidly. As recently as 2010, 2 percent of adults reported having used an e-cigarette. By 2012, that has risen to 11 percent, including half of current smokers.

  Fiore has several concerns about e-cigarettes. There are 250 brands of e-cigarettes, ranging from “mom-and-pop” producers to Big Tobacco producers. Those brands vary tremendously, so it is nearly impossible to know what you are getting. Oversight is not as strict as it is for traditional tobacco products.

  Whether e-cigarettes are a means to eventually quit smoking, or are just a convenient way to get a nicotine fix is also up for debate. Stanton Glantz is a professor of medicine at the Center for Tobacco Control at the University of California-San Francisco. In a recent article in Scientific American, he says there is not a lot of longitudinal data since e-cigarette use is so recent, but what is available is not encouraging. “I am a realist who is driven by data. I started out agnostic on e-cigarettes. While there is not a lot of information available now, what is there is pointing to dual use and e-cigarettes impeding quitting cigarettes. All the big cigarette companies are now getting into this market. They are not going to market those products in a way that jeopardizes the cigarette market.”

  In addition, the vapor that is expelled from an e-cigarette may seem less harmful than smoke from a traditional tobacco cigarette, but that’s not necessarily the case. Compounds like formaldehyde, cadmium, lead and other toxic and carcinogenic substances have been detected in the water vapor. The Scientific American article lists ten regulated compounds that can be present in e-cigarette vapor. This is of particular concern because while many public spaces are now smoke-free, those same locations may allow e-cigarette use. So second-hand vapor exposure could mean trouble.

  The Journal of the American Medical Association published an article in July 2013 that covers many of the issues raised by Dr. Fiore. It emphasizes the need for close regulation of e-cigarettes, either as a nicotine delivery system (like tobacco products), or as a smoking cessation aid.

  Glantz explains that “there’s an assumption among the harm reduction people that if you could snap your fingers and get every smoker to switch to e-cigarettes, you’d be ahead. One problem is that you can’t do that. While the industry uses social media and the internet to present e-cigarettes as a miracle way to quit … no independent studies show that e-cigarettes actually help people quit. They may even discourage quitting.”

  Recent statistics show that headway has been made in reducing the number of smokers. 2012 data shows that 18% of adults in the US are smokers. That number was about 45% at its peak in the 1960s, so that is an encouraging trend. But that still means that 45 million people in the US are still smoking. And in Wisconsin, that comes out to almost a million adult smokers. In addition, smoking is increasingly concentrated in poor communities, among people with lower levels of formal education, and those with mental health & substance abuse issues. With smoking more concentrated in these demographic groups, more outreach and affordable support is more important than ever.

  The UW Center for Tobacco Research and Intervention offers a variety of resources for smokers wanting to quit, including the free Wisconsin Tobacco Quit Line at 1-800-QUIT-NOW (800-784-8669).