Posted September 22, 2011, 10 07 am Harvey B. Simon, M.D., Editor, Harvard Health

Kicking the cigarette habit is one of the best things that smokers can do for themselves. Nicotine replacement products, prescription medications, and counseling can all help. What about the newest tobacco substitute, the electronic cigarette? Despite the appeal of so called e cigarettes, we don t know enough about their safety or effectiveness to give them the green light.

Electronic cigarettes come in a variety of shapes. Some look like cigarettes, pipes, or cigars, while others are disguised as pens or other more socially acceptable items. Whatever their shape, they all are built around a battery operated heating element, a replaceable cartridge that contains nicotine and other chemicals, and an atomizer that converts the chemicals into an inhalable vapor.

A study published this spring in the American Journal of Preventive Medicine concluded that electronic cigarettes may help smokers quit. Whether they are a safe way to quit is another question preliminary studies from the FDA, New Zealand, and Greece raise some concerns.

There are three reasons to worry about electronic cigarettes. First, the dose of nicotine delivered with each puff may vary substantially. An FDA analysis recorded nicotine doses between 26.8 and 43.2 micrograms per puff. It also detected nicotine in products labeled as nicotine free.

Second, electronic cigarettes deliver an array of other chemicals, including diethylene glycol (a highly toxic substance), various nitrosamines (powerful carcinogens found in tobacco), and at least four other chemicals suspected of being harmful to humans. To be sure, the dose of these compounds is generally smaller than found in “real” cigarette smoke. But it isn’t zero.

Third, by simulating the cigarette experience, electronic cigarettes might reactivate the habit in ex smokers. They could also be a gateway into tobacco abuse for young people who are not yet hooked.

We need scientific studies of e cigarettes. Until then, it’s caveat emptor, buyer beware. And be aware that there are better and safer ways to quit. The most effective strategy involves using nicotine replacement or a medication along with some sort of counseling or support, either in person, by telephone, or even by text message.

If you want to quit, solid information and advice are available at , a Web site developed by the National Cancer Institute. Any of the approved methods are vastly preferable to smoking and to electronic cigarettes.

Dr. Harvey Simon is Editor of the Harvard Men’s Health Watch, a monthly newsletter written to help men lead healthier, longer lives. Related Information How to Quit Smoking 10 Minute Consult Print Related Posts

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Comments 103 Topics Addiction Prevention

Are electronic cigarettes safe?

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Electronic cigarettes aka e cigarettes are devices that deliver nicotine in vapor form to users via a simple battery powered system. Electronic cigarettes look like real cigarettes, and some even have an illuminated tip! The manufacturers of electronic cigarettes promote the devices as alternatives to conventional cigarettes and as smoking cessation tools.

What’s the point of electronic cigarettes?

Electronic cigarettes were created to provide smokers with another tool to help wean them off tobacco products and eventually stop smoking. Nicotine is the main addictive component in tobacco. So, just like the nicotine patch and nicotine gum, electronic cigarettes should satisfy smokers’ cravings and allow them to stop using tobacco products, which contain many toxins and cancer causing chemicals in addition to nicotine.

Electronic cigarettes might theoretically prove more effective than other forms of nicotine replacement because they more closely mimic the act of smoking, and thus serve as a more lifelike substitute. However, although research has shown that electronic cigarettes can help people stop smoking, there haven’t been any head to head comparisons with other forms of nicotine replacement in large populations.

So electronic cigarettes are a good thing, right?

Not so fast. The FDA highlights the following safety concerns with regard to electronic cigarettes

  • Electronic cigarettes have been associated with dry cough, and mouth and throat irritation.
  • Electronic cigarettes may reduce lung function according to some studies, although other studies haven’t found a substantial effect.
  • After analyzing the delivery cartridges in electronic cigarettes, the FDA found amounts of at least two well known cancer causing chemicals.
  • Electronic cigarettes can cause a large rise in the blood level of nicotine, and nicotine isn’t entirely harmless besides being addictive, it can raise the heart rate and blood pressure and damage small blood vessels, such as the coronary arteries, which supply blood to the heart.
  • No study has yet adequately assessed the long term safety of electronic cigarettes.

Are there other concerns about electronic cigarettes?

Yes. The manufacturers of electronic cigarettes market them to young people, putting them at risk for developing a nicotine addiction that could lead to eventual tobacco use. Electronic cigarettes are produced in a variety of flavors including chocolate, vanilla, strawberry, and mint that are meant to appeal to adolescents. Currently, electronic cigarettes can be sold without age restrictions, and they don’t require warning labels.

What if I use electronic cigarettes only recreationally?

We discourage everyone particularly young people from using electronic cigarettes as a recreational drug. We don’t know their long term safety, and nicotine addiction is a real concern.

So what’s the best option if I want to quit smoking?

If you want to stop smoking, there are alternatives whose efficacy and side effects are better understood. These range from forms of nicotine replacement, to prescription medications, to interventions such as behavioral therapy. If you’re having trouble quitting smoking on your own, talk to your primary care physician, who will be delighted to help you sort through the alternatives and come up with a plan that best suits your needs.

A healthier, happier life starts with doctors who put your needs first. Learn more about One Medical Group and our convenient locations in the San Francisco Bay Area, New York City, Washington, DC, Boston, Chicago, and Los Angeles. Tags e cigarettes, electronic cigarettes, quitting smoking, smoking, smoking cessation
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