E-cigarettes Are Not Harmless, But Are They Still Helpful? - Virtua Article

E-cigarettes Are Not Harmless, But Are They Still Helpful?

By Emilio Mazza, MD, PhD, Pulmonolgist—Virtua Pulmonology

Those interested in trying e-cigarettes may be confused about the risks involved. Many believe that because the nicotine is delivered through water vapor, they’re harmless. While e-cigarettes likely cause less harm than traditional cigarettes, they shouldn’t be considered a “safe” alternative.

In addition to water and nicotine, e-cigarette vapor also contains propylene glycol and glycerin (as well as flavoring). Propylene glycol and glycerin are considered relatively safe in other products we use like cosmetics, medications, and even food. But, we don’t yet know the impact of inhaling them into our lungs. In general, intentionally inhaling a foreign substance is never a good idea. Some early research has suggested that e-cigarettes can trigger a variety of inflammatory responses in the lungs, including pneumonia and asthma.

Since e-cigarettes haven’t been around that long, long-term research simply isn’t available yet. Surely, there are potential dangers that we just don’t know about...yet.

E-Cigarettes Might Help with Smoking Cessation—Or, They Might Not

There’s ongoing debate in the healthcare community about e-cigarettes and smoking cessation. In fact, the New England Journal of Medicine recently posted a poll on its website asking if providers would recommend e-cigarettes to their patients for this purpose. The results indicate approximately two-thirds of providers would recommend e-cigarettes for smoking cessation, while one-third would not.

In my practice, I have seen one patient successfully use e-cigarettes to quit smoking. But, quitting usually requires more than just a nicotine alternative. Behavior modification and close monitoring and counseling with a physician offers a thorough approach that’s more likely to be successful. There’s also the possibility that the e-cigarette will replace the traditional cigarette as a new addiction for the patient, which I’ve seen happen as well.

E-Cigarette Use is On the Rise Among Middle- and High-School Students

2015 data from the National Youth Tobacco Survey says 5.3% of middle-schoolers and 16% of high-schoolers used an e-cigarette at least once in the last month (up from 0.6% and 1.5%, respectively, in 2011). The same survey shows a considerable drop in the use of traditional cigarettes among these age groups.

Young people are clearly trying e-cigarettes in record numbers. They’re less regulated than traditional cigarettes, and they’re also easier for underage kids to get, particularly through the internet. The variety of e-cigarette designs may also be a draw. Some are made to look like traditional cigarettes, while others come in a variety of colors and patterns, light up in creative ways, or look like a cool new tech device (especially since many are charged via USB cords).

Bottom Line: Tread with Caution

The jury is still out on the real long-term risks of e-cigarette use. Here’s what you need to know:

  • If you don’t have a nicotine addiction, using e-cigarettes will give you one—steer clear of them.
  • If you have children, educate them about the known and potential risks.
  • Finally, if you’re a smoker and you want to use e-cigarettes to quit, remember the pros and cons, and talk to your doctor to develop a comprehensive plan that will help you succeed.

Updated October 31, 2018

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