E-Cigarettes or electronic cigarettes are also called e-vaporizers are handheld devices that resemble and simulate the feeling of smoking. E-Cigs use is becoming common among the new generation as a result of the advertisements in media and social media and easy availability. Studies are being conducted to analyze their benefits and hazards.

Are e-cigs harmless?

Most people favoring e-cigs talk about e-cigs being less harmful than cigarettes. However, since they contain nicotine, they are not totally harmless. Furthermore, some of the studies also found that teens who smoke E-Cigs are more likely to start smoking actual cigarettes later than those who never used e-cigarettes1. Similarly, another study found that high school students were seven times more likely to start smoking when they were followed after six months. Other studies noted that those individuals who used e-cigs were less likely to quit smoking than those who never used e-cigs. Furthermore, e-cigs contain e-liquids that contain different chemicals including carcinogens and chemicals like cadmium that is harmful to the lungs.

E-Cigs reduce cigarette craving ...

[caption id="attachment_3223" align="alignnone" width="749"] E-Cigs reduce cigarette craving[/caption] Having said that, e-cigs are less harmful than cigarettes. They have been used to reduce cigarette cravings and as an aid to quit smoking. Although e-cigarettes are not FDA approved, studies are still being conducted to find their effectiveness in smoking cessation. A recent study published in the NEJM (New England journal of medicine) compared the efficacy of e-cigs with nicotine replacement as an aid to smoking cessation2. The study concluded that after one year of intervention, the abstinence rate was 18% in the e-cigarettes group vs 9% in the nicotine replacement group. Furthermore, the majority of the patients in the e-cigs group were compliant with the therapy than those on nicotine replacement therapy. Overall, throat irritation was more common in the e-cigs group while the incidence of a cough and phlegm production was reduced. The authors concluded that e-cigs are better at smoking cessation than nicotine replacement therapy.

E-Cigarettes are a gateway to addiction ...

[caption id="attachment_3224" align="alignnone" width="960"] Once a smoker - Always a smoker[/caption] Although, e-cigs may be a good aid to smoking cessation the effect is probably a short–term. In the letter to the editor of NEJM, the author states “We fear that the creation of a generation of nicotine-addicted teenagers will lead to a resurgence in the use of combustible tobacco in the decades to come. Even if these adolescents do not switch to regular cigarettes, the creation of a large cohort of nicotine-addicted adults has consequences beyond the adverse physiological effects of nicotine”3. He also stated that since nicotine is a gateway to addiction and is as addictive as heroin, more and more teenagers will become drug users. Buspirone is an alternative to E-Cigarettes in individuals who are strongly considering smoking cessation. Recently, more case reports of serious lung diseases and respiratory failure resulting in deaths have been reported with the use of these vaping techniques.

References:

1. Leventhal AM, Strong DR, Kirkpatrick MG, et al. Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence. JAMA. 2015;314(7):700-707.
2. Peter Hajek, Anna Phillips-Waller, Dunja Przulj, et al. A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy. NEJM. 2019. 
3. Jeffrey M. Drazen, Stephen Morrissey, and Edward W. Campion. The Dangerous Flavors of E-Cigarettes. NEJM. 2019.