I recently was surprised to see cigarettes for sale at several kiosks at my local mall. At least, I thought they were cigarettes. Then I discovered that they actually were "electronic cigarettes"--battery-powered puffables that produce no smoke and contain no known carcinogens or tar.
The look-alikes, which are less expensive than cigarettes, are made to re-create the real experience. They're marketed in fancy packages with gold inscriptions and photos of good-looking people "smoking." They produce a vapor that looks like smoke, and the tip glows red as you puff on it. When you inhale, your lungs get a dose of chemicals that typically include nicotine, which gives smoking its kick and makes it addictive. But their biggest advantage, one saleswoman told me, is that electronic cigarettes--or "cigars," "cigarillos," or "pipes" designed on the same principles--help smokers kick the habit.
That caught my attention. I know how hard it is for many of my patients to quit smoking. If there's something new out there to help them, I want to know about it.
Back home, an Internet search turned up thousands of hits and promises: "A great aid for those struggling to stop smoking." "No risk of cancer." "Use anywhere: indoors, airports, hospitals." But I could find no scientific research at all.
Dr. Jack Henningfield, an expert on addiction who serves as a scientific adviser on tobacco to the World Health Organization (WHO), calls e-cigarettes "renegade products" for which "we have no scientific information." The electronic cigarette, he says, is a vehicle to deliver nicotine to the body. Its effects, he says, "are not benign," especially when breathed into the lungs.
While there is a "data void," scientists worldwide question the claim that e-cigarettes help stop smoking. If anything, they worry that these aggressively marketed products could introduce more people to an addiction they never had. Indeed, the WHO has stated that e-cigarettes are not "a legitimate therapy for smokers trying to quit." Dr. Henningfield notes that some manufacturers "blatantly go after young people," advertising e-cigarettes with flavors "like chocolate and candy."
Other nicotine substitutes--the "patch," or gum, for example--are licensed as drugs and require Food and Drug Administration approval. But e-cigarettes, nearly all of them manufactured in China, have not been licensed as drugs or regulated.
Recently, however, the FDA initiated a ban on imports of e-cigarettes on the ground that they constitute unapproved drug-delivery devices (an action being challenged in court). It may take additional measures to restrict their sale.
Without more evidence, we won't know whether e-cigarettes have the potential to do any good or if they really do pose health risks. For now, if you're a smoker trying to quit, talk to your doctor about other, proven methods.
