Can e-cigarettes Help to Quit Smoking?

Use of e-cigarettes to Quit Smoking

Dear Dr. Mahler:

My husband wants to quit smoking. He has tried just about everything, but none of them have worked for more than a week or two. Now he wants to try smoking electronic cigarettes. What do you think?  

His doctor has told him that he has early emphysema. He is fairly active in the community and works 25 hours a week at Home Depot. 

Joan from Columbus, OH

Dear Joan,

I congratulate your husband on wanting to quit smoking.  E-cigarettes are a $2.2 billion industry in the United States, and use is increasing rapidly among adults and teenagers. 4% of US adults are regular users.

Components 

Electronic cigarettes are battery-powered devices that simulate the feeling of smoking, but without tobacco. Smoking an e-cigarette is called vaping. There are four parts.  The battery powers the e-cigarette and is usually rechargeable.

Components of an e-cigarette

Components of an e-cigarette

The battery connects to atomizer which turns nicotine liquid into vapor. Next in line is the cartridge where the nicotine liquid is stored before vaporization and where new liquid is refilled. Many newer e-cigarettes combine the cartridge with the atomizer into one component. The final part is the mouthpiece or tip. This funnels vapor from the cartomizer into the vapor’s mouth. The user activates the e-cigarette by taking a puff.

There are many types of e-cigarettes as shown.

Battery charger with USB port.

Battery charger with USB port.

Hand grenade type e-cigarette

Hand grenade type e-cigarette

 

 

 

 

 

 

Quitting Smoking with e-cigarettes

There is controversy about using e-cigarettes to help people quit smoking. However, the benefits and the health risks are uncertain, and the long-term health effects are unknown. Compared to smoking tobacco, e-cigarettes are safer for both users and bystanders.There is tentative evidence that they can help people quit smoking. They have not been proven to work better than nicotine replacement products such as the patch or gum.

Woman vaping an e-cigarette.

Woman vaping an e-cigarette.

The World Health Organization takes the view that there is not enough evidence to recommend e-cigarettes for quitting smoking. In one review, there was no difference in quit smoking rates between those using e-cigarettes and those using nicotine replacement products (as examples, gum and patches).

Safety

The vapor contains flavors, propylene glycol, formaldehyde, nicotine, carcinogens, heavy metals, and other chemicals. Overall, e-cigarettes reduce exposure to carcinogens and other toxic substances compared with smoking tobacco in cigarettes. The nicotine in the vapor is associated with heart disease and potential birth defects. There is inadequate research to demonstrate that nicotine is associated with cancer in humans.

One main concern is that e-cigarettes are unregulated. There are risks from misuse or accidents such as fires by vaporizer malfunction and explosions from battery failure. A recent article in the Seattle Times described four young adults who experienced injuries to the face, hand, and arm due to exploding e-cigarettes. In October 2015, one 24 year old man lost front teeth and suffered cuts to his lips and gums due to blast injury from an explosion.

In summary, I encourage your husband to use whatever method to help him quit smoking. If he decides to use e-cigarettes, he should hopefully do this to quit smoking and then to quit using e-cigarettes. He may consider using nicotine patch or gum instead of electronic cigarettes.

Also, I encourage your husband to discuss his plans with his health care provider.

Best wishes to both of you for success in your husband quitting,

Donald A. Mahler, M.D.

I Want to Quit Smoking: Can e-cigarettes Help Me Give Up Tobacco?

Should I try e-cigarettes to quit smoking?

Dear Dr. Mahler:

What are your thoughts about e-cigarettes? I want to quit smoking cigarettes and have tried the patch, gum, and Chantix without success. Do they work? Are they safe? I am 59 and have “moderately severe” COPD according to my doctor. She says electronic cigarettes do not have all of the chemicals that are in cigarettes.

Cam from Kingston, Ontario, Canada

Dear Cam:

Your question is important and timely. Before I answer it, here is some brief information on electronic cigarettes.

There are numerous types for vaping e-cigarettes.

Various electronic cigarettes displayed in a store.

Electronic cigarettes contain no tobacco. The burning of tobacco produces smoke (combustion) which makes particles and gases that can cause cancer (carcinogens). Thousands of toxins have been identified in tobacco smoke.

 

With electronic cigarettes, the vapor contains only trace or no toxins and no carbon monoxide gas. The vapor usually includes flavorings and  a chemical called propylene glycol. Current evidence shows that e-cigarette vapor is much less toxic then cigarette smoke. Nicotine is the major chemical in e-cigarettes and is highly addictive as everyone knows.

Experts state that the greatest potential but unproven benefit of e-cigarettes is to help people quit smoking cigarettes. So far, there are two studies that have examined the success of e-cigarettes in helping someone quit smoking. Overall, about 10% of individuals using e-cigarettes were able to quit tobacco smoking, which was similar to use of nicotine patch.

Although many young people are experimenting with vaping e-cigarettes, most of these are already smoking regular cigarettes. Studies in animals show that the developing brain is vulnerable to the effects of cigarettes. Thus, preventing sales of electronic cigarettes to youth as proposed by the FDA is important.

Person vaping e-cigarette

A person vaping e-cigarette.

Finally, most experts suggest that e-cigarettes should meet safety standards and be regulated. Right now, there is no regulation as to what additives or how much nicotine is actually in electronic cigarettes.

When someone in my practice asks the same question as you have, I provide a brief explanation, and then state that vaping electronic cigarettes appears to be safer then smoking cigarettes. Ideally, someone might use e-cigarettes as a way to quit smoking cigarettes, and then eventually quit vaping.

Of course, you should discuss this with you health care provider.

For more information, see Point and Counterpoint: Does the Risk of Electronic Cigarettes Exceed Potential Benefits? in the journal CHEST, September 2015.

Best wishes on quitting,

Donald A. Mahler, M.D.