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
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.
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.
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.
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.
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).
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.