by BERKELEY WELLNESS
| AUGUST 13, 2014
Electronic cigarettes, or e-cigs, are promoted as a
healthier, cleaner, and cheaper alternative to regular cigarettes. But no one
really knows how much safer e-cigs are, since there has been little good
research on the health effects and no data on their long-term use.
Any realistic discussion of the risks of
“vaping”(inhaling the nicotine-laced vapor) versus smoking assumes that e-cigs
would replaceregular cigs—that is, that they would help smokers quit. Not
surprisingly, marketers often suggest that e-cigs can aid in smoking cessation,
though they are not allowed to make this unsubstantiated claim.
In a wide-ranging Scientific Review inCirculation in
March, researchers from UC San Francisco analyzed five observational studies
looking at the effects of e-cigs on smoking behavior. On the basis of these
studies, it concluded that “e-cigarette use in the real world is associated
with significantly lower odds of quitting smoking” (emphasis added). The
researchers also analyzed four clinical trials on e-cigs for smoking cessation
and found them unconvincing and flawed.
In contrast, an English observational study inAddiction
in May found that smokers who used e-cigs in an attempt to quit were twice as
likely to succeed as those who used OTC nicotine replacement tools such as
patches (20 percent vs. 10 percent).
How can these findings be reconciled? According Stanton
Glantz, Ph.D., senior author of the Scientific Review, “Putting all six studies
together (the five we reviewed plus the new study) suggests that e-cigs discourage
quit attempts among smokers in general but may increase success for the
(smaller number of) people who use them to quit, resulting in a net negative
effect of e-cigs on overall quitting rates.”
Some of these studies suggest that e-cigs, even when they
don’t help people quit, allow them to smoke less (still about half a pack a
day, on average). But, as was discussed in the Scientific Review, such dual use
of e-cigs and tobacco may not reduce health risks much—or at all. Research has
consistently shown that when people merely cut down on smoking, the risks don’t
drop in proportion to the cutbacks. Smoking even a few cigarettes a day, for
instance, still greatly increases the risk of a heart attack—then add in the
(still unknown) risks of vaping.
A major concern is that e-cigs will simply keep people
hooked on nicotine, allowing them to circumvent no-smoking laws in public but
continue smoking elsewhere.
In April the FDA finally said it intends to start
regulating e-cigs (forbidding unsubstantiated health claims and sales to
minors, for instance, and requiring warning labels), but this will be a long
drawn-out process, especially if the industry fights some measures, as
expected.
Meanwhile, as the UC San Francisco researchers concluded,
people should be aware that e-cigs are unregulated, contain toxic chemicals,
are of unknown safety, and have not been proven effective as cessation aids.
Bystanders, especially children, should not be exposed to the vapor.
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