Survey: E-Cigarettes May Help Smokers Quit
WebMD Health News
Feb. 8, 2011 — Can puffing electronic cigarettes help smokers quit smoking?
It sounds wrong. E-cigarettes should be banned, says a long list of prestigious anti-tobacco groups including the American Cancer Society and the American Lung Association. But a federal court has stymied FDA efforts to keep them off the U.S. market.
Meanwhile, more and more Americans are buying e-cigarettes. And many of them say they’ve used the nicotine vaporizers to quit smoking real cigarettes, according to a new survey by Michael B. Siegel, MD, MPH, of Boston University School of Public Health.
“If you look at the evidence, these are a lot safer than regular cigarettes — and they are effective for some people in helping them quit smoking cigarettes,” Siegel tells WebMD.
Siegel and colleagues emailed surveys to 5,000 first-time buyers of Blu brand e-cigarettes. Replies came back from 222 of them (4.5%), of whom 216 said they were smokers.
Six months after their purchase, 31% of these smokers said they’d quit cigarettes and two-thirds of them said they’d cut back on the number of cigarettes they smoked. A third of those who’d quit smoking also quit using e-cigarettes.
Those are pretty impressive numbers, as only about 18% of smokers who quit actually do so for at least six months. But Siegel notes that a survey like this doesn’t prove anything. All it can do is hint that maybe, just maybe, e-cigarettes can do some good.
Tobacco policy expert Michel Eriksen, ScD, director of the Georgia State University institute of public health, agrees with Siegel on this point. Eriksen, who was not involved in the Siegel study, is a former director of the CDC’s Office on Smoking and Health.
It might have value. “The potential for electronic cigarettes in being helpful in smoking cessation is real but unestablished yet,” Eriksen says.
What’s needed is proof from rigorous studies, Siegel says. Proof that e-cigarettes really do help people quit smoking. And proof that e-cigarettes can safely be used as quit-smoking devices.
That seems simple enough. But e-cigarettes’ strange legal limbo clouds both issues.
FDA Frustrated in Banning E-Cigarettes
E-cigarettes use a battery-driven heater to vaporize liquid nicotine and flavoring from a small cartridge. To make the vapor visible, the cartridges also dispense propylene glycol (PEG), commonly used for theatrical “smoke.” Users puff or inhale the vapor from a mouthpiece.
To almost everybody, that sounds like a device for delivering nicotine. But because the nicotine is ultimately derived from tobacco plants, a federal court has ruled that e-cigarettes are — legally speaking — tobacco products and not nicotine-delivery devices.
Since they are tobacco products, the court ruled, the FDA lacks authority to regulate e-cigarettes as drugs or devices as long as they are marketed without claims of therapeutic effect.
This means that companies distributing e-cigarettes in the U.S. cannot sell their products as smoking-cessation devices, even though that is the only public health reason for their use.
“It is a bizarro world where the potential of e-cigarettes is not being realized for legal reasons,” Eriksen says.
“This is a great public health opportunity,” Siegel says. “You have companies willing to market the product as a smoking-cessation device. But they are wary of doing it because don’t want to run afoul of the FDA.”
In January, the U.S. Court of Appeals rejected the FDA’s appeal.
“FDA is currently evaluating the D.C. Circuit’s Jan. 24 ruling and considering its legal and regulatory options,” FDA spokesman Jeff Ventura tells WebMD.
Are E-Cigarettes Safe for Smoking Cessation?
Are e-cigarettes safe? The FDA thinks not, for several reasons:
- E-cigarettes may get people, especially young people, addicted to nicotine, leading to cigarette use.
- The cartridge may contain toxic ingredients. One FDA study did find a small amount of an antifreeze-like chemical in at least one cartridge, but Siegel points to 16 other studies that find no such contamination. “Based on identified chemicals and quantities, there is basically not anything of alarm,” he says.
- E-cigarettes have not been tested for efficacy and safety. Moreover, they are produced overseas with little oversight to ensure good manufacturing practices. “By being unregulated, there is no knowledge of the purity of what is being inhaled,” Eriksen says. “It is a concern about the safety of this new behavior.
- E-cigarette cartridges contain varying amounts of nicotine, so users don’t know what dosage they are getting.
In a recent article, University of California, Riverside researchers Anna Trichounian and Prue Talbot, PhD, note additional safety concerns, such as leaky cartridges that get nicotine on users’ fingers and confusing or absent instructions.
But what if e-cigarettes are used by people who want to quit or to cut back on real cigarettes? Just about the only thing on which all sides agree is that cigarettes are extremely dangerous — not just because they deliver nicotine, but because they burn and deliver highly toxic combustion by-products.
“Everyone would agree that e-cigarettes are safer than traditional smoking,” Eriksen says. “That does not mean they are safe. There may be other risks unknown at this point.”
Siegel argues that if e-cigarettes are less harmful than real cigarettes, then people who smoke them instead of real cigarettes are reducing the harm they do to themselves. He points out that nicotine replacement patches and nicotine gum aren’t totally safe, but that many people keep on using them even after they’ve stopped smoking cigarettes.
“If it’s a choice between smoking and e-cigarettes, you are much better off with the e-cigs,” Siegel says. “Even though this looks like smoking, it is a lot better than using regular cigarettes.”
This means that companies distributing e-cigarettes in the U.S. cannot sell their products as smoking-cessation devices, even though that is the only public health reason for their use.
“It is a bizarro world where the potential of e-cigarettes is not being realized for legal reasons,” Eriksen says.
“This is a great public health opportunity,” Siegel says. “You have companies willing to market the product as a smoking-cessation device. But they are wary of doing it because don’t want to run afoul of the FDA.”
In January, the U.S. Court of Appeals rejected the FDA’s appeal.
“FDA is currently evaluating the D.C. Circuit’s Jan. 24 ruling and considering its legal and regulatory options,” FDA spokesman Jeff Ventura tells WebMD.
Are E-Cigarettes Safe for Smoking Cessation?
Are e-cigarettes safe? The FDA thinks not, for several reasons:
- E-cigarettes may get people, especially young people, addicted to nicotine, leading to cigarette use.
- The cartridge may contain toxic ingredients. One FDA study did find a small amount of an antifreeze-like chemical in at least one cartridge, but Siegel points to 16 other studies that find no such contamination. “Based on identified chemicals and quantities, there is basically not anything of alarm,” he says.
- E-cigarettes have not been tested for efficacy and safety. Moreover, they are produced overseas with little oversight to ensure good manufacturing practices. “By being unregulated, there is no knowledge of the purity of what is being inhaled,” Eriksen says. “It is a concern about the safety of this new behavior.
- E-cigarette cartridges contain varying amounts of nicotine, so users don’t know what dosage they are getting.
In a recent article, University of California, Riverside researchers Anna Trichounian and Prue Talbot, PhD, note additional safety concerns, such as leaky cartridges that get nicotine on users’ fingers and confusing or absent instructions.
But what if e-cigarettes are used by people who want to quit or to cut back on real cigarettes? Just about the only thing on which all sides agree is that cigarettes are extremely dangerous — not just because they deliver nicotine, but because they burn and deliver highly toxic combustion by-products.
“Everyone would agree that e-cigarettes are safer than traditional smoking,” Eriksen says. “That does not mean they are safe. There may be other risks unknown at this point.”
Siegel argues that if e-cigarettes are less harmful than real cigarettes, then people who smoke them instead of real cigarettes are reducing the harm they do to themselves. He points out that nicotine replacement patches and nicotine gum aren’t totally safe, but that many people keep on using them even after they’ve stopped smoking cigarettes.
“If it’s a choice between smoking and e-cigarettes, you are much better off with the e-cigs,” Siegel says. “Even though this looks like smoking, it is a lot better than using regular cigarettes.”
February 12th, 2011 at 7:00 pm
First I am really surprised that a brand like Blue actually has such a high rate of success. This may be the worst electronic cigarette on the market for quitting. The real rate with better products is at least double that 31 percent.
I keep seeing things like there are additional safety concerns, such as leaky cartridges that get nicotine on users’ fingers. What is the safety concern here? where is the evidence that it is a safety concern.
The next thing is that people will smoke them and get addicted to nicotine. Again where is the evidence? We don’t know if anyone who doesn’t already smoke will use E cigs. We know that smoking is addictive and one of the compounds nicotine addictive. What do we know about nicotine addiction by itself? Tens of thousands of e cigarette users including myself have easily cut down our use of nicotine. Many don’t even use it.
I hear a lot of wild speculation but just don’t see any evidence not to use e cigarettes as a means to quit smoking. Maybe the FDA should get off it’s butt and do some real studies.
February 13th, 2011 at 8:47 am
I smoked for 36 years, and have been smoke free for 6 months because of this invention. My first kit is long gone, having been replaced by a personal vaporizer that provides long battery life and satisfying vapor production. It does not, in any way, resemble a tobacco cigarette. There are brands that are aggressively marketed, and many smokers are so desperate to stop smoking that they do pay the exorbitant prices for these inferior products. Many of these people then turn to the internet and find that there are cheaper, better quality choices, and a number of forums that have reviews of both the hardware and the liquid, which can be ordered in varying nicotine strengths. Many users do not use liquid from China, because there are many vendors in the United States that sell better liquid. The Blu electronic cigarette is sold with Johnson Creek juice products, that are made in the US. The Johnson Creek website includes a listing of all the ingredients in their liquid. Is this alternative 100% safe? Perhaps not, but after using it for six months, I do know that I feel great, I am breathing better, my senses of smell and taste have markedly improved, I am saving over $200 each month, my car doesn’t stink anymore, I no longer have to go outside in bitter cold temperatures for a cigarette break, and I have no intention of ever lighting up another cigarette. I am 50 years old and have made the personal decision to use this wonderful invention that does what it was designed to do, which is allow me to use nicotine without all of the harm that tobacco smoke was exposing me to. When I learned of the absurd reality that the FDA and misguided government officials are trying to prevent me from accessing a life saving invention, I realized that freedom in this country is in jeopardy. How can it be that government would actively work to ban something that has no record of deaths related to its use, when the very thing it is meant to replace is known to cause death? This is shameful, and I will do everything humanly possible to ensure that this product remains available as a viable alternative for adult smokers. Banning electronic cigarettes is an unconscionable death sentence for many people who use nicotine.
February 13th, 2011 at 9:33 am
Electronic cigarettes are being embraced by long-term cigarette smokers for the simplest of reasons. They work! People who have smoked for decades have learned that our other choices do not work. Vaping is cheaper. Improved health is OBVIOUS within weeks and becomes more apparent witn more time. The many flavor options and nicotine strength choices give freedom to the user to tailor their smoking cessation to their own lifestyle.
I smoked for 46 years and accidentally quit smoking using a personal vaporizer. No one in the world is more surprised than I am. Extensive research has led me to believe that the only honest complaint one can have against vaping is that it IS going to hurt a few segments of society–in the pocketbook. Those who are most threatened are the pharmaceutical companies, the governments’ tax men and (to a lesser degree) the tobacco companies.
Anyone who does not fall into those three groups will only gain greatly by smokeless alternatives. Trust me. I know. So does my next door neighbor who is 70 and has suffered from severe COPD from smoking. Last year I turned her on to vaping and she has avoided her twice-a-year hospitalizations ever since. She also has seen how amazing vaping can be for one’s health.
February 13th, 2011 at 4:17 pm
I actually had no intention of quitting initially, I just wanted to cut down on my spending by ALSO using an ecigarette. However, it wasn’t long at all before I wasn’t smoking tobacco at all anymore, and was only vaping. Within DAYS I felt my health improve, and now it’s months later and I can jog again without getting winded. I have no cough unless I have a cold.
And one thing that really helps with these compared to attempts I made in the past – I don’t get tempted to smoke when I’m around smokers, and I have 2 in my family. When I quit before, as soon as I got around my family, I would break.
February 14th, 2011 at 11:00 am
I smoked a pack of cigarettes a day for 45 years. Tried everything to quit but to no avail over many years. On August 2, 2010 I tried a electronic cigarette, and have not touched a regular analog cigarette since. I am breathing better, no coughing, generally feeling better.
My wife smoked for 40+ years. She had bronchial asthma issues and had a spot on her lung. She needed a doctor prescribed RX daily steroid inhaler to breath. Well August 7, 2010, she tried the e-cigarette. She has not touched a regular cigarette since. AND, her lung capacity has returned to normal. The spot on her lung is gone, and no more steroid inhaler for her to be able to breath anymore.
The electronic cigarette has been a true Godsend for us.
February 18th, 2011 at 12:50 pm
As a decades long smoker, I had no intention of quitting smoking. My husband needed to quit smoking for health reasons. I purchased 2 starter kits just before Xmas 2010. Neither of us have “smoked” since 1-1-2011.
The only harmful aspect to electronic cigarettes is the lack of revenue they produce for big tobacco, big pharma and big government.