E-Feedback on E-Cigarettes

During the second hour of our show this Wednesday, we had a broad, bustling conversation about the recent boom of electronic cigarettes. Suddenly, they're everywhere, and a lot of our online audience seemed to agree. Are they a solution to the age-old question of how to quit smoking? Or just addiction in a different form? We took some of your questions and comments to our guests, Dr. Michael Siegel and Stanton Glantz. 

Here's what they had to say to you:

While the vapor may be relatively "safe," what about the safety of heating the actual materials the e-cigarettes are made of?  Are they plastics and metals manufactured in China without regulation? What types of toxicity do those materials produce when heated?

Stanton Glantz: That's a good question.  Unfortunately no one has done the study needed to answer it.  My guess is that some of the toxins that are appearing in the vapor are coming from these sources.  For some more info on these toxins, see this site and the reports linked off that page. Most ecigs are made in China.  There is no regulation of the manufacturing there (or in the USA).  One thing that has been established is that the quality control is poor, including the fact that the nominal nicotine levels and the actual nicotine levels are often very different.

Dr. Michael Siegel: : This is a very good point. One of the problems with the electronic cigarette market is that there are hundreds of different brands and it is possible that there could be a small number of brands that don’t follow appropriate manufacturing standards. Fortunately, the FDA is currently working on regulations for electronic cigarettes that will tackle this problem. One of the main advantages of FDA regulation of electronic cigarettes will be a uniform set of standards that all companies have to follow. This will greatly help to give the consumer more confidence in the general safety of the product.

I don't see why existing smoking bans should have to allow indoor use of e-cigarettes. I don't want to breathe the vapor either.

Dr. Michael Siegel: It is really up to each workplace and/or locality to decide how to apply existing smoking bans to electronic cigarettes. My personal feeling is that they do not need to be banned unless there is evidence that they are actually cause harm to bystanders. However, I can certainly understand your desire not to want to breathe the vapor.

Wondering if airlines will allow or prohibit the use of e-cigarettes. Chewing tobacco is not allowed on planes.

Stanton Glantz:  Some ban them.  The Dept of Transportation has had a rule pending for a long time, but, like the rest of tobacco regulation, Obama is moving very slowly.

Dr. Michael Siegel: I  believe that the FAA has already ruled that e-cigarette use is not allowed on airplanes. And I can certainly understand why they chose to take that action.

I strongly disagree this can actually help out quit smoking, what can happen is that [yo]u became more addicted to nicotine.

 Dr. Michael Siegel: Actually, the general experience of most vapers is that you become less addicted to nicotine than if you continue smoking. The reason for this is that electronic cigarettes do not deliver nicotine anything close to the way that real cigarettes do. In addition, you no longer have the taste of the cigarette, which is a huge factor in the addiction. So the general experience is that the level of addiction is actually lowered. Many people who switch from cigarettes to e-cigarettes and subsequently able to get off the e-cigarettes as well.

Stanton Glantz: That is likely why the population studies show that e-cigs don't help and may hurt cessation.

Many of our online audience members wondered if e-cigarettes were really an effective way to quit smoking.

 Dr. Michael Siegel: A clinical trial released just last week showed that e-cigarettes are as effective as the nicotine patch for smoking cessation. They are clearly not a panacea, but for many people who have not succeeded with traditional NRT, they have been effective. No one approach works for everyone. The advantage of e-cigarettes is that they offer some hope to many people who have tried and failed with other approaches. The more options available for smokers to quit, the better.

Others on our web feed were curious about the potential danger of the vapor released from many e-cigarettes.

Dr. Michael Siegel: The question is not necessarily whether the vapor is “Safe” but whether it is “safer” than cigarette smoking. No one should claim that vaping is safe in an absolute sense. Of course, it is not safe. You are inhaling nicotine, so it can’t possibly be considered safe. But you have to compare this with the alternative – which for most people is continuing to smoke cigarettes which we know are deadly. Cigarettes are the most hazardous consumer product on the market. So if you have a choice between smoking cigarettes and switching to e-cigarettes, then you are much better off making the switch. The reality is that while quitting nicotine use completely is the best option, this is not a realistic outcome for most smokers.