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URMC / Patients & Families / Health Matters / January 2014 / Where There’s Smoke: Clearing the Air About e-Cigs and Quitting

Where There’s Smoke: Clearing the Air About e-Cigs and Quitting

So you’ve decided to kick that smoking habit. As you plot your strategy for success, should you consider swapping tobacco for e-cigarettes? Are the trendy electronic devices a safe alternative? Can they actually help you stop smoking?
While recent articles in the Journal of the American Medical Association raise questions about their safety and lack of regulation, our tobacco dependence counselor Avi Dressler fills us in on some facts about e-cigs.
man with cigarettes and e-cigarette
What are e-cigarettes?
E-cigarettes come in many shapes and sizes. Some look like long cigarettes; others look like cigars or pipes. To use one, you inhale through a mouthpiece, triggering a sensor that switches on a battery-powered heater and, on many brands, a light at the “lit” end of the e-cigarette. 
Inhaling gives you a puff of hot gas that attempts to mimic the sensation of inhaling tobacco smoke. When you exhale, there's a cloud of vapor that looks a lot like smoke.
Using e-cigarettes is often referred to as “vaping.” The heater vaporizes a liquid solution in a cartridge that is then inhaled by the user. The solution may contain nicotine and other chemicals, and most commonly includes propylene glycol, the stuff of which theatrical smoke is made. It also is an ingredient in antifreeze. Some studies have shown that cartridges may contain carcinogens, chemicals known to cause cancer.
Are e-cigs safe?
Use of electronic cigarettes is growing as people search for alternatives to traditional tobacco products. Ads tout the benefits of e-cigarettes, including their use in public, smoke-free environments. Some even suggest that e-cig use is healthy. Many manufacturers of e-cigarettes claim their product is a safe alternative to tobacco products.
However, the U.S. Food and Drug Administration (FDA) is questioning their safety. The FDA analyzed samples of two popular brands and found varying amounts of nicotine and traces of toxic chemicals, including carcinogens. This prompted an FDA warning about potential health risks associated with electronic cigarettes. To date, though, the devices remain uncontrolled by any governmental agency. Some states, including New York, have begun to ban sales of e-cigarettes to minors.
So let’s compare:
  • Cigarettes
    • Smoking cigarettes harms nearly every organ of your body and causes heart disease, cancer, and many other illnesses.
    • More than 4,000 chemicals exist in cigarette smoke. More than 70 of them are known carcinogens.
  • E-cigarettes
    • E-cigarette cartridges can contain propylene glycol, a common food preservative also found in antifreeze. The health effects of inhaling propylene glycol in e-cigarettes are not yet well understood.
    • Though they contain nicotine, the amount can vary from brand to brand and even from cartridge to cartridge. Manufacturers are not required to tell consumers how much nicotine they put in each cartridge or to be accurate about how much is in each cartridge.
    • Preliminary studies have found carcinogens in e-cigarette cartridges, though fewer and at lower concentrations than found in tobacco cigarettes.
    • Other chemicals can be found in cartridges, with types and amounts varying from brand to brand.
What’s the bottom line on e-cigarettes?
Because they are so new and there is so little research on them, there is no perfect answer about their safety or effectiveness as a quitting aid. Without knowing the potential health effects, we can’t yet recommend using e-cigarettes as an alternative to smoking. 
What we do know is that there are well-researched and safe ways to kick the smoking habit.
There are five safe, effective nicotine replacements to help smokers stop: patches, gum, lozenges, inhalers, and nasal sprays. Each of these is proven to increase your odds of quitting for life.
Two safe and effective medications are also available to help: Bupropion (also known as Zyban or Wellbutrin) and Chantix. 
Stopping smoking is the best thing you can do for your health. You can greatly increase your chance of stopping by combining a nicotine replacement or medication with counseling from a health care provider.
Avi Dressler
Avi Dressler is a clinical research coordinator and tobacco dependence counselor at the URMC Healthy Living Center, part of the Center for Community Health. The Healthy Living Center offers programs to help you lose weight, manage blood pressure or cholesterol, stop smoking, and reduce stress.

Lori Barrette | 1/7/2014

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