?When a colleague introduced me to the electronic cigarette, I thought it was an ingenious idea. Also known as an e-cigarette, it's a battery-powered device capable of creating a chemical vapor that is said to deliver nicotine in a less harmful way. My colleague, a smoker for more than 20 years, said this was the answer she had been waiting for to help her quit.
After my entrepreneurial brother asked me for my medical opinion on the device, I decided to do some more research. The e-cigarette industry has flourished into a $1.7 billion market with more than 200 companies in the United States, and he was considering an investment in this booming field.
Delving a little deeper into the e-cigarette trend, I found the device's safety claims might just be smoke and mirrors.
Advocates for e-cigarettes claim that the devices are a healthier alternative to cigarettes, as they cut down on dangerous ingredients found in tobacco. However, the Food and Drug Administration discovered the delivery cartridges contained impurities, some of which are known cancer-causing agents. No evidence exists that the chemicals are harmful in the amounts found, but long-term studies have yet to be done.
The device itself is suspect. The e-cigarette is not classified as a medical device, so the product is not held to the same rigorous standards as other devices, such as nebulizers. In 2012, a man was horribly injured by his device when it exploded in his mouth, causing the loss of several teeth and part of his tongue. In 2013, an e-cigarette exploded while it was connected to its car charger. The hot coil landed in a car seat, causing a fire and second-degree burns to a 3-year-old passenger.
While studies found e-cigarettes helped a small percentage of people remain cigarette-free after six months, the device did very little overall to help smoking cessation. In addition, there is concern that it can lure nonsmoking consumers because of its benign appearance. E-cigarette manufacturers have come under scrutiny for selling devices with appealing flavors, such as cherry and chocolate, and for using celebrities in their marketing campaigns.
Teens could be particularly vulnerable, as there are inconsistent regulations limiting sales to minors nationwide. The National Youth Tobacco survey revealed 10 percent of high school students have tried e-cigarettes. Opponents of the device say it is nothing more than a pathway toward addiction, since nicotine has a notoriously high addiction potential due to stimulation of the brain's reward system.
The future of the e-cigarette industry in the United States remains uncertain. The New York City Council recently passed a bill banning their use in public areas. Several states have imposed indoor e-cigarette bans, and other states, including California, are considering it. The FDA has yet to impose legislation on the device, leaving both advocates and opponents in anticipation.
As a physician who treats patients of all ages, including curious adolescents transitioning into adulthood, I find that my patients want to know more about e-cigarettes. I endorse what I feel is best for my patients, and e-cigarettes do not fall into this category. Until further research is performed that validates their use, I will encourage my patients and entrepreneurial family members to steer clear of them.
– Maily Creamer is board certified in internal medicine and pediatrics and is a member of Hoag Medical Group.
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