Electronic cigarettes (e-cigarettes or e-cigs) are considered nicotine delivery systems (ENDS), which are devices that can deliver nicotine in an aerosolized form. Not only is the e-cig industry booming, but as we have discussed previously (see here), the science related to e-cigarettes is also booming, with progressively more publications on health impacts, chemistry, technology, and policy initiatives. As a result, it is increasingly important for individuals and organizations interested in e-cigs to stay on top of the science, or risk missing important studies or findings related to their safety, effectiveness, or regulatory status.
Currently, e-cigs are largely unregulated in the U.S., and proponents of e-cigs quickly point out that they are valuable cessation and harm reduction tools. Meanwhile, opponents cite the lack of scientific data on e-cigs, and that they pose a number of risks such as the potential to renormalize smoking behavior, maintain nicotine addiction, expose users to toxic chemicals, and may act as a smoking re-entry gateway.
E-cigs are certainly on regulators’ radars, as evidenced by a recent workshop by FDA late last year, in addition to another one on potential health effects of e-cigs in March, 2015. In addition, various medical associations have issued policy statements, including the American Heart Association and a joint statement by the American Association for Cancer Research and the American Society of Clinical Oncology.
Overall, the general sentiment is that based on the currently available scientific evidence, e-cigs can possibly modify patterns of tobacco use and affect the health of the public, and as such, warrant additional study.
Below are some of the arguments being put forth as pros and cons to e-cigs as they relate to human health:
Arguments Supporting the Use of E-cigs
There is a growing body of data supporting the safe and effective use of e-cigarettes. Some of the findings from recent studies are listed below.
– Relative toxicity needs to be assessed in comparison to the well-described adverse health effects of smoking cigarettes. Essentially, while e-cigs may pose some intrinsic hazards, public health may benefit if e-cigs are demonstrated to be much less hazardous.
– Preliminary data suggest that that e-cig emissions are much less toxic than cigarette smoke
– Short-term exposure studies in healthy humans have had little to report in terms of serious adverse health effects.
– Some data suggest that e-cigs may hold promise as a smoking-cessation tool
– Some proponents tout e-cigs as possibly the most promising product for tobacco harm reduction to date
Arguments Against the use of E-cigs
Some science has been published suggesting that there may be questions with respect to safety of e-cigs or that e-cigs may not be as effective a smoking cessation tool as others espouse.
– E-cigs have the potential to renormalize smoking behavior, initiate or maintain nicotine addiction, and sustain dual use (tobacco smoking and ENDS)
– E-cigs could potentially serve as a gateway to re-initiation of smoking by ex-smokers
– E-cigs may especially pose harm to youth, since they may increase the chance that non-smokers (or formers smokers) will use e-cigs, or may discourage smokers from quitting altogether
– Limited data are available to suggest e-cigs can be effective cessation tools. Data largely based on a couple of randomized controlled trials, a cross-sectional study, and mostly surveys and anecdotal reports.
– Some e-cig systems have the capacity to heat liquids to high temperatures that may attain blood nicotine levels similar to those of cigarette smokers
– Potential for acute nicotine toxicity if e-cig liquids are ingested (either accidentally or intentionally), or exposure with the skin
– Combustion of e-cig liquid constituents, such as propylene glycol, can generate byproducts that are classified as irritants, and even potential carcinogens
– Levels of metals such as tin, silver, iron, nickel, cadmium, and copper have been detected in some e-cig vapor
Scientists have been publishing studies in the peer-reviewed literature and making presentations at scientific meetings on all aspects listed above for nearly a decade now. The science will only continue to grow and it is critical that if you or your clients have an interest in this topic that you follow the literature rigorously and systematically.
At ISS, we have scientists that have mastered monitoring the e-cigarette science literature, and we’ve designed a tool to help us do it even better. We call it DataTrove. Give it a try by signing up for your free 1-month trial, and you’ll get a summary of the latest e-cigarette science in your inbox once per week.
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