Electronic Cigarette Devices

The roots of the modern cigarette go back to the 9^th century when the Mayans and Aztecs used tobacco in religious ceremonies.   It was not until 1880 a cigarette machine was invented and cigarettes were manufactured in mass numbers. At that time cigarettes became available to many more people. 

We did not have what we call evidence-based practice at that time.  Therefore many medical and non-medical practices were passed down through generations and never proven to cure an illness.  It was not until the late 1800s that the Food and Drug Administration started regulating products to protect public health.

Had the modern cigarette become available to the public in 1900, cigarettes as we know them may not be on the market because of the proven negative health impacts associated with them, although, many of those effects do not show up until years later.  Evidence-based testing may have kept them off the market. Keeping that in mind, it is very easy to see why medical experts in tobacco cessation, including those here at Green Bay Oncology, do not support the use of electronic cigarette devices at this time.  There is no evidence that we will not be dealing with negative health effects from the electronic cigarette twenty years from now.

What we do know about electronic cigarettes…

1. Nicotine content varies widely across brands (some contain as much or more than a traditional cigarette and others contain no nicotine at all)
2. Nicotine alone has health effects as well, including high addiction rates (addiction to the chemicals), fast heart beat, nausea, vomiting, increased blood sugar, constricting blood vessels, hardening of arteries and even overdose.  Nicotine replacement therapies contain nicotine but are effective in treating tobacco addiction while avoiding other toxic chemicals.
3. Evidence about safety and efficacy is lacking and poor quality
4. Electronic cigarettes do not contain tar
5. These devices are widely accessible to people of all ages including adolescents
6. A recent Italian study showed that the electronic cigarette may be as effective as a other tobacco cessation treatments
7. Tobacco companies are selling the devices
8. Many other countries have banned the use of electronic cigarette devices

What we do not know…

1. The chemical – both heavy metal and carcinogen – content of electronic cigarettes
2. Whether these devices serve as a gateway “drug” for adolescents that later transition to tobacco products
3. How, if at all, will these products impact tobacco cessation efforts?
4. What are the long term effects of the ingredients within the device(s)?
5. Are there roles in healthcare to utilize the positive effects of nicotine alone?

In summary, right now there is not enough evidence-based information on electronic cigarette devices to make sound medical decisions to argue for or against using these products.