E-cigarette sales surpassed $1 billion last year, more than tripling their sales from 2012. They’ve been widely supported as a healthier alternative to cigarettes, and are often used as an intermediate step for those trying to quit smoking.
However, new evidence suggests that the liquid nicotine used in e-cigarettes can be more dangerous than a traditional cigarette.
What is an E-Cigarette?
An e-cigarette is a device containing a rechargeable lithium battery and five ingredients: propylene glycol, glycerol, nicotine, water, and flavoring. The device also contains an atomizer or heating coil, an LED light to simulate a burning cigarette, and a sensor that registers when you take a drag.
The atomizer heats the liquid to its boiling point, which then becomes vapor the smoker can inhale. The vapor has the smell of whatever flavor cartridge is being used, like mint, tobacco, or raspberry.
According to a study published in the journal Addiction, smokers had a 60% higher chance of quitting using e-cigarettes than if they used willpower alone or over-the-counter nicotine replacement therapies such as patches or gum.
Liquid Nicotine –A Deadly Poison?
The primary ingredient in e-cigarettes is liquid nicotine, a powerful neurotoxin. Even tiny amounts, if ingested or absorbed through the skin, can cause vomiting and seizures.
Most “e-liquids” contain nicotine levels equivalent to a traditional cigarette – 1.8 to 2.4 percent. However, because the FDA does not yet monitor e-cigarettes some contain higher concentrations of up to 10 percent and are easily accessible on the Internet. At these levels, a tablespoon is enough to kill an adult.
Reports of accidental poisoning, especially among children, have significantly increased since 2012. There were 1,351 reports of poisoning cases related to e-cigarettes in 2013. That’s a 300 percent increase since 2012, and the number is on pace to double in 2014.
A family practitioner wrote, “I encourage the use of e-cigarettes among adult smokers while making the point that this recognizes and acknowledges how addictive nicotine really is and why no one should even start because they will always miss the most addictive drug known. Nicotine addicts are never “ex-smokers”, but “recovering” smokers who are waiting for circumstances to cause a relapse.”
In addition, a study conducted by the University of Athens, Greece, found that e-cigarettes can cause damage to the lungs. They studied 32 volunteers, of whom eight were non-smokers and 24 were regular smokers.
After using the e-cigarettes for 10 minutes, non-smokers saw an average increase in airway resistance of 24 percent. Regular smokers with no current respiratory issues saw an increased resistance of 44 percent. Interestingly, smokers with COPD and asthma did not see an increase.
In light of the potential harmful effects of e-cigarettes, the FDA has proposed certain regulations, including banning sales to anyone under 18, requiring warning labels and full disclosure of ingredients.
Until a federal law passes, many states are passing their own similar legislation. However, vials of the “e-liquids” remain readily available for refillable e-cigarettes. Both the opposition and the supporters of e-cigarettes recognize the need for regulation and responsible use.
Another family practitioner wrote inside Sermo, “They are better than cigarettes, but young people are taking them up because they think they are ‘safe.’ The safest thing is to smoke nothing. Put a warning on them like they do cigarettes.”
If you’re a healthcare professional with a patient considering switching from traditional cigarettes to e-cigarettes, would you support the decision? Do you think the benefits outweigh the risks? If you’re an M.D. or D.O., please join us inside Sermo to discuss.
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