July 20, 2012 -- Electronic cigarettes are picking up steam -- and not surprisingly, especially among smokers.
That is the main message that comes from a new study in the American Journal of Public Health.
About 40% of individuals reported they had heard of e-cigarettes, and awareness was highest among smokers. What's more, smokers seem to be among the most likely to use e-cigarettes.
E-cigarettes go by many names including vapors, personal vaporizers, and nicotine vaporizers. There are many brands, flavors, and nicotine strengths available for purchase at convenience stores and on the Internet. They are not regulated by the FDA as a drug delivery device because they are not marketed as quit-smoking aids.
"This is an unproven device and we know very little about its long-term health effects," says researcher Jennifer Pearson, PhD, MPH. She is a research investigator at Legacy, an antismoking group in Washington, D.C. "E-cigarettes are probably less harmful than combustible cigarettes, [but] we don't have data to say that and can't talk about long-term effect."
There are many unknowns and unanswered questions, she says. For example, have they encouraged former smokers to reignite their nicotine addiction? Are current smokers using them to quit or to circumvent smoke-free indoor air laws? And how are they affecting people who have never smoked. "Are they acting as a gateway products?"
Pearson and colleagues call for greater regulation of these products until these questions are answered.
Anatomy of an E-Cigarette
E-cigarettes resemble traditional cigarettes. They have a cartridge, a mouthpiece, a vaporizer, and an indicator light. Here's how they work: You inhale, and the vaporizer converts a nicotine-containing solution into a vapor mist. The smoker then inhales this vapor. When the vaporizer runs out, you can purchase refill cartridges.
According to many harm-reduction advocates, their main selling point is that they only contain nicotine, not all of the other hundreds of other chemicals found in tobacco. This suggests that they may be a safer cigarette.
The new findings suggest that smokers are interested and have tried e-cigarettes as cessation devices. E-cigarette manufacturers do not market their products as such. But "the word on the street is that these are cessation devices and should be used as such," Pearson says.
E-Cigarettes May Be Here to Stay
Another issue with e-cigarettes is that you can't always be sure what you are getting when you purchase nicotine cartridges.
Pearson suggests using FDA-approved smoking cessation tools to quit smoking.
Michael Siegel, MD, disagrees. He is the associate chairman of community health sciences at the Boston University School of Public Health.
They do have an important role to play in getting people to quit smoking, he says. "Taking them off of the market would be a disaster because essentially all of these smokers would be forced to go back to cigarette smoking," he predicts.
"They feel like a cigarette, look like a cigarette, and you smoke it like a cigarette and see vapor when you exhale," he says. This is appealing to a smoker who is often as addicted to the nicotine as the actual act of smoking a cigarette.
They are not attracting new smokers, he says. "Very few never-smokers are using these products, so all the concerns that kids and nonsmokers are going to use them seem unfounded," Siegel says.
Gilbert Ross, MD, agrees. He is the executive director and medical director of the American Council on Science and Health, a New York City-based consumer education/public health organization.
"E-cigs contain only water vapor, safe [diluents] such as glycerin, and nicotine, in a cigarette-like delivery device, and [are] highly likely to be much less harmful than inhaling combusted tobacco smoke."