E-Cigarette Smoking: A Better Option or Just as Harmful?

October 22, 2015 Brigham and Women's Hospital

The Association also calls for strong new regulations to prevent access, sales, and marketing of e-cigarettes to youth, and for more research into the product’s health impact.

The ingredients used in e-cigarettes are not regulated by the FDA, and the risks of smoking them are unclear.

Electronic cigarettes (e-cigs) are becoming a popular nicotine alternative to smoking combustible cigarettes. The e-cig industry is not federally regulated, and the potential hazards of smoking e-cig vapor have stirred up much debate. Some contend that smoking e-cigs may be a safe aid for weaning smokers off of cigarettes, while others are unsure about their safety.

“E-cigarettes may help some people quit smoking, but the American Heart Association (AHA) recommends them only as a last resort,” says Elliott Antman, MD, a cardiologist at Brigham and Women’s Hospital and Immediate Past President of the AHA, who is studying the effects of e-cigs. The AHA’s policy recommendation is that e-cigarettes that contain nicotine are tobacco products and should be subject to all laws that apply to these products. The Association also calls for strong new regulations to prevent access, sales, and marketing of e-cigarettes to youth, and for more research into the product’s health impact.

The ingredients used in e-cigs are not regulated by the FDA, and the health benefits and risks of smoking them are unclear. Aside from nicotine and a few other ingredients, researchers are unsure of exactly what ingredients are used to make the vapor. It is possible that the ingredients may be harmful or even worse than regular cigarettes.

“Nicotine is a dangerous and highly addictive chemical, no matter what form it takes – conventional cigarettes or some other tobacco product,” says Dr. Antman.

Roughly 20 percent of Americans smoke cigarettes. Cigarettes are full of harmful carcinogens, tar, and the addictive nicotine that makes smoking a difficult habit to curb. It has been long known that smoking cigarettes can increase one’s risk for developing diseases such as asthma, cancer, and heart disease.

E-cigs have helped some smokers to successfully reduce or quit smoking, which, in turn, may reduce their risks of developing smoking-related diseases. E-cigs are sleek, battery-operated devices that produce a small amount of flavored vapor when inhaled. Like cigarettes, e-cigs contain nicotine but are suspected to contain fewer toxins than cigarettes. Smokers who switch to e-cigs can still achieve the effect they seek from nicotine, but perhaps with less harmful ingredients than in cigarettes.

However, more research is needed to make any conclusions on the safety of their ingredients.

Dr. Antman said the AHA policy underlines the fact that there still aren’t adequate research and regulations to ensure that e-cigarette users know what’s in the vapor they are inhaling and what dangers it poses.

Another concern is that e-cigs have lured in a market of new nicotine users – youth and non-smokers. Unlike cigarettes, there is currently no federal oversight on age restrictions for e-cigs. E-cigs are heavily marketed to children and young adults through ads that tout them as being trendy, with over 7,000 enticing flavors to choose from. “These flavors are specifically designed to be attractive to youth,” says Dr. Antman.

Youths that are otherwise too young to purchase cigarettes are now getting their hands on these trendy e-cigs and putting themselves at risk for health consequences associated with smoking nicotine. This is raising concerns in the public health community. “We have disturbing signals that individuals who tend to use e-cigarettes are a bit more likely to later become users of conventional combustible tobacco products,” explains Dr. Antman.

Cigarettes also produce noticeable volumes of secondhand smoke that also may harm bystanders, putting the public at risk for the same diseases as smokers. E-cigs emit vapor that is less odorous and detectable than cigarettes. Consequences of secondhand exposure to e-cig vapor are also unknown, though some suspect second-hand exposure may be less harmful.

“In the meantime, we should stop marketing them to youth, regulate them properly, and put them under smoke-free regulations,” Dr. Antman says.
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– Skylar M.

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