Things to Know Before You Vape

In recent years, electronic cigarettes (e-cigarettes) have increased substantially in popularity. They are commonly advertised as a “healthier” and cheaper alternative to cigarette smoking.

Smoking e-cigarettes, an activity known as vaping, is not approved by the Food and Drug Administration (FDA) as a method for smoking cessation. It is important to remember that e-cigarettes contain nicotine. Unlike FDA-approved nicotine replacement therapies, such as the patch, lozenge and gum, which contain regulated amounts of nicotine, the nicotine found in e-cigarette cartridges can vary widely among brands.

Without large scale, well-designed research studies it is difficult to determine the real impact of e-cigarettes both now and in the future. Furthermore, by appealing to teenagers and young adults, there is the concern that e-cigarettes usage will reverse the progress made in smoking prevention, as well as normalize smoking behaviors.

A Battery-Operated Nicotine Delivery Device

Let’s look closer at what an e-cigarette is. An e-cigarette is a battery-operated nicotine delivery device.

Rather than inhaling smoke from burning tobacco, users inhale a vaporized liquid solution. In 2009, the FDA published a study that identified varying levels of nicotine in these solutions, even in some e-cigarette cartridges that claimed to be nicotine free, and known carcinogens including diethylene glycol, an ingredient found in anti-freeze, and nitrosamines.

Although sale to minors is prohibited in Maryland, virtually anyone can sell or buy e-cigarettes. Convenience stores, gas stations and grocery stores offer the most popular brands. Unlike traditional tobacco products there are no restrictions on Internet sales, which makes it relatively easy for youths to make online purchases. This may account for teen use of e-cigarettes doubling between 2011 and 2012.

While e-cigarette manufacturers may claim they do not market directly to young people, flavored cartridges such as bubble gum, caramel and chocolate clearly appeal to children.

And the industry has exploded. Revenues for e-cigarette companies have doubled every year since 2008, and the market exceeded $2 billion in 2013.

A Lot of Unknowns for E-Cigarette Safety

So, are they safe? While it is widely believed e-cigarettes are less toxic than cigarette smoking, there are no scientific studies to support this belief. Furthermore, there is no information as to the future effects of vaping or the effects of second-hand vapor inhalation.

Most importantly, the lack of regulations for the e-cigarette industry leads to a wide variation in e-cigarette nicotine levels and potentially toxic substances in the vapor.

Without scientific data establishing the safety and efficacy of e-cigarettes, there is no basis for recommending them as an alternative to cigarette smoking.

Combining counseling and medications is proven to be an effective way to quit. The FDA has approved several forms of nicotine replacement therapies, including gum, lozenges, transdermal patches, inhalers and nasal spray, as well as bupropion and varenicline (Chantix).

Talk to your doctor about how to stop smoking. If you have teenagers, talk to them about the dangers of e-cigarettes and vaping.

Author

By Stephen Cattaneo, MD, medical director of Thoracic Oncology at Anne Arundel Medical Center. He may be reached at 443-481-5838.