E-cigarettes versus tobacco cigarettes!

Should government restrict electronic cigarettes like the tobacco cigarettes – emblazoned with warnings and subject to tight marketing restrictions? As electronic cigarettes have become a $1.5 billion business in the United States, meaning they are getting more popular, the Food and Drug Administration have found this topic interesting.

Groups like American Lung Association and the Campaign for Tobacco-Free Kids are promoting intensive regulation. They worry that e-cigarettes will make smoking ordinary again, especially among teens and that the health risks haven’t been fully established. They are quick to push back in response to anything that might make e-cigarettes more attractive, such as the NJOY King ad that aired during the Super Bowl or when actors were shown “vaping” at the Golden Globes. DiCaprio and Julia Louis-Dreyfus

Last month was 50th anniversary of the office’s first warning about the dangers of smoking and a surgeon general’s report was released last month which had little to say about electronic cigarettes . Its suggestions for further reducing tobacco use were nothing new, including: prohibit indoor smoking, increase taxes on cigarettes, launch media campaigns and reduce the nicotine content of cigarettes.

How dangerous electric cigarettes are?

Many critics say that there is need for more research, but it is easily understandable that e-cigarettes are more safer than tobacco cigarettes. In process of smoking no tobacco leaves are combusted, so they don’t release the tars and gases that lead to cancer and other smoking-related diseases. In e-cigs, a heating element converts a tobacco liquid into an aerosol that users exhale as a white plume.

The limitations for electric cigarettes comes in varying concentrations of nicotine — from high (36 mg per milliliter of liquid) to zero — to help smokers wean themselves off cigarettes, as well as e-cigarettes, and the addictive stimulant in nicotine. But even if people continue using electronic cigarettes with some nicotine, regular exposure has generally kind effects in healthy people, and the FDA has approved the extended use of nicotine gums, patches and lozenges.

The other main ingredients in e-cigarettes are propylene glycol and glycerin. These are generally regarded as harmless — they’re found in toothpaste, hand sanitizer, asthma inhalers, and many other FDA-approved foods, cosmetics and pharmaceuticals. There are also traces of nitrosamines, known carcinogens, but they are present at levels comparable to the patch and at far lower concentrations than in regular cigarettes — 500- to 1,400-fold lower. Cadmium, lead and nickel may be there, too, but in amounts and forms considered nontoxic.

“Few, if any, chemicals at levels detected in electronic cigarettes raise serious health concerns,” a 2011 study in the Journal of Health Policy determined. “A preponderance of the available evidence shows [e-cigarettes] to be much safer than tobacco cigarettes and comparable in toxicity to conventional nicotine replacement products.”

Could e-cigarettes be the way to quit smoking?

The potential for e-cigarettes to help people quit smoking is encouraging, but so far there has been little research on their effectiveness. A study published in the Lancet in November concluded that e-cigarettes, with or without nicotine, were as effective as nicotine patches for helping smokers quit. Granted, in most of the times patches help people stay off cigarettes for more than a few months. But there are reasons to think that e-cigarettes would be even more effective outside the laboratory.

Participants in the Lancet study were randomly assigned to nicotine e-cigarettes, patches or placebo e-cigarettes. And e-cigarettes have several advantages over nicotine patches and gums. For one, they provide a quicker fix, because the pulmonary route is the fastest practical way to deliver nicotine to the brain. They also offer visual, tactile and gestural similarities to traditional cigarettes.

Participants in the Lancet study were randomly assigned to nicotine e-cigarettes, patches or placebo e-cigarettes. And e-cigarettes have several advantages over nicotine patches and gums – they provide quicker fix, becouse the pulmonary route is the fastest way to deliver nicotine to the brain. They also offer visual, tactile and gestural similarities to traditional cigarettes.

Reporter Megan McArdle tested the comparison for a Bloomberg Businessweek article this month: “After I’d put it together, I had something surprisingly close to one of the cigarettes I used to smoke. The mentholated tobacco flavor rolled sinuously over my tongue, hit the back of my throat in an unctuously familiar cloud, and rushed through my capillaries, buzzing along my dormant nicotine receptors. The only thing missing was the unpleasant clawing feeling in my chest as my lungs begged me not to pollute them with tar and soot.”

E-cigarettes might lead young people to smoking

This is where anti-smoking advocates get worried about e-cigarettes being too attractive and encouraging people — especially young people — to become addicted to nicotine and, in some cases, to progress to smoking. The Centers for Disease Control and Prevention stoked concerns with data released in September showing that 1.78 million middle and high school students had tried e-cigarettes and that one in five middle school students who reported trying them said they hadn’t tried traditional cigarettes. “This raises concern that there may be young people for whom e-cigarettes could be an entry point to use of conventional tobacco products, including cigarettes,” the CDC concluded.

According to that same CDC study, however, an extremely small percentage of teenagers use e-cigarettes regularly — only 2.8 percent of high school students reported using one in the previous 30 days in 2012. And while that number is rising — it was 1.5 percent in 2011 — teenage cigarette smoking rates are at record lows. That might suggest that increased exposure to e-cigarettes isn’t encouraging more people to smoke. But the numbers are so small that it’s too early to make definitive claims about the relationship between teen vaping and smoking.

What action should be taken with e-cigarettes?

Yes, we still need research on the long-term health and behavioral impacts of e-cigarettes. There is an analogy between electronic cigarettes and cellphones – when cellphones became popular in the late ’90s, there were no data on their long-term safety. As it turns out, the risk of a brain tumor with prolonged cellphone use is not zero, but it is very small and of uncertain health significance.

The FDA should call for reliable, informative labeling and safe manufacturing standards for e-cigarettes. It should also allay concerns about potential gateway use and youth addiction to nicotine by banning the marketing and sale of e-cigarettes to minors. It should not be heavy handed in restricting marketing and sales to adults.

Instead, promoting electronic cigarettes to smokers should be a public health priority. Given that the direct medical costs of smoking are estimated to be more than $130 billion per year, along with $150 billion annually in productivity losses from premature deaths, getting more smokers to switch would result in significant cost savings — as well as almost half a million lives saved each year.

We should make e-cigarettes accessible to smokers by eschewing hefty taxes, if we tax them at all, and offering free samples and starter kits. Those kits, which contain a battery, a charger and nicotine-liquid cartridges, typically run between $30 and $90. To reduce the hurdle to initiation, any payer of smoking-related costs — health insurers, Veterans Affairs medical centers, companies that offer smoking-cessation programs for their employees, Medicare, Medicaid — should make the starter kits available gratis. Users should have to pay for their own replacement cartridges, but those are much cheaper than cigarette packs.

It may be hard for anti-smoking activists to feel at ease with e-cigarettes in light of their view that traditional cigarette makers have long downplayed the health dangers of their product. This perception has generated distrust of anything remotely resembling the act of smoking. It doesn’t help that major tobacco companies are now investing in e-cigarettes.

But if we embrace electronic cigarettes as a way for smokers to either kick their nicotine addictions or, at least, obtain nicotine in a safer way, they could help instigate the wave of smoking cessation that anti-smoking activists — and all of us — are hoping for.

Source: Washington Post

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