E-cigarettes: a doctor's view of the good, the bad and the ugly

Do e cigarettes work? Are they safe?

First, my own experience as a doctor I have found e cigarettes to be one of the most effective methods of cutting down or quitting smoking for recalcitrant smokers.

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This is because e cigarettes are not only a nicotine replacement therapy, they are a total smoking cessation therapy, as vaping simulates the act of smoking, and you physically draw vapor into your mouth.

I have found e cigarettes to be one of the most effective methods of cutting down or quitting smoking for recalcitrant smokers.

Several years ago I learned a technique for hypnotizing smokers to quit, and the biggest obstacle to overcome other than the nicotine was the image that people had of themselves with a cigarette in their mouths. E cigarettes allow a cigarette addict to perpetuate the image and the nicotine, but to lose the tar and other cigarette toxins that cause cancer and emphysema.

Though there are no long term studies to show I m right about e cigarettes for smoking cessation, there is one recent study in the British journal Lancet that did demonstrate that e cigarettes were at least as successful as a nicotine patch.

But if I see e cigarettes as a potential tool to quit for adults, at the same time, I am very concerned about the growing role e cigarettes are playing for teens, many of whom are non smokers the first time they try an e cigarette.

According to the Centers for Disease Control e cigarette use among high schoolers is now up to 10 percent, double from a year ago, with 80 percent also smoking tobacco.

Dr. Tom Frieden, head of the CDC and a top expert in preventive health, told me that e cigarettes can be a gateway drug, with nicotine addiction leading to more tobacco use.

I believe that, and though 12 states including New York ban e cigarette use for minors, few are listening, and kids can still buy their e cigarettes on line.

On top of this problem, liquid nicotine is now being sold in different flavors on line, at much higher concentrations than is found in an e cigarette, which generally includes nicotine levels in the 1.8% to 2.4% range.

The low concentration is less risky, but Vaporworld, for example, sells a gallon of liquid nicotine at 10 percent concentration for only $195, and Liquid Nicotine Wholesalers charges $110 for a liter at the same concentration. With this high concentration, experts say that just a tablespoon could be enough to cause serious harm.

Nicotine is a potent neurotoxin which can be ingested or absorbed through the skin, leading to seizures, vomiting, and rapid heart rate. The number of poisoning cases linked to e liquids was 1,351 in 2013, up 300 percent from the year before.

So clearly, there is a rising concern over the safety of nicotine liquids as well as nicotine addiction.

I believe that in the right hands, e cigarettes can be an effective tool for quitting smoking, perhaps the best we currently have available.

Unfortunately, they are frequently not getting into the right hands, and I also know many smokers who carry both cigarettes and e cigarettes around, and don t actually cut down on tobacco.

The FDA is planning on increasing regulations on e cigarettes, and I think this is a good idea, though not likely to solve the problem.

I wish there was a way of regulating e cigarettes so that a doctor has a definite role, and can guide her patients to e cigarettes to be used as a treatment rather than as another party chemical.

Unfortunately, the chances of e cigarettes becoming prescription only is about as likely as the chance of cherry flavor being replaced by the taste of cigarette ash in bubblegum.

Dr. Marc Siegel, a practicing internist, joined FOX News Channel (FNC) as a contributor in 2008.

E-cigarettes target youth with festivals, lawmakers say — bloomberg

E cigarette makers aim to hook youth on their products using music festivals, free samples and candy flavored versions, U.S. Democratic lawmakers said.

The findings, in a survey released today by members of Congress, should prod U.S. regulators to curb the industry, the lawmakers said. While e cigarettes currently are unregulated, the Food and Drug Administration is working on a plan that would extend its tobacco oversight to the products.

Six of nine companies surveyed had sponsored or provided free samples at 348 events in the last two years, including the Bonnaroo and Coachella music festivals and Grand Prix races. Six companies including Green Smoke, acquired April 1 by Altria Group Inc. (MO) and Lorillard Inc. (LO), also offer flavors such as cherry crush and vanilla dreams.

These are the same tactics that were used by major cigarette manufacturers before they were banned, said U.S. Representative Henry Waxman, a Democrat from California, on a conference call. Our findings demonstrate the FDA regulation of e cigarettes is necessary to prevent manufacturers from targeting youth with aggressive marketing practices.

E cigarettes are battery powered tubes that simulate the effect of smoking by producing nicotine vapor. E cigarette smokers are sometimes referred to as vapers. The FDA found there isn t enough information on the products to determine if they re less harmful than traditional cigarettes, according to a study published today in the journal Tobacco Control.

In October, the agency submitted a proposal to oversee the industry to the White House s Office of Management and Budget that authorizes all regulations. The proposal is still under review at OMB, according to the office s website.

Prod to Act

This report we re issuing today should be a prod for them to act, Waxman said.

The use of e cigarettes by middle school and high school students in the U.S. doubled to 10 percent in 2012 from 2011, the Centers for Disease Control and Prevention found in September. The agency has also said e cigarette related calls to poison centers rose to 215 a month in February, compared with one a month in September 2010.

Waxman and U.S. Senator Richard Durbin, a Democrat from Illinois, led the investigation. Durbin called e cigarettes a gateway to smoking rather than a cessation tool as some studies have asserted.

Regulation Urged

The congressional report calls on the FDA to assert its authority over e cigarettes and companies to immediately prevent the sale of the products to anyone younger than 18 and refrain from television and radio advertising. The FDA should ban flavored e cigarettes that appeal to youth and companies should stop selling them as well, the report said.

Altria has expressed support for FDA regulation, David Sutton, a spokesman for the Richmond, Virginia based company, said by telephone.

Obviously, we think that the agency should include an appropriate set of marketing regulations, Sutton said. Those regulations should allow the companies to communicate to adult vapers.

Sutton declined to specify the type of marketing regulation the FDA should impose.

NJOY has long supported sensible regulations, Whit Clay, a spokesman for the company at Sloane & Co., said in an e mail.

Reynolds American Inc. (RAI) backs strengthening and updating state youth tobacco control laws to prohibit youth purchase of tobacco products, Jane Seccombe, a spokeswoman for the Winston Salem, North Carolina based company said.

$7.5 Billion in Sales

Bloomberg Industries estimates global e cigarette sales may reach $7.5 billion in 2015, compared with $3.5 billion last year. The sales projection almost cuts in half an October estimate of $14 billion in 2015 sales based in part on expected advertising restrictions.

Six e cigarette companies spent $59 million in 2013 to market their products, double the amount spent the year before. Seven of the manufacturers including NJOY and Reynolds have used radio or television advertisements, some featuring celebrities such as Jenny McCarthy. Seven companies also used social media sites such as Facebook and Twitter to market their products.

Twenty eight states have prohibited the sale of e cigarettes to minors while most companies had some type of restriction on youth sales.

Given the varied scope and company oversight of these policies, their effectiveness at restricting sales to minors is unclear, according to the congressional report.

To contact the reporter on this story Anna Edney in Washington at aedney

To contact the editors responsible for this story Reg Gale at rgale5 Angela Zimm, Andrew Pollack