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Are E-Cigarettes Safer?

Are electronic cigarettes really safer than regular ones? What do you view as the pros and cons of using them?

Answer (Published 1/31/2011)

Electronic cigarettes (known as e-cigarettes) are battery-operated products that look like cigarettes and provide nicotine, flavorings and other chemicals. The manufacturers claim that e-cigarettes offer the pleasures of smoking without the smoke, smell, carcinogens, tar and carbon monoxide.

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Because they contain no tobacco, promoters claim that e-cigarettes can be "smoked" in non-smoking areas (the "smoke" produced is chemically enhanced odorless water vapor). Some also claim that substituting e-cigarettes for the real thing increases lung capacity and reduces the appearance of wrinkles due to the effects of smoking on the skin.

I do not believe most of the claims. E-cigarettes are a sophisticated delivery system for one of the most addictive of all drugs. Nicotine triggers a short-term increase in blood pressure, heart rate, and the flow of blood from the heart. It also causes arteries to narrow. You may not be getting all of the tars and other carcinogens delivered by regular cigarettes, but if you make a habit of using e-cigarettes, your cardiovascular system will still be on the receiving end of the harmful effects of nicotine.

Findings from a study of e-cigarettes by researchers at the University of California, Riverside and published in the January, 2011, issue of Tobacco Control were not reassuring. The investigators tested five brands of e-cigarettes and found "design flaws, lack of adequate labeling and several concerns about quality control and health issues."

They reported that e-cigarette packages lacked adequate information on the product's contents and proper usage, and omitted appropriate warnings. They also noted that some e-cigarette cartridges were found to leak, which could expose others, such as children and pets, to nicotine. In a press release, the lead researcher emphasized that there are "virtually no scientific studies on e-cigarettes and their safety."

The FDA had been trying to regulate e-cigarettes as a drug used for smoking cessation, but in December 2010 a Federal Appeals Court ruled that the devices must be treated like tobacco products. This short-circuits the FDA's attempts to ban import of e-cigarettes into the United States on the grounds that they are drugs that haven't been studied for safety and efficacy.

If you smoke tobacco in any form, I urge you to quit now. As for e-cigarettes, based on what I've read, I think we need to know much more about their safety. Nicotine is nicotine and however you receive it, it isn't good for you.

Andrew Weil, M.D.

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