In our lifetime, we have seen everything from greeting cards to dating options to cigarettes transition from activities we could only do in the real world to those we can now perform in the virtual world. Now you’re confused, right? You’ve heard of E-Cards, and have probably sent and received your fair share, maybe starting back in junior high with Blue Mountain cards. And in this modern time of ours, we’re inundated with commercials for the thousands of versions of online dating options available to those of us who have been unlucky in love in the three dimensional world. But who has ever heard of E-Cigarettes?
Until recently, I hadn’t either, but CNN’s article “FDA hazy on e-cigarettes’ safety” peaked my interest. According to that article, an e-cigarette is exactly that: an electronic cigarette. They come in many shapes and sizes, and they resemble various smoking devices like pipes, cigars and cigarettes. The most popular version is shaped like a cigarette complete with brown filter, white body, glowing red end and realistic puff of smoke when in use. These virtual cigarettes, however, do not involve any actual smoking of the frequently mentioned cancer-causing agents delivered to our lungs when smoking tobacco. These cigarettes contain only pure liquid nicotine — a highly addictive chemical substance free from carcinogens. To clarify, I say free from carcinogens here because it has been shown that nicotine does not cause cancer, but that the tar and other substances found in cigarettes do. Thus, according to one of the manufacturers of e-cigs via CNN, they provide users with a nicotine patch’s purity while also satisfying the oral fixation often associated with cigarette use.
The way the product works actually is quite elegant. The user inhales from the filter end, or mouthpiece, in the same way they would smoke a real cigarette. This activates a battery-powered heating element that vaporizes the liquid nicotine stored in the mouthpiece. Simultaneously, the end of the e-cigarette glows red from an LED to simulate the actual glow of a cigarette, and the vaporization of nicotine results in the realistic puff of smoke that is produced. Additionally, the batteries in e-cigarettes can be recharged via wall outlet, car and even USB port. Beyond the simple oral fixation provided, e-cigs go a long way toward accurately capturing the full experience of smoking provided by actual cigarettes without the hazardous chemicals. In other words, e-cigarettes seem like an ideal solution to helping people quit smoking, because they provide all the effects of smoking lacking in other smoking cessation products like nicotine gum or the patch.
So if these battery-powered cigarettes are so great, why has the United States Food and Drug Administration been blocking importations of the product since last summer? According to the aforementioned article, the FDA has not approved these devices because of lack of scientific proof that they are safe or effective. The manufacturers have stated that they are “pretty sure” the products are safe based on laboratory testing in Europe, but even the World Health Organization remains hesitant to endorse these products as smoking cessation aids without further peer-reviewed studies for safety and efficacy of smoking cessation, a position the body took in September 2008. Because e-cigs are such new products, even the manufacturers admit they are uncertain of e-cigarettes’ potential side effects, though no negative outcomes have been reported to date and there are no chemicals in the virtual cigarettes that have been proven to cause cancer. It should be noted that while the FDA is denying further importation of this product, it has not gone so far as to confiscate products already being sold in the U.S.
The lack of cancer-causing agents in e-cigs in combination with their intricate illusion of smoking a real cigarette might cause you to wonder why the FDA seems intent on denying smokers access to a device that could help them quit smoking. While I cannot speak for the FDA directly, I can say the lack of peer-reviewed, double-blind trials — the gold standard of medical research — using e-cigarettes to verify that they are both effective and safe is the primary source of concern for the FDA. Because of the lack of trials, we cannot be sure of the side effects from inhaling pure nicotine and for all we know, they could be quite dangerous, even without cancer as a potential outcome. Additionally, there are already products on the market with proven safety and efficacy for smoking cessation, which eliminates the need to make another method quickly available without proper testing. Moreover, the FDA already has deemed the other smoking cessation products on the market safe because of rigorous testing and known dosage; the amount of nicotine and the manner in which it is absorbed from those various products is understood. With these new e-cigarettes, the dosing is uncertain because it has not been studied, and there is nothing to moderate the access the nicotine has to our systems. We also are unaware of the potential effects of pure nicotine — which has not been used in other smoking cessation products — could have without further testing.
From my perspective, I think e-cigarettes seem like a great way to help people quit smoking, except that the oral fixation they provide is simply a stop-gap, because smokers will eventually have to stop using the virtual cigarettes as well. This makes me wonder how effective such a device will truly be if it provides no natural transition from itself to life without nicotine replacement therapy in the same manner that products already on the market, such as patches and gum, do. Additionally, I worry that e-cigs will become a substitute for cigarettes entirely, which doesn’t sound like such a horrible consequence until you consider the possibility that people who currently do not smoke because of the side effects of smoking tobacco, might take up e-cigs to have the experience of smoking without the deadly consequences. But nicotine addiction in any form is not healthy. Thus, I remain reserved but curious — perhaps this is the miracle smoking cessation solution we’ve all been awaiting.
Katie McBeth is a University Medical student. She can be reached at k.mcbeth@cavalierdaily.com.
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