The E-Cigarette: A Bad Moon Rising?

I think it was around Christmastime last year, while frantically traipsing through the mall in search of bargains, that an over-eager kiosk salesperson stepped into my path.  Wonderful, I thought.  Another person trying to sell me overpriced hand cream. I tried to go around her, hoping she’d get the hint—to no avail.  Oddly, instead of launching into a speech about my unhealthy cuticles, she asked me if I was a smoker.

And that’s when I noticed she was selling e-cigarettes:  plastic cigarettes that look almost exactly like the real deal. (They even puff out odorless vapor that looks strikingly like cigarette smoke.)  She explained to me that these can be a great tool for quitting smoking, because they look and feel like cigarettes.  “It’s just like smoking, but without the nasty health effects.”

What a cool idea, I thought.  My father, a former (heavy) smoker, told me once that quitting smoking was a total nightmare for him.  Why? Because he didn’t just crave the nicotine in the cigarettes; he craved the whole smoking ritual: taking that first puff of the day while sipping his coffee, taking breaks at work and chatting with his friends, etc, etc.  Quitting smoking wasn’t just about omitting nicotine from his life; it was about changing his lifestyle.

From that perspective, e-cigarettes seem like a good way to ease the transition from smoker to non-smoker. They look like cigarettes, taste like cigarettes, and feel like cigarettes but the “smoker” is no longer exposed to  40+ human carcinogens multiple times a day.  On top of that, e-cigarettes don’t produce that thick, noxious cloud of smoke that clings to your hair, skin, and clothing, and makes everyone around you cough.   “I feel like this could save my life,” said one satisfied customer, who reported cutting her smoking from 3 packs a day to 1 ½ packs a day.(1)

But Katie Zezima of the New York Times astutely points out the dark side of these products—namely, that we don’t really know anything about how safe they are.

In addition to delivering nicotine, which is obviously an addictive drug, e-cigarettes use propylene glycol to create the artificial smoke. Propylene glycol, also used in anti-freeze, is “generally recognized as safe” (GRAS) to consume, but is it safe to inhale? Says Dr. Richard D. Hurt, director of the Nicotine Dependence Center at the Mayo Clinic: “I don’t think so, but I’m not sure anyone knows for sure.”

Critics are also asking if these products could be a “gateway” through which children and teens become addicted to nicotine-containing products.  E-cigarettes can be smoked without the nicotine, but there are no restrictions on purchasing them either way. Marketed as a safer way to “enjoy smoking” that provides users with the “freedom to smoke most everywhere,” e-cigarettes are easy to get online or in shopping malls. They also come in a variety of flavors.   “There’s nothing that prevents youth from getting addicted to nicotine,” says Jonathan Winickoff, chairman of the American Academy of Pediatrics Tobacco Consortium.

But then, of course: there’s the obvious question: 

Could they really be worse than smoking regular cigarettes?

It’s a good question. Smoking remains THE number one cause of preventable death in the United States, with 400,000 people dying each year from smoking-related causes. There are more than 4,000 chemicals in tobacco and tobacco smoke, 60 of which are known human carcinogens…. and the statistics go on and on…(2)

Still, there’s reason to be concerned. E-cigarettes are well-advertised, easy to purchase nicotine-delivery (AKA drug delivery) systems that no one is regulating.  And because Congress is close to giving the FDA power to regulate tobacco, their producers are getting nervous. Already, their lawyers are coming out of the woodwork, ready to pounce.  The Electronic Cigarette Association, an industry trade group, already has on its website a petition to the FDA wherein customers can “stand up for [their] rights.”  The petition requests that “the FDA allow us to continue to use and purchase these nicotine delivery devices at our own discretion while further testing commences from the FDA.” It continues: “If you ban these devices millions will return to tobacco products which would be a guaranteed death sentence for many.”

Meanwhile, e-cigarette distributor Smoking Everywhere is pulling out the bigger guns and getting ready to challenge the authority FDA doesn’t yet have. “The FDA has the power to regulate Nicorette gum and the like because it is marketed as a smoking cessation product,” one of their lawyers told the New York Times.  In contrast, e-cigarettes are “just a tar-free way to enjoy smoking.”(3)

And I thought they could be used to quit smoking. How naive of me!

All I can say right now is that we should keep our eyes open on this one. The more I read about this issue, the more intrigued I am.  Even if e-cigarettes are a much healthier alternative to regular cigarettes, the way they are being marketed sets off my alarm bells.  Like regular cigarettes, e-cigarettes deliver nicotine– a highly addictive drug.  And manufacturers have a clear incentive to market their product as a cigarette “supplement” or cigarette “replacement” rather than as a tool for reducing nicotine dependence. Something tells me that the proponents for the “future of smoking” (4) aren’t as health-conscious as they claim they are.

Notes

(1) This quote from Katie Zezima’s NY Times article: “Cigarettes without Smoke, or Regulation.” June 1, 2009.

(2) See:  CDC. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000-2004. JAMA. 2009;301(6):593-594 OR MMWR. 2008;57:1226-1228.  See also “Fast Facts:  Morbidity and Mortality Related to Tobacco Use.” Accessed June 1, 2009.

(3) Lawyer quote from Katie Zezima’s article, Ibid. “..tar-free way to enjoy smoking” quote from “What is an electronic cigarette?” FAQ page from Smoking Everywhere. Accessed June 4, 2009.

(4) Ibid.

Comments

  1. #1 Liz
    June 6, 2009

    “Propylene glycol, also used in anti-freeze, is “generally recognized as safe” (GRAS) to consume, but is it safe to inhale?”

    Diacetyl is also considered GRAS to consume, but we know now that it’s very dangerous to inhale. I hope the same doesn’t turn out to be true with propylene glycol, but it might.

  2. #2 compcat
    June 9, 2009

    Propylene glycol has been used to produce smoke in the theatre and cleanroom testing industries for some time. It would be interesting to see if this population of occupationally exposed individuals has seen any problems.

  3. #3 sartre
    June 12, 2009

    Propylene glycol has is also used to produce smoke in night clubs. Maybe fda can regulate night clubs also. E-cigarettes are better than cigarettes. I have been a smoker for more than a decade, I moved to e-cigarettes 6 months ago and i can tell the difference.
    This may be an academic topic for likes of yourself but this can be difference between life and death for a lot of folks. So do think carefully about the motivations behind attempts to ban e-cigarettes (loss of tax revenue and tobacco lobby groups come to mind).

  4. #4 Smoking
    June 26, 2009

    How can Water Vapor (You breathe it all the time as it’s in the air… and especially when you shower), propylene glycol, and flavoring possibly be worse than the 4,000 plus chemicals in tobacco smoke? I don’t think anyone is saying that ecigarettes like you see at http://greensmoke.com/mycigarettes are “safe”… but it seems like a step forward. For years we have known that Tobacco Cigarettes are not safe and as of this month June 22, 2009 President Obama signed a bill that will grant the FDA regulatory powers over the Tobacco Industry. So whats needed is not the Pro’s and Con’s what is needed is testing and proof of how dangerous they are. You would think Big Tobacco would be making their own BRAND ecigs? Think about how much easier it would be for Phillip Morris to release and ecig that supposedly tasted just like their Marlboro Product? They would surly have plenty of customers.

  5. #5 Electronic Cigarettes
    August 19, 2009

    Propylene Glycol is already found in tobacco cigarettes and is inhaled, along with thousands of other substances including 30 or 40 that are known to cause cancer. So, for the sake of argument, let’s say PG is bad for you. Would you rather have a product with 1 (or even 2, 3 or 4) bad compounds in it or one with 30 or 40 plus another few thousand that we aren’t sure about?

    As for quitting smoking, the electronic cigarette continues the action of smoking and can still deliver nicotine, which is the addictive substance. This is one of the issues the public health organizations have with the product, that and the fact it is a competing product with smoking cessation products which their donors make. But in any case, smoking is a legal action. And if an action only effects those participating, then isn’t it a little fascist to be against the people who partake in that action?

    Read more about the debate over the electronic cigarette at http://www.e-cig.org/2009/07/26/electronic-cigarettes-health-safety-and-quit-smoking-claims/

  6. #6 Johnny Blaze
    October 9, 2009

    I got my own electronic cigarette a few months ago, and it really as an awesome little device. I am very skeptical of the E-liquid found in most e-cigarettes after the recent FDA findings. They said that the “Chinese Poison” contains the same chemicals found in Antifreeze…scary. Since then, I Started using only American Made Electronic Cigarette E-Liquid as the quality control is better here in the United States. I have been very happy thus far with Halo brand smoke juice, but there are a couple of others out there too including Johnson Creek and Cloud 9.

    Johnny Blaze

  7. #7 Sammy
    October 15, 2009

    A little sanity took place this week when California Governor Arnold Schwarzenager saved electronic cigarettes from being banned for everyone in the state with a Veto pen! Glad he showed some common sense…

  8. #8 Brian K
    October 28, 2009

    I did quite a bit of research on this prior to ordering my own, and my purposes for purchasing are directly related to quitting, which I haven’t seen other posts about. I’m currently taking Chantix to quit smoking, and have quit (with the exception of one cig) for the last 16 days. As this article mentions, there is a major lifestyle change, for me especially after specific activities or in social situations, so I did my research and purchased an e cig starter kit from crown7, which is US-based and has a strong position on quality. Now the thing most people aren’t mentioning is you CAN buy these without nicotine, like I did…

    When you’re quitting, regardless of what method, you’ll get cravings and for a long time after you quit. If a non-nicotine fake cig prevents me from picking up a real one, and gets rid of that knot in the center of my chest, then for me that helped…

    Personally, I really enjoyed smoking… I didn’t like what I was doing to my body, the smell, or how much I had been spending on an addiction… Whether someone uses this device as a healthier replacement for smoking or a non-nicotine helper for during their quitting process, people should have the choice.

    Now, with the news hype about propylene glycol, the problem with those stats is the quantity used. OK, so if there is 50% or more concentration of it, then it’s considered bad, so why don’t any of the neh-sayers say that esmokes are no where near that… Furthermore, there was a study in the 40′s that Propylene Glycol actually has benefits in the air, jem.rupress.org/cgi/content/abstract/75/6/593 but there is nothing (and I mean nothing) to support allegations about it having any negative effects in small amounts. http://toxnet.nlm.nih.gov states it takes 1qt of PG to be fatal, and the liver filters it and your body relieves it, so it’s not the big deal they’ve made it out to be. Plus, with that antifreeze thing the news likes to bring up, the news forgot to mention that PG is in antifreeze only as a replacement to the toxic additive that was killing pets who were lapping up the antifreeze due to it’s sweet taste.

    Now on the flip-side, there are people that are allergic to Propylene glycol, but the esmoke companies aren’t trying to hide PG is in the cartridges, so they are giving proper disclosure. If you’re highly allergic, you’d know it, because it’s in hair products and other items used day to day, and someone strongly allergic would avoid these, just as they would avoid esmokes (if that were the case). Even so, the manufactures are trying to produce the cartridges with another substance that is less controversial, but then again, there isn’t long term studies on that being inhaled either, so chances are it’ll be the same problem (with the right-wings).

  9. #9 Patty
    December 15, 2009

    I’m a 35 year smoker. I’ve been “quitting” most of that time….and actually, I thought, sometimes successfully, for a few months, etc., etc. I’ve used everything over the counter and prescription… It’s a tiring subject for myself, and many others, I’m sure. So…I ordered and rec’d my first e-cigarette starter kit this past week. In researching this device on the Internet, I discovered there a whole communities/forums online devoted to just the e-cig, known also as “vaping.” I even joined a couple of these forums to ask “newbie” questions. I was a bit bewildered that there is a whole vocabulary/jargon in these forums, and the goal of the communities is the enhancement of e-cigarette smoking…not “quitting.”
    They all say they are “smoke-free” for x amount of days, but the reality is that the e-cigarette is a nicotine delivery device, no matter how you FLAVOR it. We’ve smoked and couldn’t quit smoking because we’re ADDICTED to nicotine…plain and simple.
    I purchased my kit with the intention of using it as a true quit-smoking aid, by gradually cutting down the amount of nicotine, which is possible by ordering cartridges or bottled juice in decreasing amts. of nicotine, till reaching zero nic. That said, this is NOT what most people using the e-cigarette mean by “quitting.” And in my smoker’s mind, one has not quit smoking by trading one nicotine delivery system for another. The reality is…that nicotine is so highly addictive. The e-cigarette will likely become the preferred means of receiving nicotine, because it is so much more pleasant, cleaner-feeling upon inhaling and much better tasting in the mouth, leaving no bad smoke aftertaste.
    One thing I’ve noticed, in trying to find objective opinions and research about the e-cigarette, is that the Internet is FLOODED with articles which are “disguised” as medical opinions or scientific findings in favor of the e-cig, which are, in fact, produced by e-cigarette companies selling one or more brands of the devices.
    I could go on and on…debating with myself over the e-cig. I’ll just say I still intend to use it as a valid quit-smoking device.

  10. #10 Penn Mason
    January 10, 2010

    Electronic cigarettes have the potential to be a life-saving intervention for millions of smokers. The FDA and the anti-smoking groups need to embrace this product and support the appropriate testing, not remove it abruptly from the market and sentence over a million e-cigarette users to disease and even death by a return to conventional cigarettes.Smoke Power Electronic Cigarettes have amazing quality and value. Read Our Press Release You will see that Smoke Power has excellent products. Electronic Cigarette E-Liquids to!

  11. #11 Joseph Phillips
    January 22, 2010

    I sell this product, and it is important as an industry that none of the vendors ever make false claims that this is a healthy alternative. A electronic cigarette is a “healthier” alternative to smoking tobacco. The only harmful substance it contains is nicotine. They do not bother people around you, and you save money. They reduce the amount of cigarettes that you smoke, and hopefully lead to the consumer to stop smoking! Make sure you are not over charged for your electronic cigarette starter kit. A lot of retailers are extremely overpriced. My site >eCigarettes4less gives you a lot more, for a lot less. See for yourself,and most importantly get off Tobacco!

  12. #12 Victor Battles
    February 14, 2010

    Unless use of the device is limited to a short-term, you’re simply substituting one nicotine addiction with another.

    Some carcinogenic chemicals have been found in the few brands and which limited testing has been done.

    The products are manufactured in China so purchasing them is really supporting the Chinese economy.

  13. #13 Jack
    February 18, 2010

    I’ve seen E-Cigs that don’t even carry propylene glycol. Propylene glycol is used in cars, it’s a chemical in the coolant. There are special anti-freeze mixtures you can buy that do not contain propylene glycol and they must be used in things like boats and RV’s.

    Chemists at R. J. Reynolds Tobacco Company conclude that cigarette smoke is 10,000 times more concentrated than the automobile pollution at rush hour on a freeway yet smoking tobacco is legal. There are thousands of chemicals found in regular tobacco, about 4,000. It is proven that smoking kills hundreds of thousands each year.

    Here’s some of the chemicals in tobacco smoke:

    Ammonia: Household cleaner
    Angelica root extract: Known to cause cancer in animals
    Arsenic: Used in rat poisons
    Benzene: Used in making dyes, synthetic rubber
    Butane: Gas; used in lighter fluid
    Carbon monoxide: Poisonous gas
    Cadmium: Used in batteries
    Cyanide: Deadly poison
    DDT: A banned insecticide
    Polonium: Cancer-causing radioactive element
    PROPYLENE GLYCOL: Used in anti-freeze to prevent freezing.

    So now water vapor passing through a liquid nicotine soaked ball of cotton is going to do what? If you could grow a plant in your backyard that could be vaporized and then inhaled to cure your muscle aches or your stress and that plant came with historical proof that daily use of the plant doesn’t cause cancer or emphysema? Would that be illegal? Oh wait it is.

    Testing doesn’t mean anything. If they ban E-Cigs because of the propylene glycol then they should ban the regular cigarettes that have 43 known cancer-causing (carcinogenic) compounds. They won’t. It’s proven that smoking takes people closer to death and makes them sick but it’s okay because there is a warning on the package.

  14. #14 Patty
    February 19, 2010

    Two months have passed since I posted here after ordering the ecig kit. As I stated in my original post, I purchased this as a means of quitting. I have some things to share re/my experience so far.
    First of all, this really CAN be a valid method of quitting smoking altogether, if one chooses to do so. I still take a puff on the ecig occasionally, but last week, I went all week without it …and without any type of withdrawal, and none of the adverse experience in previous attempts to quit regular cigs. This week, just because I wanted to, I’ve taken a few puffs daily, but this morning, for instance, I forgot all about it, and didn’t miss it while at work or driving home. This kind of thing was virtually impossible while I was smoking tobacco. I would wake up anticipating my morning “hit”. My conclusion from this is that tobacco cigarettes contain something more addictive than nicotine. I was smoking Marlboro lights for years, and simply could not quit. Now I know I can quit.

    I have something to add here, though, about the ecig that is not so pleasant…. I had decided to try some of the “flavored” juice, which I ordered. This seems to be a popular selling point of the ecig, that you don’t just have to stick with tobacco flavor, but can go to fruity or dessert flavors. I ordered the “mocha mint” of my American juice manufacturer. I liked it, but I began experiencing severe shortness of breath. I researched this to find if anyone else was having similar problems, and there was a big discussion on one forum of this issue, with others having the same problems. The general concensus was that the flavorings cause this: as in “popcorn lung,” which is a condition found in people who work in popcorn factories around a lot of artificial flavorings. I stopped using the ecig altogether until shortness of breath abated. I think the highly flavored juices may be problematic.