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5 Things We Don’t Know About Electronic Cigarettes

Published on 08 July 2015

Later this summer, the FDA is expected to announce new rules requiring federal approval for most e-cigarette devices and nearly all flavored liquid nicotine juices. Right now, there are few regulations in the industry. Goldie Peters, Pharm.D., BCPS, assistant professor of pharmacy practice, at St. Louis College of Pharmacy regularly lectures about smoking cessation. He says there are many things we don't know about the products.

What is an e-cigarette?

These companies are very clever to never make any medical or therapeutic claims. They say it’s a device for nicotine use. Nicotine is not regulated by the FDA, but tobacco is regulated.

How much nicotine is delivered?

The FDA has analyzed some e-solutions and found they delivered nicotine, but the amount varied widely by device and puff.  Like anything else that's not regulated, you can't trust the label. Investigators found that some solutions labeled as nicotine-free did indeed contain nicotine. They also found that solutions promising nicotine failed to deliver as well.

How safe are they?

One of the ingredients in many e-cigarette solutions is propylene glycol. It's also found in foods like ice cream and coffee creamer. We know that when that chemical is inhaled,it irritates the lungs. There are cases where patients have developed a rare form of pneumonia from using e-cigarettes.   

What are the long-term effects?

The marketing materials for these devices say they are safe, but in reality we really don't know. They have been available on the market for less than 10 years. In that time, there have not been any scientifically significant studies showing the lasting effects of e-cigarettes.

Will they help you quit smoking?

Adults are using e-cigarettes as a method to stop smoking but the devices are not approved by the FDA for smoking cessation. There is not any solid, long-term data yet to show that e-cigarettes can be used to stop smoking.

I tell all of my patients who are trying to quit that it will be one of the hardest things they ever have to do. Anyone looking to kick the habit needs to have strong internal motivation. Without it, the success of the medications, nicotine gum or lozenges, and patch will not be optimal for smoking cessation.  If a patient of mine wants to use an e-cigarette as a way to stop smoking, I’ll take that as a positive first step and I’ll give them all the support and knowledge I have to help them in their efforts.  I want that patient to become an informed consumer on the product they have chosen, along with discussing the FDA approved smoking cessation therapies.

Tomorrow: two of the things we do know about e-cigarettes.

Photo credit: Different types of electronic cigarettes via photopin (license)

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