Safety, effectiveness of e-cigarettes unknown

E-cigarettes run on batteries and look like real cigarettes, cigars or even ballpoint pens. Users inhale doses of nicotine or other toxins found in tobacco in vapor form. Because e-cigarettes do not contain tobacco or create smoke, manufacturers are marketing them both as a safer alternative to smoking and as a cessation aid.

Of the two studies appearing online and in the April issue American Journal of Preventive Medicine, one shows that consumer interest in e-cigarettes currently is much higher than interest in more traditional products.

“Although we don’t know much about the health effects of e-cigarettes, they are by far the most popular smoking alternatives and cessation products on the market,” said lead author John Ayers, a doctoral candidate at Johns Hopkins Bloomberg School of Public Health.

His group monitored English-language Google searches in the USA, Canada, the UK and Australia from January 2008 until September 2010. They compared searches for e-cigarettes with searches for a nicotine lozenge and for cessation products like nicotine patches, nicotine gum and the drug Chantix (varenicline).

Between July 2008 and February 2010, searches about e-cigarettes increased sharply in all nations, especially in the United States. “We found that e-cigarettes were more popular in U.S. states with stronger tobacco control,” Ayers said. This, he said, suggests that consumers are using e-cigarettes to either bypass smoking restrictions or to quit when faced with restrictions.

To see if searches on e-cigarettes led to sales, his group monitored online shopping searches. Shopping search trends mirrored informational search trends, they found.

In the second study, Michael Siegel, M.D., looked at e-cigarettes’ effectiveness as smoking cessation aids using an online survey. Siegel, a professor at the Boston University School of Public Health, obtained 5,000 email addresses of people who had made a first-time purchase in 2009 from an e-cigarette distributor.

Of the 222 consumers replied to the survey, 216 were qualified to participate. Nearly 67 percent of these respondents said they reduced the number of cigarettes they smoked since using e-cigarettes and 49 percent reported that they had quit smoking for an unspecified time after trying e-cigarettes.

Siegel acknowledged and other smoking cessation experts have said that it is possible that smokers who had greater success cutting down or quitting were more likely to respond. This would bias the results, which already relied on a small fraction of those contacted.

“We don’t know anything about the 95 percent of the people who deleted the email,” said Jennifer Unger, Ph.D. “Maybe they’re still smoking the same number of cigarettes. Maybe they are using even more nicotine than before because they’re smoking ordinary cigarettes and e-cigarettes.” Unger, with the Institute for Health Promotion and Disease Prevention Research at the University of Southern California, has no affiliation with either study.

“Neither of these two studies provides scientific evidence that e-cigarettes are effective in helping people to quit,” said John Pierce, Ph.D., a professor of cancer prevention at the Moores Cancer Center at the University of California at San Diego. “It’s not clear to me that e-cigarettes aren’t harmful in some way. It’s not clear to the FDA, either.”

In Sept. 2010, the Food and Drug Administration cited five e-cigarette distributors for “unsubstantiated claims and poor manufacturing practices,” according to an agency release. In January 2011, the FDA moved unsuccessfully to block e-cigarette importation.

More information: Siegel MB, Tanwar KL, Wood KS. Electronic cigarettes as a smoking-cessation tool: results from an online survey. Am J Prev Med 40(4), 2011.

Provided by Health Behavior News Service