Addressing the Evidence of E-Cigarettes as a Healthier Alternative
The regulatory bells are chiming and the demonizing campaigns are in full swing. International bodies such as the World Health Organization and the American Lung Association are calling for quick regulation over e-cigarettes. But these prejudicial decisions, made without fully addressing the evidence, could potentially cause more harm than good. For this reason, whenever a decision on policy or regulation is made, it should be made with a deep concern and focus toward all available evidence.
A recent article in the British Journal of General Practice addressed the concerns related to e-cigarettes by presenting the available evidence. The authors list the safety of e-cigs, effect on smoking prevalence, effect on smoking cessation, and e-cigs as a gateway as the four main concerns regarding use of electronic cigarettes.
For the first concern, safety of e-cigs, the authors based their judgment on the toxicology reports of the vapor produced when the device heats the e-liquid, a flavored compound of mostly propylene glycol and varied levels of nicotine. Their review found that the vapor “contains nothing like the concentration of carcinogens and toxins as cigarette smoke.” The reports indicated that toxin levels were well below 1/20th of the concentration found in cigarette smoke.
Concerning the risk that e-cigs may re-normalize smoking and perhaps slow the rate of decline, the authors reviewed monthly reports that survey the adult population and found an increase in the rate of smoking cessation accompanied by continued fall in the prevalence of smoking over the period that e-cigarettes have increased in use.
With respect to the effect that e-cigs have on smoking cessation, a recent study surveyed over 6000 respondents and found a 60% increased likelihood of remaining abstinent when an e-cig was used in their most recent quit attempt.
The final concern addressed the notion of e-cigs as a gateway to smoking. The authors indicate that no study has accurately addressed this concern, given a flaw in the method used to determine whether something is a gateway or not. They go on to point out that use among those who have not smoked regularly remains extremely small at 0.2% in England.
With the evidence in favor of e-cigs regarding these concerns, it remains difficult to see what justification organizations have in jumping to conclusions and calling for regulation. It seems illogical to make decisions before all the evidence is scrutinized and analyzed. The position taken by Erika Sward, V.P. of the American Lung Association, that “E-cigarettes are guilty until proven innocent,” seems to pass judgment on a device that could potentially reduce the scourge of tobacco and tar altogether.