The case for E-cigarettes

Brad Rodu, a professor of medicine at the University of Louisville, is the foremost proponent of tobacco “harm reduction” in the world. Harm reduction refers to the fact that cigarettes are the most uniquely harmful version of tobacco; other forms do not even have 1/1000 of the potential harm. Now that e-cigarettes are available, Rodu and co-authors consider how these are a potent force for harm reduction. A fresh look at tobacco harm reduction: the case for the electronic cigarette.

Smokers of any age can reap substantial health benefits by quitting. In fact, no other single public health effort is likely to achieve a benefit comparable to large-scale smoking cessation. Surveys document that most smokers would like to quit, and many have made repeated efforts to do so. However, conventional smoking cessation approaches require nicotine addicted smokers to abstain from tobacco and nicotine entirely. Many smokers are unable – or at least unwilling – to achieve this goal, and so they continue smoking in the face of impending adverse health consequences. In effect, the status quo in smoking cessation presents smokers with just two unpleasant alternatives: quit or suffer the harmful effects of continuing smoking. But, there is a third choice for smokers: tobacco harm reduction. It involves the use of alternative sources of nicotine, including modern smokeless tobacco products like snus and the electronic cigarette (E-cig), or even pharmaceutical nicotine products, as a replacement for smoking. E-cigs might be the most promising product for tobacco harm reduction to date, because, besides delivering nicotine vapour without the combustion products that are responsible for nearly all of smoking’s damaging effect, they also replace some of the rituals associated with smoking behaviour. Thus it is likely that smokers who switch to E-cigs will achieve large health gains. The focus of this article is on the health effects of using an E-cig, with consideration given to the acceptability, safety and effectiveness of this product as a long-term substitute for smoking.

The message is that public health initiatives will be much more successful in the area of smoking cessation if nicotine alternatives, such as e-cigarettes and snus, are on offer. The harm from tobacco mainly comes from combustion of tobacco leaves, which generate copious amounts of noxious chemicals, and these are largely absent from alternative, non-smoking forms of tobacco, as well as e-cigarettes.

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6 comments
Ironthumb says August 5, 2015

I am not really sure of E cigs. Here are the reasons:

1) The solution is VEGETABLE -OIL BASED

and

2) Combustion is still present – but in E cigs they burn the cotton which is dipped in the solution to produce the smoke

Tell me what you think

Reply
    P. D. Mangan says August 5, 2015

    Well, what I know about e-gigs is the solution is glycerin-based; while that does have a vegetable origin, it’s not the same thing as vegetable oil. As for combustion, it’s not burned, it’s vaporized – hence the word “vaping”. Granted there’s plenty that’s not known about e-cigs since people haven’t been using them very long, but they are vastly safer than cigarettes, I think we can say that with near 100% certainty.

    Reply
Ken says February 9, 2016

Hi I’ve been trying e-cigs for a year, but it’s really hard to completely drop cigarettes and I keep returning to the habit. Would you by any chance know if cigarette filters could at least help reduce the toxins involved in smoking if I can’t fully drop the habit?–Assuming of course that the end goal is “harm reduction”, this seems better than nothing.

Thanks

Reply
    P. D. Mangan says February 9, 2016

    Ken, as far as I recall, filters do little to nothing in removing toxins, and in fact the fiberglass in the filters can cause other damage. Those who smoke filtered cigs often get a different type of lung cancer, one caused by inhalation of fiberglass.

    Couple suggestions: is your e-cig strong enough? Using higher nicotine juice may help you from craving cigarettes. Also, smokeless tobacco, either Copenhagen-style or Swedish snus, is vastly safer than cigarettes, and may help you control the urge to smoke a lot better. See this post: http://roguehealthandfitness.com/nicotine-tobacco-and-harm-reduction/

    Reply
Herman Rutner says March 24, 2016

As a chemist who never smoked ( for obvious health reasons ) and without any vested financial interest, my opinion is purely personal and rational based on my observations of smokers and being aware of a considerable body of info on smoking including physiological effects of pure nicotine.
I believe smoking of high nicotine cigs by WW II GIs was a major factor in boosting the fighting morale. Cigs in K rations eaten under combat conditions were the most important item often traded for food items. Why? Because nicotine is a psycho active energizer and euphoria booster of enormous value under stress conditions, both military and also in civilian jobs, improving performance and productivity. I knew one young scientist who took a smoke break every hour, yet performed her duties nearly twice as fast and efficient as non smokers.
I suspect that the elimination of smoking among current GIs may well be a factor in the substantially higher incidence of reported post traumatic combat stress.
Re ecigs the nicotine may well be the safest and most effective rec drug producing well being and euphoria with minimal immediate and long term side effects apart from harmless dependence.
The reported toxicities of vaping of ecigs are most likely from potentially toxic combustion products from oxidized solvent carriers, not from thermally vaporized nicotine. I believe improved versions using unheated vapor free aerosols free of organic carriers are far preferred, even though not producing visible vapors. And visible vapor clouds are obviously undesirable to non smokers and may be the excuse for banning ecigs.

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