The Future of E-cigarettes: What Lies Ahead?
Image source: ecigarettesrus.com.au
Smoking cigarettes has long been known to be a deadly habit, and many studies carried out over the past decade have hard evidence that tobacco smoke leads to a wide variety of fatal diseases. It is also a known fact that upon quitting, the risk of serious illnesses such as heart disease, chronic lung disease and cancer quickly diminishes.
The most current statistics (provided by the Victorian government website – Better Health Channel [1]) point to cigarette smoking as one of the leading causes of death in Australia, with the number of male smokers outnumbering females. One out of every five smoking-related deaths are of individuals who belong to the 35 to 64 age group.
Nicotine is highly addictive, and with sufficient exposure, the body becomes highly dependent on the substance. Withdrawal symptoms can vary among individuals, ranging anywhere from restlessness, depression, irritability, cravings to changes in sleeping patterns. These symptoms coupled with the fact that smoking is a social habit, makes it difficult for most to quit without additional aids.
Smoker Statistics
Although Australian government has been fairly successful with reducing the number of current smokers with each consecutive year through the media as well as deterring new smokers via high tax levies, around 3 million still smoke regularly. Statistics from Action on Smoking and Health Australia in 2010 show that around 50 deaths daily are attributed to either active or passive smoking [2].
Australians have become more aware of the dangers of cigarette smoking and since February 2011, around 100,000 individuals filled prescription scripts for subsidized nicotine patches (4-week treatment) provided as part of the Pharmaceutical Benefits Scheme (PBS) [3] offered by the Gillard government. This significant number is a good indication of just how many people have the intent of butting out.
Nicotine patches are not the only available forms of NRT however. Hundreds of thousands of smokers worldwide have switched over to e-cigarettes, buying them mostly via the internet, despite warnings by US health authorities who state that these devices and their components have not undergone sufficient testing to be labelled as safe. With most of the electronic cigarettes being manufactured in and getting shipped in from China, the FDA have seized multiple shipments of these devices into the United States. Karen Riley, a spokesperson for the FDA said, “These appear to be unapproved drug device products, and as unapproved products they can’t enter the United States”. Australia may well be following suit.
E-cigarettes as NRT’s
Electronic cigarettes are battery operated and are intended to be used as nicotine delivery devices.
The electronic cigarette essentially fulfills the same goals as other nicotine replacement therapies such as patches and chewing gum. Doses of nicotine are delivered into the blood stream when vapour is inhaled, much like cigarette smoke. Some manufacturers have even gone so far as to make the devices resemble real cigarettes, so that they are more appealing to consumers.
The scale of electronic cigarettes users in Australia is still dwarfed by that of the United States and the United Kingdom. This is due to Australian law prohibiting the sale of products with nicotine content, however it is still currently legal to import nicotine liquid from overseas in small quantities for personal use. Since e-cigarettes are not promoted here in Australia, most smokers in the past were not even made aware of what these products do or that they even exist.
Electronic cigarettes, over the past year are gaining more exposure of late via the media but the question is, how effective are they in deterring smokers from picking up smoking again in the long-term? What are the abstinence rates?
The consensus from various review sites and forums on the whole are positive, with the majority of them claiming that e-cigarettes have helped them successfully quit smoking. Allegedly, users on these forums prefer using the e-cigarette over traditional tobacco, claiming that they have seen noticed health improvements since making switch over. They also claim that since these devices mimic the look, taste and feel of traditional cigarettes, giving up smoking is a lot easier compared to other forms of NRT’s like nicotine patches.
Case Studies:
A very recent study done in 2011 by the American Journal of Preventative Medicine stated that overall, 31.0% of the subjects reported abstinence after 6 months. Of the sample, 70% of them who used e-cigarettes more frequently each day had remained abstinent for over 6 months. This might suggest that for e-cigarettes to work effectively, more frequent doses of nicotine may be necessary. [4]
Another test study on electronic cigarettes was conducted in 2011 and the report was published publicly by the Journal of Medical Case Reports. The study titled “Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series” [4], had three subjects (two men and one woman) use e-cigarettes as smoking cessation devices. All three of whom had a history of relapses in the past and had gone back to smoking tobacco, had managed to quit successfully during the period of the trial which lasted 6 months.
Long-term Effects
The problem the FDA and other health authorities have with e-cigarettes is that the doses of nicotine are not controlled and their fear is that e-cigarette users may not be fully aware of what other substances or contaminants may be present. Another argument is that because manufacturers make “e-liquids” so appealing (with almost any flavor a user might desire),minors may be more likely to buy e-cigarettes become nicotine dependent.
What the real effects of using these devices are over a long period of time still remains unclear. Until long-term clinical trials are conducted, health authorities such as the FDA are going to see them as a threat and a potential health hazard. The reasoning is that the components of these products have not yet been tested for safety and cessation efficiency, and thus should be avoided.
Various short-term clinical studies on specific brands of e-cigarettes have been done over the past few years by independent companies such as Health New Zealand Ltd [5], and the conclusion was that those devices posed no threat to general health, but the health authorities are yet to be convinced.
User communities globally are currently making a stand against the banning of these cessation devices, and much to their frustration because authorities are turning upon deaf ears.
The argument is that, over the past 4 to 5 decades, much statistical evidence has been gathered to confirm the link between smoking and related diseases such as cancer and death, yet tobacco cigarettes and cigars are still being legally sold and are attainable everywhere. Various brands of electronic cigarettes that have been clinically tested on the other hand have been proven safe, yet the U.S. and Australian health authorities are banning the sale of e-cigarettes. This eliminates a potentially viable avenue for smokers who have tried other options such as nicotine gum and patches but have been unsuccessful in their attempts to quit.
References:
[1] Better Health Channel: Smoking statistics
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Smoking_statistics
[2] Action on Smoking and Health Australia:
“Taxation and funding the fight against tobacco”
http://www.ashaust.org.au/lv3/action_funding.htm
[3] Australian Department of Health and Ageing: Pharmaceutical Benefits Scheme
http://www.hirc.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr11-nr-nr132.htm?OpenDocument&yr=2011&mth=07
[4] American Journal of Preventative Medicine: “Electronic Cigarettes As a Smoking-Cessation Tool”
http://www.ajpmonline.org/article/S0749-3797(10)00792-0/abstract
[5] Journal of Medical Case Reports:
“Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series”
http://www.jmedicalcasereports.com/content/5/1/585/abstract
This article was authored by Mech. He can be contacted via his e cigarette review site – http://www.ecigaddict.com
