The Scientific Evidence for E-Cigarettes

I am honored to join Drs. Riccardo Polosa and Pasquale Caponnetto and their colleagues at the University of Catania in Italy as a coauthor of a new scientific article on e-cigarettes published in Harm Reduction Journal (available here).  We scientifically disprove the stated premise of a recent NPR broadcast (here), “… little is known about the potential health effects [of e-cigarettes].” NPR “expert” Stanton Glantz stated that “e-cigarettes today are the triumph of wishful thinking over data.”  Our publication shows that e-cigarettes are the triumph of scientific evidence over feigned ignorance.

For the benefit of members of the Flat Earth Society, I reproduce our summary here:

“The dream of a tobacco-free, nicotine-free world is just that—a dream. Nicotine’s beneficial effects include correcting problems with concentration, attention and memory, as well as improving symptoms of mood impairments. Keeping such disabilities at bay right now can be much stronger motivation to continue using nicotine than any threats of diseases that may strike years and years in the future.

“Nicotine’s beneficial effects can be controlled, and the detrimental effects of the smoky delivery system can be attenuated, by providing the drug via less hazardous delivery systems. Although more research is needed, e-cigs appear to be effective cigarette substitutes for inveterate smokers, and the health improvements enjoyed by switchers do not differ from those enjoyed by tobacco/nicotine abstainers.

“It is of paramount importance that government and trusted health authorities provide accurate and truthful information about the relative risks of smoking and alternatives to smoking. If the public continues to be misled about the risks of THR products, millions of smokers will be dissuaded from switching to these much less hazardous alternatives. One of us recently wrote that, “It’s time to be honest with the 50 million Americans, and hundreds of millions around the world, who use tobacco. The benefits they get from tobacco are very real. It’s time to abandon the myth that tobacco is devoid of benefits, and to focus on how we can help smokers continue to derive those benefits with a safer delivery system” [reference here].

“In the absence of regulatory standards, it is important that currently marketed products are of high quality. For example, the hardware should be reliable and should produce vapour consistently. The liquids should be manufactured under sanitary conditions and use pharmaceutical grade ingredients, and labels should contain a list of all ingredients and an accurate and standardized description of the nicotine content.

“According to a recent article by CDC researchers, the proportion of U.S. adults who have ever used electronic cigarettes more than quadrupled from 0.6% in 2009 to 2.7% in 2010 with an estimated number of current electronic cigarette users of about 2.5 million [reference here]. Although rigorous studies are required to establish THR potential and long term safety of electronic cigarettes, these figures clearly suggest that smokers are finding these products helpful. If they were ineffective one would not expect the market to take off as it is. Most importantly, even if this THR product proves to be effective for only 25% of the smoking population, it could save millions of lives world-wide over the next ten years.”

[Originally Published at Tobacco Truth


#1 Bruce W. Adkins on 11.15.13 at 8:38 AM

The key message in this ‘scientific’ report is that “rigorous studies are required to establish any ‘tobacco harm reduction potential and long term safety of electronic cigarettes” . . .

When is the U.S. Food Drug Administration going to finally do something regarding e-cigarettes, any nicotine delivery device, and the equal regulation of all tobacco products??

#2 Jim on 11.16.13 at 6:33 PM

Brought to by the e-cig manufacturers of America. 🙂
The mistake made here is the e-cig industry thinks it’s about public health. The reality is as far as the government is concerned its all about the money.
They talk a good game about public health but if you think about it why hasn’t the government ever talked about a tobacco ban? Why not say by 2030 or whatever date you wanna pick tobacco will be illegal. I think we all know the answer.$$$$$$$ Once the government gets done with taxing and regulating e-cigs the small mfgr will be gone leaving the majors and a couple other players left to meet demand. Regulation will be a good thing as right now lots of this stuff comes from China so quality control is an issue.

#3 Chris Price on 11.23.13 at 6:17 AM

Jim, the carrot/stick argument is a traditional one, no doubt – but in the world of THR you only need the carrot. It’s not necessary to ban cigarettes (and why add yet another item to the drugs war), since if the alternative products are good enough, consumers move across of their own accord. We know this, because:

1. In Sweden, male smoking prevalence falls 1% a year and will be just 5% by about 2016. Smoking will be a tiny minority activity among Swedish males, at some point fairly soon. Sweden has a realistic chance of being the first developed country to shrink smoking down to an insignificant level – and all by voluntary action not coercion.
2. In the UK and USA, 10% of smokers are already ecig users and the figure is growing so fast that at least 25% of smokers will be ecig users by 2020.

A combination of (genuine) Snus and ecigs is a winner. There is little need to take any action against cigarettes if you offer free and unhindered access to those alternatives (and providing they are unrestricted, of course).

As you say, a lot of effort is wasted arguing about the health benefits when in reality policy is all about money, and health issues are all but irrelevant. But it’s hard to base an argument for the acceptance of products on anything other than health – government, pharma and the cigarette trade stand to lose tens of billions, and that’s what counts. Ecigs will gradually turn off the money tap: the smoking money machine that generates billions for so many people. In a situation where the new product will only turn off huge incomes, it’s tough to make any headway – a vast number of people benefit from the money machine and every man’s hand is against you. Smokers are expendable: the only minority group that can legally be discriminated against and even killed without redress.

#4 Emelia Parker on 12.03.13 at 7:18 AM

I am an e cigarette user and I have started using e cigarettes when I was searching for some alternative to quit the habit of smoking as there are various bad effects of smoking on health. E cigarettes as do not contain tobacco they only have nicotine present inside them in liquid form. By switching to e cigarette those one can live a longer life as tobacco cigarettes are really very harmful. One can also quit the habit of smoking with these cigarettes in little time. Today, many people are using e cigarettes and they are living a healthier life, then before.

#5 OTP Kid on 12.16.13 at 7:16 PM

I agree that ecigs should be taxed at the same rate as cigarettes

#6 Chris Price on 12.16.13 at 8:00 PM

Why do you say that? What would the justification be? Ecigs will most likely turn out to be about 1,000 times less harmful than cigarettes. Somewhere in the coffee area, most likely. Perhaps ecigs should be taxed at the same rate as coffee, or 1,000 times less than cigarettes.

There is also an argument that ecigs should be taxed much more highly than anything else, because they will cause people to live much longer and put far more strain on government support services for the elderly, and increase costs dramatically. I see that as a genuine argument because it makes economic sense. It also means tobacco cigarettes should be given away free, of course, since they reduce state costs so efficiently.

#7 OTP Kid on 12.20.13 at 6:36 PM

ecigs are addicting gateway products and everyone is aware of that, they are also merely bridge products between cigarettes. thus, tax them like other nicotine products. this argument that they should not be taxed because they are healthier than cigs is bogus. the products are virually untested chemical inhalers made in third workd factories in the Peoples Republic of China, the same folks who put lead paint in children’s toys. people are buying them because they’re cheap due to no tax and because they can smoke them in more venues. make the playing field level and the bloom will quickly be off the rose

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