The health risks of smoking are well publicized – as well as causing around 90% of lung cancers and many other cancer types, smoking can also trigger lung, heart, and circulatory diseases. The most recent survey from the US showed that 43% of smokers had tried to quit in the past year, but without medication or other help, only 4% to 7% had managed to give up at any given attempt. Electronic cigarettes (e-cigarettes) are the newest product available in the fight to quit smoking, yet little is known about whether they really work and their health benefits and risks. As regulatory agencies around the world start to take more control over e-cigarettes we review the burning questions around these products.
E-cigarettes were first patented in the 1960s, but it wasn’t until 2004 that a commercially available version went on the market in China as an aid to stop smoking. Since then hundreds of different brands and variations on the design have become available around the world. E-cigarettes are essentially battery powered metal or plastic rods that allow smokers to inhale nicotine. They also light up and release puffs of vapor to mimic regular cigarettes. Usage of e-cigarettes is rapidly growing; the proportion of US adult smokers who had tried them doubled from 10% in 2010 to 21% in 2011. Yet the official US government quit smoking website currently recommends not to use e-cigarettes due to a lack of information on safety and efficacy.
So what is known about e-cigarettes?
E-cigarettes should give smokers a hit of nicotine without them inhaling the more than 7,000 chemicals found in conventional cigarette smoke, including the 70 cancer causing agents. This should in theory reduce the cases of cancer and other diseases seen in smokers. The devices may help people trying to stop smoking more than nicotine patches, gum, or sprays as they replicate the feeling, gestures, and habits of actual smoking. There is currently limited research to back this up, a study published in the Lancet in 2013 showed that e-cigarettes were modestly effective at helping smokers to quit, but only at levels similar to nicotine patches. Few adverse events were seen for e-cigarettes in this study, but the authors reiterated that further research is needed to fully assess the overall benefits and harms of these products.
Due to this lack of research, and regulation, the harm that e-cigarettes could cause is unknown. There is no clear way to know how much nicotine is being inhaled from different e-cigarettes, or which other chemicals are being inhaled from unregulated devices. Potentially harmful chemicals have been documented in some e-cigarette cartridges, including irritants, genotoxins, and animal carcinogens. There are also fears that using e-cigarettes won’t actually lead to smokers quitting, instead just using e-cigarettes at times when they can’t smoke regular cigarettes. With the raft of marketing around these products, there is also speculation that this will encourage minors to use e-cigarettes and then transition to conventional smoking. A CDC study from 2012 reported that 160,000 US middle and high school students had tried e-cigarettes directly without having smoked conventional cigarettes before.
Governments and regulatory agencies around the world seem unsure on how to handle e-cigarettes, with some countries banning them outright, some regulating them as tobacco products, and others classifying them as medical devices. Some of the major regulatory agencies are now beginning to take control of the matter. The US FDA announced in April that they would extend their tobacco authority to cover additional products including e-cigarettes. This means that manufacturers would have to register with the FDA, report product and ingredient listings, and only market products after successful review. The FDA can also add a minimum age restriction to buying e-cigarettes. The European Parliament also put new rules in place in February to ensure the safety and quality of e-cigarettes. These include manufacturers notifying the EU on ingredients, nicotine dose, and methods of production amongst other things. Hopefully with these tighter regulations and further clinical study, the true risks and benefits of e-cigarettes in smoking cessation can be discovered.
Crown Bioscience supports the addition of any new weapons in the fight to help smokers quit, and to reduce the number of cases of smoking-related diseases. Crown Bioscience supports research into lung cancer through the use of our large collection of clinically relevant Xenograft and Patient-Derived Xenograft models available for drug discovery and translational sciences. Contact us today at firstname.lastname@example.org to discover how we can transform your lung cancer research.