E-cigs the lesser of two evils? Maybe, but that still doesn’t make them safe

ron1Let’s face it. We humans sometimes do things that we know are unhealthy, like eating an entire bag of chips, texting while driving, and peeking into Halona blowhole. And some of us smoke cigarettes.

If you can’t stop people from doing something unhealthy (like smoking), what if you can make it, well, less unhealthy?

Since being introduced in the United States around 2007, e-cigarettes have become a worldwide, multi-million dollar market. They come in a wide variety of brands, devices, nicotine levels and flavors.

However, as use and demand for the devices grow, so does concern about the potential health effects of e-cigarettes. In recent months, there have been mounting calls for greater regulation of products, including from Hawaii’s attorney general.

Questions remain

I don’t smoke. Secondhand smoke makes me cough and I hate the smell that clings to my clothes. So my first reaction to electronic cigarettes, popularly called e-cigs, was relief. I could stand right next to a “vaper” (someone using an e-cig) and not be subjected to unpleasant secondhand smoke. No coughing, no stinging eyes, no clinging odor.

But in researching e-cigarettes, I also found that there is still much we don’t know about their long-term health effects.



I recently spoke to Dr. Thaddeus Herzog, a researcher at the University of Hawaii  Cancer Center, who said electronic cigarettes will be the subject of considerable research in the years to come. In fact, the UH Cancer Center published a study earlier this year that found smokers are trying e-cigarettes to quit smoking regular cigarettes, even though their effectiveness hasn’t been proven.

“I try to take a balanced view of e-cigarettes,” Herzog said. “There’s certainly potential harm, but the potential of helping people quit conventional cigarettes cannot be ignored.”

Trying to quit

For this piece, I sat down with two e-cig users, Prima and Ron, and asked them why they started using e-cigs. Both said they were looking for a way to stop smoking regular cigarettes, and after being unsuccessful with nicotine patches and gum, they took up e-cigs.

For two years, Prima used e-cigs and regular cigarettes together. But two months ago, when regular cigarettes started tasting “weird,” she switched to using only e-cigs.

Ron switched from regular cigarettes to e-cigs this year. “I’m more hooked on the actual action of smoking, rather than the nicotine, so I was trying to find something that would replicate smoking without as much harmful effects,” he said. “It does a pretty good job.”

The battery-powered devices convert liquid nicotine into a vapor that the user inhales. No match is needed since there is no flame. There’s also no tobacco, no ash or smoky smell. Most importantly, the absence of tobacco and other harmful chemicals found in cigarettes reduces a person’s chances of getting lung cancer or other diseases associated with cigarettes.

Ron, a cigarette smoker for about 18 years, said he used to have a smoker’s cough. But since he switched to e-cigs, the cough has disappeared. Smoker’s cough is a persistent, phlegmy cough that usually develops in long-term smokers.

The takeaways

So are e-cigs a good thing or not? The answer might depend on who you talk to. On the surface, e-cigs might seem an improvement because they don’t involve tobacco, fire, or smoke – the three things that cause the most problems with regular cigarettes. But here are some points worth considering:

1. We really don’t know enough about how these will affect users over a decade or more. Remember how long it took to establish the connection between tobacco and cancer?

2. Don’t dismiss nicotine as harmless. It’s a highly addictive substance that perks you up and calms you down at the same time, a combination that may also elevate your blood pressure and heart rate, and inhibit the release of insulin.

Prima, who smoked cigarettes for 34 years with no blood pressure problems, recently experienced an alarming spike in her blood pressure that was eventually attributed to the e-cigs. The device she uses has a high nicotine level and delivers a concentrated dose of nicotine to her system.

“So you’re getting more of it with one hit, compared to regular cigarettes,” she said. Prima plans to decrease the nicotine level each month until she can quit e-cigs altogether.

3. What’s really in those things? E-cig makers are not required to disclose all the ingredients or chemicals used in their products.

The U.S. Food and Drug Administration (FDA) did a small study in 2009 to analyze a sample of two brands of nicotine cartridges. The study found that a cartridge labeled nicotine-free actually contained nicotine. In some cartridges, they also found cancer-causing compounds, one of which was a chemical found in antifreeze.

Herzog stressed that while e-cigs might be the lesser of two evils for current smokers, there are still lots of unanswered questions about their health effects.

Also, while smokers are increasingly turning to e-cigs to kick the habit, e-cigs have not been tested and approved as a smoking cessation aid.

And, most importantly, if you currently don’t smoke, don’t start using e-cigs to look cool or do the “in” thing. Go pierce a body part instead. Whatever e-cigs are, they aren’t considered healthy, so don’t take them up.

“Anytime you’re breathing something that’s not clean air, that’s probably not a good idea,” Herzog said. “If you’re not a (tobacco) smoker already, no one should be advised to start using them.”

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