Do e-cigarettes work? Are they safe?

First, my own experience as a doctor – I have found e-cigarettes to be one of the most effective methods of cutting down or quitting smoking for recalcitrant smokers.

This is because e-cigarettes are not only a nicotine replacement therapy, they are a total smoking cessation therapy, as vaping simulates the act of smoking, and you physically draw vapor into your mouth.

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Several years ago I learned a technique for hypnotizing smokers to quit, and the biggest obstacle to overcome other than the nicotine was the image that people had of themselves with a cigarette in their mouths. E-cigarettes allow a cigarette addict to perpetuate the image and the nicotine, but to lose the tar and other cigarette toxins that cause cancer and emphysema.

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Though there are no long term studies to show I’m right about e-cigarettes for smoking cessation, there is one recent study in the British journal Lancet that did demonstrate that e- cigarettes were at least as successful as a nicotine patch.



But if I see e-cigarettes as a potential tool to quit for adults, at the same time, I am very concerned about the growing role e-cigarettes are playing for teens, many of whom are non-smokers the first time they try an e-cigarette.

According to the Centers for Disease Control e-cigarette use among high schoolers is now up to 10 percent, double from a year ago, with 80 percent also smoking tobacco.

Dr. Tom Frieden, head of the CDC and a top expert in preventive health, told me that e- cigarettes can be a gateway drug, with nicotine addiction leading to more tobacco use.

I believe that, and though 12 states including New York ban e-cigarette use for minors, few are listening, and kids can still buy their e-cigarettes on line.

On top of this problem, liquid nicotine is now being sold in different flavors on-line, at much higher concentrations than is found in an e-cigarette, which generally includes nicotine levels in the 1.8% to 2.4% range.

The low concentration is less risky, but Vaporworld, for example, sells a gallon of liquid nicotine at 10 percent concentration for only $195, and Liquid Nicotine Wholesalers charges $110 for a liter at the same concentration. With this high concentration, experts say that just a tablespoon could be enough to cause serious harm.

Nicotine is a potent neurotoxin which can be ingested or absorbed through the skin, leading to seizures, vomiting, and rapid heart rate. The number of poisoning cases linked to e-liquids was 1,351 in 2013, up 300 percent from the year before.

So clearly, there is a rising concern over the safety of nicotine liquids as well as nicotine addiction.

I believe that in the right hands, e-cigarettes can be an effective tool for quitting smoking, perhaps the best we currently have available.

Unfortunately, they are frequently not getting into the right hands, and I also know many smokers who carry both cigarettes and e-cigarettes around, and don’t actually cut down on tobacco.

The FDA is planning on increasing regulations on e-cigarettes, and I think this is a good idea, though not likely to solve the problem.

I wish there was a way of regulating e-cigarettes so that a doctor has a definite role, and can guide her patients to e-cigarettes to be used as a treatment rather than as another party chemical.

Unfortunately, the chances of e-cigarettes becoming prescription-only is about as likely as the chance of cherry flavor being replaced by the taste of cigarette ash in bubblegum.