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Rise in Popularity of E-Cigarettes Sparks AHA Concerns and Recommendations — Physician’s First Watch

Medical News |
August 26, 2014

Rise in Popularity of E-Cigarettes Sparks AHA Concerns and Recommendations

By Larry Husten

Edited by David G. Fairchild, MD, MPH

The recent dramatic rise in popularity of e-cigarettes threatens to reverse hard-fought progress in the war against smoking, according to a new policy statement from the American Heart Association.

The AHA didn't completely reject the use of e-cigarettes as a smoking cessation aid. The statement notes that although the evidence is "sparse," some studies have suggested that e-cigarettes may be equal to or better than nicotine patches for smoking cessation. The AHA continues to recommend that physicians encourage "proven smoking-cessation strategies as the first line of treatment" but also states that "clinicians should not discourage" e-cigarettes when other methods to quit smoking have failed or when patients want to use e-cigarettes to help them stop.

The AHA expresses "concerns that these products may be another entry point for nicotine addiction among young people." These worries are supported by a new CDC study published in Nicotine & Tobacco Research that shows a tripling in the number of youths who had never smoked a cigarette but who used e-cigarettes, from 79,000 in 2011 to 263,000 in 2013. Further, intention to smoke conventional cigarettes was twice as high among e-cigarette users than nonusers.

The AHA says, "Unregulated e-cigarettes could potentially turn back the clock to the days when smoking in public was normal behavior, undoing years of work on smoke-free laws and hampering current enforcement."

Reader Comments (1)

LOUIS COLASANTI

There has been an on-going confusion, bordering on confabulation, in numerous articles about e-cigarettes. I have written before about the fact that, after almost 50 years of being a smoker, since starting to use e-cigs {a year ago now}, I have yet to smoke another cigarette. But the issue I would like to call attention to today is a rather loose use of terminology that has too often been characteristic of a number of pieces that have appeared in these pages, and the attendant confusion that can only hamper honest science and informed public policy. First and foremost, e-cigarettes are not equivalent to smoking. There have already been studies that have tried to distinguish between the relative dangers of e-cigarettes as nicotine delivery systems – similar in that regard to gum or the patch – and the long-ago established risks associated with actual smoking. We know that, in large measure, it is the combustibles in cigarettes that are responsible for most of the unwanted health outcomes. To decry e-cigarettes as threatening "to reverse hard-fought progress in the war against smoking," or to state that they "could potentially turn back the clock to the days when smoking in public was normal behavior, undoing years of work on smoke-free laws" is a complete misprision. There is no smoke associated with e-cigarette use, period. If one wants to focus on the potential of e-cigarettes as a gateway to actual cigarettes, or to if one seeks to limit access to e-cigarettes in the same way we limit access to actual cigarettes, that makes sense. Indeed, if one wants to focus on the potential negative health outcomes of nicotine use in itself, all well and good. But to equate e-cigarettes and actual smoking is to miss at least two essential differences and can only confuse the much-needed discussion and the decisions that will follow.

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