E-Cigarettes: Smoking Cessation Aids, Gateway Drugs, or Both?

MDedge News

Electronic or e-cigarettes are widely viewed as harmless alternatives to conventional cigarettes, because they deliver nicotine and other chemicals via vaporization of a flavored liquid rather than by combustion of tobacco leaves.   Some smokers view e-cigarettes as innocuous substitutes for regular cigarettes, while others view them as smoking cessation devices similar to nicotine gum, nicotine patches, medications, and behavioral modification strategies.

The US Food and Drug Administration, however, has not approved e-cigarettes as smoking cessation aids, because they may expose users or “vapers” to some of the same toxins found in cigarette smoke. Additionally, public health authorities are concerned that while e-cigarettes may help some people kick the cigarette habit, they are just as likely or more likely to start adolescents on the road to a lifetime tobacco habit. In fact, e-cigarette and vaping liquid manufacturers appear to be fueling an e-cigarette epidemic among teens, with designs that can be easily concealed and flavors targeted to youthful palates, such as fruit, candy, cream/custard, vanilla, and blueberry lemonade.

The 2019 annual meeting of the American Association for Cancer Research (AACR) featured a major symposium titled “A Discussion of the US Youth E-cigarette Epidemic: Using Science to Inform Policy to Prevent Another Generation from the Dangers of Nicotine Addiction.” Lung Cancer Journey interviewed two of the symposium participants, each a leading advocate for tobacco and e-cigarette control.

Roy S. Herbst, MD, PhD, is the Ensign Professor of Medicine (Medical Oncology) and Professor of Pharmacology at Yale University, and Chief of Medical Oncology at Yale Cancer Center and Smilow Cancer Hospital in New Haven, Connecticut. In this interview, he discusses his concerns as a clinician and as the head of an AACR committee on tobacco control about the potential for dual use of e-cigarettes and conventional cigarettes, and about the marketing of e-cigarettes to pre-teens and adolescents.

Brian A. King, PhD, MPH, is Deputy Director for Research Translation in the Office of Smoking and Health at the US Centers for Disease Control and Prevention (CDC) in Atlanta. He discusses in this interview the CDC’s perspective on the rise of electronic tobacco products and the implications for policy, planning and practice.



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