Reports

The New York Times published an article yesterday about the use of electronic cigarettes being used in Italy as a means to help smokers quit. "The user 'vapes,' or puffs on the vapor to get a hit of the addictive nicotine (and the familiar sensation of bringing a cigarette to one's mouth) without the noxious substances found in cigarette smoke."

The last decade and more has been dedicated to bringing awareness of the harmful effects of cigarette and tobacco use by many organizations globally. The World Health Organization has made smoking one of their highest concerns and the plight to counsel those still smoking leave many in public health positions frustrated with their positions. No matter how frustrating many find their positions in the fight against tobacco, Italian researchers are finding great success in eliminating cigarettes from smokers with the aid of electronic cigarettes.

Riccardo Polosa lead a team of researchers at the University of Catania. They recruited 40 hard-core smokers who had previously turned down space in free cessation program and offered them an electronic cigarette that is found in stores. The e-cigarette given works just as The Safe Cig does with a reservoir of liquid nicotine that is vaporized into a mist that resembles smoke in look and feel, without the smell.

The participants were not requested to quit smoking, but rather use their electronic cigarette as desired. At the end of six months, "More than half the subjects in Dr. Polosa's experiment had cut their regular cigarette consumption by at least 50 percent. Nearly a quarter had stopped altogether." While this study was small with only 40 participants, the results fit with other studies conducted in Italy and abroad brings hope "that electronic cigarettes could be the most effective too yet for reducing the global death toll from smoking."

With the evidence showing a positive trend in eliminating cigarettes from hundreds of thousands of people should be a premise considered, there are many fighting against electronic cigarettes, although it is not the Big Tobacco companies. A coalition of anti-smoking groups and government officials have taken it upon themselves to warn about the "dangers" of e-cigarettes and encouraging municipalities to ban their sale and use.

The controversy is part of a long-running philosophical debate about public health policy, but with an odd role reversal. In the past, conservatives have leaned toward “abstinence only” policies for dealing with problems like teenage pregnancy and heroin addiction, while liberals have been open to “harm reduction” strategies like encouraging birth control and dispensing methadone.

When it comes to nicotine, though, the abstinence forces tend to be more liberal, including Democratic officials at the state and national level who have been trying to stop the sale of e-cigarettes and ban their use in smoke-free places. They’ve argued that smokers who want an alternative source of nicotine should use only thoroughly tested products like Nicorette gum and prescription patches — and use them only briefly, as a way to get off nicotine altogether.

The Food and Drug Administration tried to stop the sale of e-cigarettes by treating them as a “drug delivery device” that could not be marketed until its safety and efficacy could be demonstrated in clinical trials. The agency was backed by the American Cancer Society, the American Heart Association, Action on Smoking and Health, and the Center for Tobacco-Free Kids.

Those opposed to electronic cigarettes suffered a crushing blow to their plight when the FDA was overruled in court, but have continued to argue that "devices like smokeless tobacco reduce the incentive for people to quit nicotine and could also be a 'gateway' for young people and nonsmokers to become nicotine addicts." Those agencies continue to cite an FDA warning that chemicals may be harmful or toxic. Dr. Polosa and other researchers including professor of medicine at the University of Louisville in Kentucky, Brad Rodu, have noted the FDA's inability to present evidence of harm and also note that there are similar trace amounts of these same chemicals found in FDA approved nicotine replacement therapy including patches and gum.

Writing in Harm Reduction Journal this year, Dr. Rodu concludes that the F.D.A.’s results “are highly unlikely to have any possible significance to users” because it detected chemicals at “about one million times lower concentrations than are conceivably related to human health.” His conclusion is shared by Michael Siegel, a professor at the Boston University School of Public Health.

“It boggles my mind why there is a bias against e-cigarettes among antismoking groups,” Dr. Siegel said. He added that it made no sense to fret about hypothetical risks from minuscule levels of several chemicals in e-cigarettes when the alternative is known to be deadly: cigarettes containing thousands of chemicals, including dozens of carcinogens and hundreds of toxins.

All parties involved in the debate agree that more research is needed to fully evaluate the benefits of electronic cigarettes. Additionally, electronic cigarettes should never be sold to persons under the legal smoking age and a guideline needs to be established to ensure quality-control for all electronic cigarette companies. The American Association of Public Health Physicians and the American Council on Science and Health see no reason to prevent adults from using electronic cigarettes.

“Nicotine itself is not especially hazardous,” the British medical society concluded in 2007. “If nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.”

“E-cigarettes could replace much or most of cigarette consumption in the U.S. in the next decade,” said William T. Godshall, the executive director of Smokefree Pennsylvania. His group has previously campaigned for higher cigarette taxes, smoke-free public places and graphic warnings on cigarette packs, but he now finds himself at odds with many of his former allies over the question of e-cigarettes.

“There is no evidence that e-cigarettes have ever harmed anyone, or that youths or nonsmokers have begun using the products,” Mr. Godshall said. On a scale of harm from 1 to 100, where nicotine gums and lozenges are 1 and cigarettes are 100, he estimated that e-cigarettes are no higher than 2.

With some of us at The Safe Cig being former smokers, we understand and realize the benefits received from the nicotine found in cigarettes. Nicotine is a highly-addictive drug that has been linked to a temporary reduction in anxiety and stress, lower weight, and faster reaction times. The benefits are real, which makes quitting smoking even more of a challenge than simply changing a bad habit. When an alternative is present that provides nicotine without the thousands of chemicals found in cigarettes, we know the benefits. We feel them every day -- as do our clients and customers.

Dr. Rodu writes, “It’s time to abandon the myth that tobacco is devoid of benefits, and to focus on how we can help smokers continue to derive those benefits with a safer delivery system.”

Quoted portions of this piece came from the article source on The New York Times Web site.

The full study is detailed at BioMedCentral.com