Controversy continues over benefits and risks of e-cigarettes
The finding is based on self reported survey data collected from 949 smokers in November 2011 and then again in November 2012. Of those smokers, 88 said they used e cigarettes.
At the end of the year, 13.5 percent of all the smokers had quit smoking, but only 9.7 percent of the e cigarette users had.
Statistically, this suggests no difference in the rate of quitting between people who smoke traditional cigarettes and those who use e cigarettes, say the study’s authors.
Important caveats
Unfortunately, however, that finding, although interesting, is not definitive.
To begin with, the low number of e cigarette users in the study, particularly those who quit smoking (nine in all) limits drawing a statistically significant conclusion about a relationship between e cigarette use and quitting something the study’s authors themselves acknowledge in their paper.
In addition, although the study collected data on the participants overall intentions to quit smoking, it lacked data on whether the users of the e cigarettes had turned to the devices specifically to help themselves kick the habit.
That means that the study may not have been comparing two equivalent groups in terms of their motivations to quit smoking.
In fact, as Dr. Michael Siegel, a professor of community health sciences at Boston University School of Public Health, angrily notes on his blog, “It is quite apparent from the study itself that the authors knew that the overwhelming majority of the 88 electronic cigarettes ‘users’ in their study had little or no interest in quitting and were not using these products as part of a quit attempt.”
Siegel takes the study’s authors to task for this
In the Table, the authors report that of the 88 e cigarette “users,” only 8.0% reported that they were trying to quit at that time (that is, within the next 30 days). And only 39.8% of the e cigarette users had any intention of quitting in the next six months. This means that we actually know for a fact that the majority of e cigarette users in this study were not using these products as part of a quit attempt.
What this indicates is that this is not simply junk science. Rather, it is a deliberate attempt on the part of the investigators to misuse data. They are using these data to draw a conclusion about whether electronic cigarettes are effective in helping smokers quit, yet they are knowingly drawing upon data from smokers who are using e cigarettes for other reasons, who may have simply tried an electronic cigarette once, and who most definitely were not using these products as part of a current quit attempt.
In other words, 92% of the e cigarette users in the study were not trying to quit. We know for a fact that 92% of the e cigarette users were not making a quit attempt. And yet the study authors interpret the data as if these smokers were trying to quit using e cigarettes, but failed!
Controversy continues
Peter Hajek, director of the Tobacco Dependence Research Unit at the Barts and The London School of Medicine and Dentistry, shares Siegel’s skepticism about the study, although he’s more diplomatic about it at least he was when talking to Nature reporter Daniel Cressey.
E cigarettes represent for many researchers the best hope so far to put a stop to smoking related death and disease by replacing deadly cigarettes with a safer alternative, Hajek told Cressey.
Thus, those researchers are going to want stronger evidence of e cigarettes ineffectiveness in quitting smoking than that offered in the new study.
Hajek also said, according to Cressey, that the new paper shows only that e cigarettes appeal to smokers who are heavily dependent on tobacco. The same results would be obtained if the survey looked at smokers who try nicotine replacement treatments, he says, and the results have no bearing at all on whether e cigarettes are or are not an effective method of smoking cessation.
Still, there s no strong evidence that e cigarettes do help smokers quit, either. So the authors of the JAMA Internal Medicine study have a point when they write that regulations should prohibit advertising claiming or suggesting that e cigarettes are effective smoking cessation devices until claims are supported by scientific evidence.
Major concern teens
The major concern about the growing popularity of e cigarettes is, of course, their appeal to young people. Another survey driven study published earlier this month in the journal Pediatrics concluded that the “use of e cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents.”
But that study s methodology has also been called into question. Its data could not determine if the e cigarettes were a gateway to smoking or if the teens had switched to the devices after becoming addicted to traditional cigarettes.
“The authors seem to have an ax to grind,” Siegel told Reuters reporter Toni Clarke. “I could equally argue that what this study shows is that people who are heavy smokers are attracted to e cigarettes because they are looking to quit.”
A poison danger
What is clear and non controversial, however, is that the liquid in e cigarettes poses a poison danger to children. Last week the Minnesota Poison Control System reported a 10 fold increase in reports of young people being poisoned by e juice that had been swallowed, inhaled or spilled onto the skin.
Five such poisonings were reported in the state in 2012. That number jumped to 50 in 2013. None of those poisonings resulted in serious injury, but, as Stacey Bangh, clinical supervisor at the Hennepin Regional Poison Center, stated in a press release, “Given this rate of increase, it’s not a matter of if a child will be harmed by these products, but when.
Not only is e juice not required to be contained in child proof packaging, it often contains flavorings, such as bubble gum and cotton candy, that appeal to young children.
Health officials strongly urge e cigarette users to keep the substances out of the reach of children.
As for e cigarettes usefulness in quitting smoking, stay tuned.
E-cigarettes: a reliable smoking alternative or vials of toxic poison? – consumerist
E Cigarettes contain liquid nicotine a powerful and possibly dangerous toxin.
For more than 50 years the Surgeon General has warned consumers of the risks associated with smoking cigarettes. Since that time, many products introduced as alternatives. One of the most recent, and popular options is the use of e cigarettes. But poison control officials say the reusable sticks contain enough nicotine to be bad for your health.
Manufacturers promote electronic cigarette as mimicking the sensation of smoking without exposing the user to the dangerous chemicals found in traditional cigarettes. But their main stimulant, liquid nicotine, could be just as dangerous to consumers, the New York Times reports.
Concerns about liquid nicotine go much farther than just affecting the person smoking. Poison control officials warn that even small amounts of the liquid pose a significant risk to the public if ingested or absorbed through the skin. Children, who may be drawn to refillable e liquid’s bright color packaging and flavors, are at a higher risk of death from coming into contact with the toxin.
Most liquid nicotine levels in e cigarettes range between 1.8% and 2.4% enough to cause sickness in children and adults. Higher concentrations, 7.2% or more, which can be found through online retailers, could be lethal for children and adults.
Since 2011, there has been one death in the United States associated with liquid nicotine, the Times reports. In that case, an adult committed suicide by injecting the liquid.
It s not a matter of if a child will be seriously poisoned or killed, says Lee Cantrell, director of the San Diego division of the California Poison Control System and a professor of pharmacy at the University of California, San Francisco. It s a matter of when.
In 2013, the number of accidental poisonings linked to liquid nicotine rose 300% from the previous year to 1,315 cases, many of which involved children. Minnesota reported 74 e cigarette and nicotine poisoning cases last year, of those cases 29 involved children two and younger.
The number of accidental poisoning cases doesn’t look to be slowing down. In the first two months of this year, 23 of the 25 cases reported in Oklahoma involved children ages four and younger.
Officials say an increase in poisonings is a reflection of the more common use and the evolution of e cigarettes in the United States. Because newer models can be refilled with a liquid combination of nicotine, flavoring and solvents, consumers may be at more risk of coming into direct contact with the toxins.
In the past, Consumerist has reported on issues with e cigarettes, many of which have had more to do with the device itself than with liquid nicotine. The most common reports involved the products exploding while being used.
However, when an e cigarette breaks users face the risk of shock and toxin poisoning. The Times reports a woman in Kentucky was admitted to the hospital with cardiac problems after her skin absorbed e liquid when her e cigarette broke.
Currently, there are no federal regulations protecting consumers from the products. However, many cities across the country have banned the products from being used in public places like parks and the subway.
Last October, 40 State Attorneys General agreed that e cigarettes need to be regulated. The Food and Drug Administration plans to regulate the products but so far nothing has been announced. Additionally, it’s unknown how regulators would enforce rules with manufacturers outside the United States or operating online.
Some e cigarette advocates say they would welcome regulations such as childproof bottles, warning labels and manufacturing standards.
Dr. Neal L. Benowitz, a professor at University of Southern California, tells the Times that manufacturing standards would likely include mandating proper precautions like wearing gloves while mixing e liquids.
There s no risk to a barista no matter how much caffeine they spill on themselves, Benowitz, who specializes in nicotine research, says. Nicotine is different.
Selling a Poison by the Barrel Liquid Nicotine for E Cigarettes The New York Times