Interest in E-cigarettes Is High, but Safety and Effectiveness Unknown

Release Date: February 8, 2011 | By Milly Dawson, Contributing Writer
Research Source: American Journal of Preventive Medicine

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Electronic cigarettes are drawing heavy media and marketing attention, and while a new study finds that consumer interest also runs high, a companion study underscores that e-cigarettes’ ability to help smokers cut down or quit is unknown.

E-cigarettes run on batteries and look like real cigarettes, cigars or even ballpoint pens. Users inhale doses of nicotine or other toxins found in tobacco in vapor form. Because e-cigarettes do not contain tobacco or create smoke, manufacturers are marketing them both as a safer alternative to smoking and as a cessation aid.

Of the two studies appearing online and in the April issue American Journal of Preventive Medicine, one shows that consumer interest in e-cigarettes currently is much higher than interest in more traditional products.

“Although we don’t know much about the health effects of e-cigarettes, they are by far the most popular smoking alternatives and cessation products on the market,” said lead author John Ayers, a doctoral candidate at Johns Hopkins Bloomberg School of Public Health.

His group monitored English-language Google searches in the USA, Canada, the UK and Australia from January 2008 until September 2010. They compared searches for e-cigarettes with searches for a nicotine lozenge and for cessation products like nicotine patches, nicotine gum and the drug Chantix (varenicline).

Between July 2008 and February 2010, searches about e-cigarettes increased sharply in all nations, especially in the United States. “We found that e-cigarettes were more popular in U.S. states with stronger tobacco control,” Ayers said. This, he said, suggests that consumers are using e-cigarettes to either bypass smoking restrictions or to quit when faced with restrictions.

To see if searches on e-cigarettes led to sales, his group monitored online shopping searches. Shopping search trends mirrored informational search trends, they found.

In the second study, Michael Siegel, M.D., looked at e-cigarettes’ effectiveness as smoking cessation aids using an online survey. Siegel, a professor at the Boston University School of Public Health, obtained 5,000 email addresses of people who had made a first-time purchase in 2009 from an e-cigarette distributor.

Of the 222 consumers replied to the survey, 216 were qualified to participate. Nearly 67 percent of these respondents said they reduced the number of cigarettes they smoked since using e-cigarettes and 49 percent reported that they had quit smoking for an unspecified time after trying e-cigarettes.

Siegel acknowledged and other smoking cessation experts have said that it is possible that smokers who had greater success cutting down or quitting were more likely to respond. This would bias the results, which already relied on a small fraction of those contacted.

“We don’t know anything about the 95 percent of the people who deleted the email,” said Jennifer Unger, Ph.D. “Maybe they’re still smoking the same number of cigarettes. Maybe they are using even more nicotine than before because they’re smoking ordinary cigarettes and e-cigarettes.” Unger, with the Institute for Health Promotion and Disease Prevention Research at the University of Southern California, has no affiliation with either study.

“Neither of these two studies provides scientific evidence that e-cigarettes are effective in helping people to quit,” said John Pierce, Ph.D., a professor of cancer prevention at the Moores Cancer Center at the University of California at San Diego. “It’s not clear to me that e-cigarettes aren’t harmful in some way. It’s not clear to the FDA, either.”

In Sept. 2010, the Food and Drug Administration cited five e-cigarette distributors for “unsubstantiated claims and poor manufacturing practices,” according to an agency release. In January 2011, the FDA moved unsuccessfully to block e-cigarette importation.

TERMS OF USE: This story is protected by copyright. When reproducing any material, including interview excerpts, attribution to the Health Behavior News Service, part of the Center for Advancing Health, is required.


For More Information:

Reach the Health Behavior News Service, part of the Center for Advancing Health, at (202) 387-2829 or [email protected].

American Journal of Preventive Medicine: Contact the editorial office at (858) 534-9340 or [email protected].

Ayers JW, Ribisl KM, Brownstein JS. Tracking the rise in popularity of electronic nicotine delivery systems (“electronic cigarettes”) using search query surveillance. Am J Prev Med 40(4), 2011.

Siegel MB, Tanwar KL, Wood KS. Electronic cigarettes as a smoking-cessation tool: results from an online survey. Am J Prev Med 40(4), 2011.

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Comments on this article
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Jolly says
February 8, 2011 at 5:08 AM

Thank you for the informative post.
Keep sharing.

e-cig supporter says
February 8, 2011 at 8:06 AM

E-cigs are making people healthier, The evidence is all over the internet in forums, visit the forums and read how people are successfully quitting smoking. And then read how much healthier they are.

There is a great need for more feedback from the e-cig community before making any judgement.

And the information for chemical study on e-cigarettes is available. And has been proven to show that it is 1000 times less toxic in comparison to smoking tobacco cigarettes.

Vegetable glycerin (VG) or propylene glycol (PG) or both liquids are used, along with a small amount of nicotine if required. And sugar free flavouring

When vaporized, on trace levels ..

It's 1000 times less toxic on trace levels when compared to tobacco cigarettes.

Tony Lightbody says
February 8, 2011 at 9:38 AM

LOL John Pierce's response is just classic. Instead of looking at the people it did help let's immediately look at who it 'Possibly' didn't help. I wonder if he should disclose any funding or support before making such a ridiculous comment. Never have I seen such a blatant disregard for peoples health from the very people who are supposed to have the publics best interests in mind. Do you smell that?? I smell big pharma contributions...

Petrodus says
February 8, 2011 at 10:17 AM

but Safety and Effectiveness Unknown

Here we go again...

Lost in many discussions on E-cigarettes is the voice of the consumer

Milly, I'd like to ask you personal question. Why is everyone on the planet so deathly afraid of surveying a hundred E-cigarette users? The reason is obvious. One couldn't truthfully post that safety and effectiveness is in unknown.

mlg says
February 8, 2011 at 11:26 AM

I don't really care if they are better or worse for the smoker. They eliminate the problems of second-hand smoke, and all the innocent people (including kids) that suffer for that. That alone is enough reason to celebrate and promote e-cigarettes. Even if they kill the smoker-- they were killing themselves anyway.

Tom says
February 8, 2011 at 11:41 AM

I love my e-cig. Now I can have a smoke anywhere I want without fear of bothering anyone else. And from what I've been reading they are a lot safer than traditional cigarettes. For more information about e-cigs, I suggest taking a look at this blog, as it has some pretty useful info about them.

Elaine Keller says
February 8, 2011 at 2:33 PM

Jennifer Unger can rest easy about the issue of nicotine overload. Dr. Laugesen of Health New Zealand found 1/10 the amount of nicotine in each vapor puff compared with an equal size puff of tobacco smoke. Dr. Eissenberg of Virginia Commonwealth University found that human subjects had barely measurable amounts of nicotine in their blood after 10 puffs. What is also being found in consumer surveys is that only about 4% are true

Elaine Keller says
February 8, 2011 at 2:35 PM

(rest of post). Only about 4% are true dual users. Up to 80% are using e-cigarettes as a complete replacement for smoking, and the rest have significantly cut down on the number of tobacco cigarettes smoked.

John says
February 8, 2011 at 5:16 PM

Propylene glycol is the active vapor producing ingredient. It's in just about every brand of mouth spray including Binaca, you remember Binaca right? It's that peppermint breath spray, and you know all that sore throat spray? It all contains propylene glycol. It's in my crest tooth paste, it's in my old spice deodorant.

Bill Ryan says
February 8, 2011 at 7:41 PM

You would think that anything that would keep people from smoking would be a good thing. But this article seems like its trying, but can't quite succeed, in putting e-cigs down. All I know is, I don't smoke cigarettes anymore since I started using one.

Jude8753 says
February 9, 2011 at 2:12 AM

I smoked for 45 years and did research on personal vaporizers in March 2010. I ordered and received my first one in April.

I haven't had a tobacco cigarette since starting with my PV. I still get the nicotine I need without all those other toxins that was making me sick.

For me it has indeed been a miracle, I figured I'd die smoking or from smoking. I finally listen to my body and it tells me I feel great now.

Too bad I will live to collect Social Security now. :)

Debra Bock says
February 9, 2011 at 2:12 PM

Articles like this just drive me nuts! They're written as if by a twelve-year-old who is trying to make a point but never gets there. If a group wants to really find out the truth, they should go to the users and not the posers. Asking the members of the numerous e-cig forums would be the responsible first step. Most members would be glad to respond to a survey to tell how e-cigs have changed their lives. This article reads as if e-cigs are being marketed as smoking cessation devices. If the writers had gone to the websites, they would have seen e-cigs are not represented that way and no promises are made. That being said, many e-cig users have quit. Many others have cut down. I am in the latter group, but look forward to the day I do quit. I can also say that I no longer wake up coughing phlem out of my lungs just so I can breathe. Maybe there aren't enough studies done to prove that e-cigs are better for you than analog (real) cigarettes, but I don't need a study to see that my health has improved. Why not ask users who have stuck with them for a while? One last note: Every time I pick up an e-cig, I would have been smoking an analog. Whoever had the thought that e-cigs would be used IN ADDITION to a smokers normal amount of analog cigarettes, is clearly not a smoker! TALK TO US! WE'LL TELL YOU ANYTHING YOU WANT TO KNOW! JOIN A FORUM AND ASK ALL THE QUESTIONS YOU WANT. But stop passing around biased

Save big pharma! says
February 9, 2011 at 11:06 PM

Electronic Cigarettes have got to go! Companies like Pfizer are losing major profits in their investments. The reports of Ecigs having as high as 80% success rates when other FDA approved NRT products are only 2% at 20 months. This is unacceptable for continued profits of Americas Pharmaceutical companies!
These companies have already paid the FDA for their approval process, and the FDA doing it's best to protect their investments. Lets support their profits by banning all electronic cigarettes.
Recently the FDA lost their appeal to label the electronic cigarette as a drug delivery device. This was a huge blow, but not the end of the fight. We should just simply ignore them. After all it will be hard for anyone to stand against us with all our finance power!

Let our children grow up with fewer options, NRT's that may improve above 2% success rates with further study, or real cigarettes.

David Holmes says
April 20, 2011 at 1:31 PM

I stopped smoking after 41 years using the ecig, only to keep finding ignorance among so called experts prevailing on the minds of the masses. I tried every other method of stopping smoking, even Chantix, nothing worked but the e-cig. Taking this from people like me would be equal to mass murder. I can show you unbiased research saying the ecig is MUCH safer than smoking, yet people like this with with a shady agenda dictates policy. Tobacco and Big Pharma will run with your lop sided views, Dr Keller. How can you say the ecig isn't proven to help smokers stop smoking while right under your nose thousands have stopped smoking using the e-cig??

Chris Kuhns says
April 30, 2011 at 7:47 AM

Smoked 12 years tried to quit 5 years in that time. Smoke free for a year and six months. I can tell the difference in my lung capacity as well with my since of smell and taste (only after a month or two) and on top of that have saved a lot off money. Money being the only thing I think people putting articles like this on the web or the news even care about.

J Coffey says
May 6, 2011 at 4:43 PM

I smoked for 34 years.
Tried a E-Cig and havent smoked a regular cigarette in a year and have not one single desire too.
I do not cough anymore,I haven't been sick AT ALL.
My sinuses have cleared up.(I used to have Sinus infections many,many times a year)
I have saved over $2500 alone just from switching to E-Cigs.
My health is tons better,I feel better.
My entire family and friends,all smokers,have the same results.

Carlos says
July 17, 2011 at 1:38 PM

I started smoking when I was 23 and am now 56. Someone at work gave me a starter kit of e-cigs about 3 months ago and I haven't had a regular cigarette since. In the 3 months since, half of my vap is nicotine free.

I have to tell you folks I'm feeling pretty good. I'm actually running up and down the stairs at home.

rnsmoker says
September 29, 2011 at 8:20 PM

I've tried everything as well gum, patches, pills. Governments both state and local are counting on tobacco taxes to pay for lot's of stuff. Look at New York where the cost of a pack of cigarettes is $10.00 compared to California at $5.00. The difference is all taxes. If enough people switch to e-cigs tax revenue will drop significantly. As soon as they can figure out how to tax them then I'll bet they will stop trying to ban them.

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January 7, 2012 at 11:24 PM

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Digital Cigarette User says
February 7, 2012 at 3:43 PM

I went from a pack a day all the way down to one a day in the span of a week using my inhaler. Most of the time I still smoke my one real cigarette a day I allow myself, even if I have to force myself to-- because it lets me know where I'm coming from.

When I smoke my real cig daily, it tastes like I'm licking an ashtray, and it feels like someone is choke-slamming my lungs.

Still on nicotine, yes, but that sounds better to me than lung cancer.

John Adams says
August 2, 2013 at 12:56 PM

Thanks you so much for this kind information. I will try electronic cigarettes.
Nicotine Free Electronic Cigarettes