Nicotine •

The Controversy Around Electronic Cigarettes

Do e-cigarettes truly help smokers quit this vice?

The controversy revolving around electronic cigarettes is never ending: while some believe in their efficacy, others state there are safer and better methods to quit smoking.

It is true that smoking cigarettes have lost much of its popularity in the United States, but there are still 480,000 people dying each year because of this habit, as reported by the Centers for Disease Control and Prevention. Additionally, there are sixteen million American citizens that have developed smoking-related diseases.

In this light of events, behavioral sciences and psychiatry professor and Duke Center for Smoking Cessation director at Duke University Jed E. Rose argues that e-cigarettes are true helpers in quitting this habit. He is opposed by medicine professor Pamela Ling from University of California’s Center for Tobacco Control Research and Education in San Francisco.

Rose believes that his previous and current research has proven that current approaches for quitting are mostly ineffective for those who have picked up the habit. He has urged for alternative approaches but in the meantime,

“Electronic cigarettes have an unparalleled potential to reduce the public-health impact of smoking, by allowing smokers to replace the habit and nicotine of smoking without the toxic effects of combustion.”

Ling has compared the rate of people who quit after using nicotine patches (six percent) with the one of those who used electronic cigarette (seven percent) and concluded that the difference is so small, smokers should completely give up on even the gesture of smoking.

She has backed her opinion with reports from the World Health Organization, the American Public Health Association, the American Medical Association and the American College of Physicians, organizations that all do not recommend electronic cigarettes because the evidence of their success is quite poor.

However, the issue does not lie in the number of people who quit, but in the fact that many add electronic cigarettes to their tobacco use. However, in the end, it all goes down to profit.

Since cigarettes have been proven to be so deadly, why are they still on the market? Because of the grand tobacco companies. Advocacy organizations for electronic cigarettes have stated they are independent of such companies. However, e-cigarette subsidiaries have been acquired by all major tobacco companies in the United States. Additionally, they also own the e-cigarette brands featuring the largest market. Coincidence?

Unfortunately, all revolves around profit in our world. If you truly wish to do good for yourself, you have to stay informed on all methods for quitting smoking and choose the one most suited to you.

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California health dept. head campaigns against ‘addictive’ e-cigarettes

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A top public health official at California health department on Wednesday opened campaign against ‘addictive’ electronic cigarettes, saying these slow killers are causing nicotine poisoning among children that in turn is threatening to decelerate the decades-long effort of the state to check tobacco use.

Ron Chapman, Director of the California Department of Public Health, released a report on e-cigarettes use in an attempt to express his serious reservations about their use as an alternative medium for traditional cigarettes at a time when the state legislature is debating whether to regulate these modern smoking devices under the tobacco regulations of the state.

“I am advising Californians to avoid the use of e-cigarettes and keep them away from children of all ages. E-cigarettes contain nicotine and other harmful chemicals. The nicotine present in them is equally addictive as the nicotine found in cigarettes,” Chapman said.

Meanwhile, the growing e-cigarette industry has criticized Chapman’s report, saying the heated liquid inhaled by the users is not as hazardous as the by-products of tobacco burning in regular cigarettes, pipes and cigars.

Gregory Conley, President of the American Vaping Association, said, “This report inappropriately paints this complex and crucial public health topic as a black and white issue. There is ample evidence that indicates vaping helps smokers quit and is far less hazardous than smoking.”

7.6 percent of people in the age group 18-29 in California used electronic cigarettes in 2013, which is up from 2.3 percent in 2012, according to Chapman’s report. The incidents of nicotine poisoning among children under the age of five increased shockingly from seven in 2012 to 154 in 2014, showed the report.

The health experts say owing to the fact that there are lesser research works on health effects of electronic cigarettes, their risks and benefits over traditional ones are the subject of intense debate.

The US Food and Drug Administration (FDA) is working in direction of finding potential product standards in the areas of toxicity, addiction and product appeal. However, FDA’s tobacco division head has noted that modern cigarettes do not cause flooding of smoke and tar in the lungs as done by the regular cigarettes.

‘Nicotine metabolism’ determines how efficiently smokers kick their habit

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A new study has found that it’s the pace of nicotine metabolism in a smokers’ body that determines how quickly they will quit the smoking habit and what’s the most effective way to do so.

The findings were concluded in a first-of-its-kind largest randomised clinical study of tobacco dependence treatment.

The researchers found that the normal metabolisers of nicotine showed better quit rates due to the use of non-nicotine replacement therapy drug varenicline (also called Chantix or Champix) in comparison to the nicotine patch when the treatment ended as well as six months later. On the other hand, slow metabolizers were found yielding similar quitting success rate due to the use of nicotine patch, but without the side-effects reported with varenicline.

According to the researchers, Pfizer’s Varenicline was equally effective as a nicotine patch in helping the smokers kick their habit. However, Varenicline reported more overall side-effects among the smokers.

Detailing the study, lead author Caryn Lerman, said, “Matching a treatment choice based on the rate at which smokers metabolise nicotine could be a viable strategy to help guide choices for smokers and ultimately improve quit rates.”

Lerman is a Psychiatry professor and director of the Center for Interdisciplinary Research on Nicotine Addiction at Penn’s School of Medicine.

Nicotine metabolism and the slow and normal metabolisers illustrate how long nicotine consumed from cigarettes stays in the body after quitting the habit.

For the study, 1,246 treatment-seeking smokers were involved and then divided into two group- slow metabolisers (662) and normal metabolisers (584).

They were randomised to 11-weeks of either varenicline (plus placebo patch), the nicotine patch (plus a placebo pill) or a placebo pill and patch. All the participants also received behavioural counseling during the trial period.

Concluding the findings of the study, the researchers said that varenicline was more effective in helping smokers quitting their habit that the nicotine patch among normal metabolisers. On the other hand, the efficacy was equivalent for both varenicline and nicotine patch among slow metabolisers. But smokers with slow nicotine metabolism reported more overall side effects from the drug, suggesting use of the patch more beneficial for them.

The findings of the study were published online in the journal Lancet Respiratory Medicine.

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