Can E-Cigarettes Help Smokers Quit?

Electronic cigarettes – now known as e-cigarettes – make many uneasy. Some think brilliant designs and candy tastes will make smoking so “cool” innumerable teenagers will plunk down their credit cards – and become hooked for life.  Others think e-cigarettes might immediately decrease public harm by cutting the number of potentially harmful chemicals in tobacco smoke from thousands – to just one.

Plants make nicotine for at least one good reason – it’s a fabulously effective pesticide.  Yet nicotine – which resets the basic life stabilizing functions of the nervous system – is usually what smokers crave.  Will e-cigarettes – which serve up vaporized nicotine – help smokers quit?

Work in New Zealand is finally showing e-cigarettes can help people quit – or cut down.

What Did the Study Show?

Six hundred fifty seven people were randomized to use nicotine patches or e-cigarettes.  Over six months, 57% of the c-cigarette smokers had halved their cigarette intake, compared to 41% of those using patches.

Only 5.8% of nicotine patch users quit smoking by six months.  For the e-cigarette smokers, the numbers were 7.3%.

Why Were the Quit Numbers So Dismal?

The usually are – unless people use multiple treatments, particularly cognitive-behavioral treatments in combination with drugs – like e-cigarettes, chantix or bupropion – people keep smoking.  Even combined treatments don’t do very well.

Nicotine really hooks people.  If you think it’s easy to quit, witness the smoke cloud surrounding AA meetings.

Will the New Zealand Experience Translate to Other Countries?

Probably not – at least not here.  New Zealand has a true national health service.  There are many, many incentives to quit smoking.  Treatments that help people quit get paid for. And e-cigarettes in New Zealand are fully regulated and sold in pharmacies – unlike in America.

Will E-Cigarettes Be Regulated in the US?

Most likely they will.  Nicotine is an important, commonly used, harmful drug.  Many health officials worry that kids will be hooked on e-cigarettes a lot faster than on conventional, stinky cigarettes. There are concerns  that other toxic substances may also be added to c-cigarettes, and that some are shoddily manufactured.

Yet the largest factor provoking regulation will probably turn out to be money.  E-cigarettes are already big business.  Tobacco, drug and food companies eagerly observe this growing market.  With their large marketing staffs and financial power, they stand to do far better in a regulated market than today’s free-for-all game.  As fictional sports agent Jerry Maguire said, “follow the money.” And there are lots of ways to make money with e-cigarettes.

How Might Companies Profit?

Beyond the high prices that accrue to many regulated items, e-cigarettes are in themselves design and fashion statements.  They can be used for multiple forms of cross-marketing and sales.  At least at present they have far less opprobrium attached to them than regular cigarettes.

And they also cost loss – often a lot less.  When they do become regulated, that cost advantage may well disappear – which may then prove a boon to traditional cigarette sales and makers.

So What Is Their Advantage?

E-cigarettes generally deliver nicotine – only nicotine.  They don’t provide the nearly ten thousand other chemicals that also reside in regular cigarettes.   They don’t pump into household air multiple carcinogens, or stuff adult lungs with radioactive alpha particles blown from polonium 210 loving  tobacco plants.   They do not create the secondary smoke that kills family members and promotes asthma in children, nor the tertiary smoke that wends its way through apartment  ventilation ducts to wreck the lungs of toddlers.  Their dose is easy to titrate.  The result – people often find it easier to decrease use of e-cigarettes compared with conventional cigarettes.

What Else is Known About E-Cigarettes?

A lot less than should be known.  The long term health effects are presently merely guessed.  Nicotine is clearly  unhealthy, but how much heart and cardiovascular disease e-cigarettes will cause is just unknown.

Still, lots of studies are in the pipe – so to speak. And a fifth of adult Americans still smoke.  Teenagers are smoking more, especially women.

Plus the prices of cigarettes are ruinous to poor people.  The stop-smoking programs promised by the hundreds of billions of tobacco settlement money have long disappeared into state budget holes.

Lots of people are smoking.  Most want to quit.  Most of the ways of quitting do not work very well.

We’ll be seeing more stories about e-cigarettes.
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