- - Wednesday, July 1, 2015

I felt as though I walked into the interrogation scene of the movie “Basic Instinct” when my patient asked me, “What are you going to do, charge me with smoking?”

He was “vaping” on an electronic cigarette while he smirked at me, obviously sensing my discomfort and enjoying it. But unlike Sharon Stone, he was a 68-year-old man, dressed in a hospital gown and awaiting surgery. He was dodging the “pesky” restriction of a smoke-free hospital environment and the need for an ashtray. On second thought, I felt as though I was on “The Twilight Zone.”

Until that day, I knew little about electronic cigarettes, also referred to as e-cigarettes. Could puffing (aka vaping) on an e-cigarette be the greatest thing to come along since sliced bread? Or are they just a wolf dressed in sheep’s clothing?

Dr. Nina’s What You Need To Know About Electronic Cigarettes (e-cigs):

What are e-cigarettes? In many ways e-cigarettes mimic traditional cigarettes—shape, the deliverance of nicotine into the lungs, the appearance of smoke. When the user inhales, it triggers a sensor that switches on a small, battery-powered heater. The heater functions to vaporize liquid nicotine in a small cartridge, activate a light at the “lit” end of the device and vaporize propylene glycol in the cartridge (the same stuff that theatrical smoke is made of).

Are e-cigarettes safe? Safer does not mean safe. Less dangerous does not mean not dangerous. The fact is that e-cigarettes do not contain as many toxic compounds as traditional cigarettes, in particular tobacco which turns to tar when smoked. However, they do contain nicotine, which is a highly addictive compound with effects on the body: increases heart rate and blood pressure; and constricts blood vessels, thereby, decreasing the amount of oxygen delivered to the heart and brain. In people who have underlying heart and brain vessel disease, this can create a perfect storm for a heart attack or stroke.

Research is also showing that electronic cigarettes contain 15 times more formaldehyde (an agent used in embalming dead bodies) than traditional cigarettes, nitrosamines a known cancer-causing agent, propylene glycol (a solvent that is used in soaps and antiperspirants), and other potentially toxic chemicals, including chromium and tin.

In regards to the vapor, it was initially thought that it does not pose harm to bystanders as second-hand cigarette smoke. However, recent studies have shown that it has the potential to weaken the immune system and cause inflammation and cell damage.

Do e-cigarettes help you quit smoking? Depends on whom you ask. The truth of the matter is that smokers are addicted to nicotine and e-cigarettes can continue to feed into the addiction. Nicotine patches and gum slowly release small amounts into the body. However, e-cigarettes create a freebase form of nicotine that goes quickly from the lungs to the heart and brain. There is the potential of putting people in “limbo” of wanting to quit and having this hope, but allowing them to continue utilizing nicotine and the ritual of smoking (even in places where traditional cigarettes are banned). There are also a number of testimonies of people who have successfully used e-cigs as a bridge to quit smoking.

Can they get kids hooked? Although e-cigarettes are being marketed as devices to help smokers quit, one of the biggest concerns is their appeal to children. Each day in the U.S., nearly 4,000 people under the age of 18 smoke their first cigarette — and more and more are reaching for electronic cigarettes. This may be because of their appealing packaging (red, white, gold wrappers) and availability of yummy flavors (caramel, butter rum, bubblegum). The concern is that we may be creating a new generation of nicotine addicts.

Hawaii recently passed legislation to increase the smoking age of traditional and electronic cigarettes after finding that 29 percent of 9th and 10th graders (13-, 14-, and 15-year-olds) have used an electronic cigarette and 19 percent use them regularly. A number of other municipalities, counties and states are also looking at means and methods to curb its use among children.

The popularity of electronic cigarettes is growing faster than our ability to clearly understand its effects. In the meantime, lawmakers and the public, appear to be taking an abundance of precaution — warning labels, restricting access to minors, preventing indoor use, disclosure of ingredients — to avoid repeating mistakes made in the past with traditional cigarettes. After all, it did take the tobacco industry decades before acknowledging the harms of tobacco smoke, only after one too many lives were affected and lost. Whatever way it falls, adults have the right to choose whether they want to vape or not, but it should be done with informed consent.

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