What We Know About Electronic Cigarettes

What We Know About E-CigarettesThe following is a summary of a public lecture given by Dr. Lynne Dawkins at the University of East London on July 3, 2013, called “Electronic Cigarettes: What We Know So Far.”

Dr. Lynne Dawkins is an Experimental Psychologist at the University of East London, and has more than 15 years of experience researching tobacco, nicotine delivery, and electronic cigarette use by new and experienced vapers. Dr. Dawkins is the leader of the Drugs and Addictive Behaviours Research Group at UEL, and is considered on of the UK’s leading authorities on e-cigarettes. She has published many papers on e-cigarette use, effects, and nicotine delivery, and has shared her research at academic conferences and in public lectures. The full video of this lecture can be viewed here. The presentation slides can be viewed here.

History of Electronic Cigarettes:

  • Electronic cigarettes were introduced in China in 2004 and in Europe in 2006. Since then, the number of e-cigarette users (also known as vapers) has skyrocketed.
  • Between 2012 and 2013, the number of e-cigarette users in the UK rose from 2% to 12% of the population. There are an estimated 1.3 million e-cigarette users in the UK as of 2013.
  • Production of E-cigarettes is rooted mostly in China with some production in both the UK and the USA.
  • Due to the rapid growth of e-cigarettes, tobacco companies are now investing in the e-cigarette market.

Current Use of E-Cigarettes:                

  • ~72% of vapers in the UK use 2nd generation e-cigarettes, meaning the non-disposable kind.
  • ~18% use disposable e-cigarettes, also known as “ciga-likes.”
  • ~9% use customized devices.
  • Regarding nicotine concentrations, ~49% of vapers use e-juice with 18mg/ml of nicotine; ~33% use 11mg/ml; ~21% use combined strengths (for a custom nicotine levels); and ~1% use 0mg/ml.

Why Do People Use E-Cigarettes?

  • People use electronic cigarettes for several important reasons. The most common of which is as an alternative to smoking.
  • Why are e-cigarettes an appealing alternative to smoking tobacco cigarettes? Because they make it easier to quit by curbing withdrawal symptoms and cravings; they are much less toxic than cigarettes; they are also significantly cheaper than cigarettes.
  • Tobacco contains more than 5000 known chemicals, 40 of which are known carcinogens (cancer-causing substances). The adverse effects of cigarettes result from the combustion of tobacco. Nicotine by itself is relatively safe, other than its addictive nature.

Smoking Cessation Stats:

  • 67% of smokers want to quit, and 75% of smokers try to quit. However, only about 8% are successful at quitting after two years (Omnibus Survey, 2009).
  • Common reasons for relapse include: liked smoking (20%), and missed the habit (12%).
  • 95-97% of unaided quit attempts end in failure.
  • Nicotine Replacement Therapy (NRT) — such as gum, patches, and inhalers — double a smoker’s chance of quitting. Even doubled, that still leaves a success rate of only 6-10%.

Why do most attempts to quit end in failure?

Some of the most common reasons include:

  • Reluctance to use nicotine while quitting.
  • Ineffective nicotine delivery from NRT.
  • Lack of control over nicotine delivery.
  • Inability to replace the “habit” of smoking. i.e. the oral fixation.
  • For many people, e-cigarettes can help overcome these issues when trying to quit smoking cigarettes.

Studies on Quitting Tobacco Cigatettes Using Electronic Cigarettes:

  • Study One Results: 74% of respondents had not smoked at all for at least a few weeks since starting to use e-cigarettes, and 14% dramatically reduced their cigarette consumption.
  • Study Two Results: 92% of respondents claimed that e-cigarettes helped them to reduce their smoking. 96% of ex-smokers claimed that using an e-cigarette helped them to quit smoking.

Survey of Smokers Who Purchased an E-Cigarette:

  • 31% of the participants were abstinent from smoking at 6 months.
  • For those participants who were using the e-cigarette more than 20 times a day, the quit rate was 70%.

Study of 40 Smokers Not Willing to Quit:

  • In this study, 40 smokers who were unwilling to quit smoking were given e-cigarettes. At 6 months, 55% of participants were either abstinent of smoking or had a reduction of at least 50% of their prior consumption of cigarettes.
  • In another study performed in Italy, 300 smokers who did not want to quit were surveyed after being given e-cigarettes 3 different nicotine levels. The abstinence rates at one year were as follows: 7.2mg = 13% abstinent; 4.8mg = 9%; 0mg = 4%.

Are Electronic Cigarettes Safe?

  • The safety of electronic cigarettes is perhaps the biggest source of contraversy. Are e-cigarettes safe? The answer is no, they are not ABSOLUTELY safe. But what is? How many products do we come into contact with on a regular basis that are not 100% safe?
  • When discussing the saftey of electronic cigarettes, the questions needs to be, are they safer when compared to traditional cigarettes?

E-Juice Ingredients, Vapor, & Safety Concerns

  • Components of e-juice include nicotine, flavorings, propylene glycol and/or vegetable glycerin.
  • Propylene glycol (PG) is found in foods, medicines, cosmetics, and artificial fog, and is generally regarded as safe for oral consumption by the FDA. Long term effects of inhalation of PG are unknown.
  • A 20 ml bottle of e-juice that is 18 mg/ml nicotine contains 360 mg of nicotine.
  • A lethal dosage of nicotine is 30 mg of nicotine (higher for a smoker). A person cannot realistically overdose from vaping e-ciagetettes due to controlled intake, and the physical effects that would be felt before reaching that amount. The only way to overdose would be to drink the liquid straight.
  • A study on E-cigarette vapor and air quality showed that over a 3-minute period, e-cigarettes contaminated the air at an amount of 43 parts per million, whereas traditional cigarettes contaminated the air at an amount of 901 parts per million.

E-Cigarettes & Minors

  • It is argued that e-cigarettes are geared towards young people, however there is no real evidence proving this.
  • In a study of Polish youth, of those who had smoked a cigarette before, only 1/5 of those youths had tried and e-cigarette. In that same study, of those who had never smoked, only 3.2% had tried an e-cigarette.

Conclusions About Safety & Regulation

  • Although e-cigarettes cannot be considered safe necessarily, they can be considered far less harmful than cigarettes. It is up to users to decide whether a safer addiction to nicotine is the right choice for them.
  • With e-cigarettes, the addiction to nicotine can be more closely monitored, and the amount of nicotine received can be better controlled.
  • The National Institute of Clinical Excellence has endorsed NRT to curb and quit smoking.
  • We now know more about e-cigarettes than tobacco cigarettes. This is due to the fact that the number of chemicals found in cigarette smoke vastly outnumbers those found in e-cigarette vapor.
  • Because of the risks associated with e-cigarette use, we must strive for safety and regulation on e-cigarettes without over doing it, and without making it a less viable option for helping those who want to quit smoking cigarettes.
  • E-cigarettes are less harmful than cigarettes, and thus have a huge potential for lowering death and disease rates associated with smoking cigarettes.
  • Electronic cigarettes must be fought for, and overregulation of electronic cigarettes is not in the best interest of public health which is a really serious matter for any people that doesn’t like cigarettes of any sort since they can even produce heart diseases, and they actually want to prevent a heart attack using the right supplements for it.