Electronic cigarettes are often presented as a safer alternative to regular cigarettes, and as a means to help smokers who want to quit altogether. A new, preliminary study from the UNC School of Medicine found no evidence of either benefit.
UNC researchers and colleagues from other schools looked at data gathered from two studies of patients with COPD, or chronic obstructive pulmonary disease, a lung condition in which breathing becomes more difficult over time. About 21 million people in the United States suffer from COPD. Those studies, sponsored by the National Institutes of Health, gathered physiological and demographic data to better understand the cause of COPD, and why some patients are more susceptible to developing the disease, a UNC School of Medicine news release states. In 2014, both studies introduced questions related to use of electronic cigarettes.
The study was published in the Journal of General Internal Medicine.
Researchers found that patients who had quit regular cigarettes, or combustibles, for electronic cigarettes (also called e-cigarettes) did not have a decrease in symptoms. The same finding was also true for smokers who consistently used both e-cigarettes and regular cigarettes, and for patients who used only e-cigarettes.
The study also found no evidence that patients who had switched exclusively to e-cigarettes were likely to stop smoking. “Individuals who had tried e-cigarettes as a way to reduce their use of conventional cigarettes were actually less likely to reduce their use or quit combustible cigarettes than those who had never tried e-cigarettes,” stated M. Bradley Drummond, director of UNC’s Obstructive Lung Diseases Clinical and Translational Research Center and principal author of the study.
Researchers had only three years of data to work with, and Drummond stressed that longer-term research is needed to understand the health effects of e-cigarettes. “When we think about the harms of electronic cigarettes” or regular cigarettes, “the alarms often do not immediately manifest themselves,” Drummond said in a phone interview. Researchers need 10 or more years of data to determine the health effects of e-cigarettes, he said. “We simply can’t detect that association in a short amount of time,” Drummond said.
Electronic cigarettes are battery-powered and turn liquid into vapor, which is inhaled. The liquid includes nicotine, flavorings, and other chemicals.
No research has ever been submitted to the Food and Drug Administration about the safety of electronic cigarettes, according to the U.S. Department of Health and Human Services. Hence, users do not know the chemicals they are inhaling, or how much nicotine is in the devices. The National Institute on Drug Abuse also notes that e-cigarettes are popular among teen-agers, and their use “can lead to nicotine addiction and increased risk for addiction to other drugs.”
The Food and Drug Administration in August 2016 extended regulation of tobacco to include e-cigarettes. Under those rules, any tobacco product on the market as of Feb. 15, 2007, is grandfathered. Products introduced or modified on or after that date are considered new tobacco products and must submit a premarket application to the FDA, the rules state. Recently, the FDA extended the date for applications for e-cigarettes to August 2022.
The previous lack of regulation poses challenges to researchers trying to determine the harm of e-cigarettes, Drummond said. The fluid can contain different levels of nicotine, flavoring and stabilizing agents. Certain flavors also may have toxins and other risks, he said.
The FDA does not recommend e-cigarettes as a means for quitting smoking. Drummond urges smokers who want to stop to use FDA-approved treatments, like nicotine gum or lozenges, skin patches and Chantix.