E-cigarettes: A New Form of Addiction

By Daniel Croft, MD

Physician Daniel Croft is assistant professor of pulmonary and critical care medicine at University of Rochester Medical Center.
Physician Daniel Croft is assistant professor of pulmonary and critical care medicine at University of Rochester Medical Center.

Since the introduction of electronic cigarettes several years ago, it’s been suggested that these electronic nicotine delivery devices could help smokers quit. This claim is incorrect.

The most recent example is a study reported in the New England Journal of Medicine that concluded patients in the United Kingdom who used e-cigarettes were twice as likely to quit combustible cigarettes as those who used FDA-approved nicotine replacement therapies. However, that was not all that they found.

After one year, 80 percent of study participants who used e-cigarettes to quit were still using e-cigarettes. They had not broken their addiction to nicotine, but rather switched to a different form of inhaled nicotine. Importantly, this would leave them vulnerable to a return to combustible cigarettes.

Although the risks and benefits of e-cigarettes are still under intense study, we do know that nicotine alone presents real dangers. It can increase the risk of cardiovascular and lung disease, and it can affect fetal growth and development. We also know that nicotine — especially the concentrated liquid form in e-cigarettes — can be extremely poisonous and potentially fatal if swallowed.

In addition, nicotine affects developing brains, a particular concern for adolescents and young adults, age groups that are more likely to try smoking or vaping and that are more susceptible to nicotine addiction. According to the U.S. Surgeon General, e-cigarettes are now the most commonly used form of tobacco by youth nationwide, and nicotine addiction can prime the adolescent brain for addiction to other drugs such as heroin and cocaine.

As an increasingly popular method for delivering nicotine, e-cigarettes deserve more scrutiny. Some major medical groups, including the American Cancer Society, have recommended only using e-cigarettes for smoking cessation when a person has failed FDA-approved methods, including nicotine replacement therapies (patches, lozenges or gum) and prescription medications like bupropion (Wellbutrin) and varenicline (Chantix). But those who choose this strategy must switch completely from combustible products (no dual use) and have a clear plan to stop e-cigarette use.

Although we do not yet know the long-term health effects of e-cigarettes, we do know that they are not risk-free.

The fact that smokers turn to e-cigarettes as a quit strategy should serve as a call for health care providers to improve support for effective cessation efforts.

We must do everything we can to help all smokers quit. If you want to quit nicotine, talk to your health care provider and contact the New York State Smokers’ Quitline at 1-866-697-8487 or nysmokefree.com. We are here for you.

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