By Michael Fergenson, AJN senior editorial coordinator

Photo by Michael Dorausch, via Flickr

Photo by Michael Dorausch, via Flickr

Last May, I wrote a post titled “E-Cigarettes: Positive Smoking Substitute or a New Problem Replacing the Old?” It explored the pros and cons of using e-cigarettes, then a relatively new and little-studied product, to aid in smoking cessation. The FDA has warned that little is known about how effective they are as smoking cessation aids and also warned that there is no way for consumers to know exactly how much nicotine and other potentially harmful chemicals are being inhaled during use. Concerns have also been raised that e-cigarettes could lead to children smoking real cigarettes. So, what have we learned since then?

One study says e-cigarettes are as effective as the patch

One study published in The Lancet, September 2013, recruited 584 smokers in Auckland, New Zealand, who wanted to quit. Half were given e-cigarettes and half got coupons for nicotine patches, and another 73 were given e-cigarettes without nicotine. The study found that smokers using the e-cigarette to help them quit were only slightly more successful than those using a nicotine patch: 7.3% of those using e-cigarettes quit smoking, compared to 5.8% of people using the patch. Either way, only 38 of the 584 quit, which wasn’t enough to enable researchers to say for sure that one approach was better than the other. In light of the small size of this study, more research must be done to see just how effective e-cigarettes are as a smoking cessation aid.

Concerns grow over youth smoking

In September 2013, the CDC published a report about e-cigarette usage among middle and high school students. According to that report, e-cigarette experimentation and recent use doubled for these students in the period from 2011 to 2012, from 3.3% to 6.8%, meaning that around 1.78 million students had used e-cigarettes as of 2012. The report expressed concern that an estimated 160,000 of these students had never used conventional cigarettes—e-cigarette use may lead to nicotine addiction and eventually result in the use of conventional cigarettes or other tobacco products. In addition, nicotine use has the potential to negatively affect adolescent brain development. Because adolescents are susceptible to social and environmental influences to use tobacco products, including e-cigarettes, the CDC says that developing strategies to prevent marketing and sales of e-cigarettes to youth is critical.

More research needed

There is still much we do not know about the safety and long-term efficacy of e-cigarettes. The FDA still warns that the contents may contain unknown, and potentially harmful, chemicals and more research is needed to see whether they are an effective means of smoking cessation. It is apparent, however, that some strategies and regulations to prevent use among teens may be practical. The European Union and United Kingdom are planning to regulate e-cigarettes as they would a medicine.

It remains to be seen if a balance can be struck between excessive regulation, which may push people back to regular cigarettes, and underregulation, which can lead to unsafe and unknown chemicals being used in e-cigarettes, along with the potential for young people to begin smoking.

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