# Studies clearing smoke around e-cigarettes



## Alex (2/2/16)

*Studies clearing smoke around e-cigarettes*
By Dr. Eddy Lang & Dr. Zoe Oliver, Calgary Herald February 1, 2016








*Geoff Braithwaite, owner of Tasty Vapor, exhales vapor after using an electronic cigarette Wednesday, Jan. 28, 2015, in Oakland, Calif. California health officials on Wednesday declared electronic cigarettes a health threat that should be strictly regulated like tobacco products, joining other states and health advocates across the U.S. in seeking tighter controls as "vaping" grows in popularity. The California Department of Public Health report says e-cigarettes emit cancer-causing chemicals and get users hooked on nicotine but acknowledges that more research needs to be done to determine the immediate and long-term health effects. (AP Photo/Ben Margot) na0217-tb-Ecigarettes*
*Photograph by: Ben Margot , Calgary Herald*
Two years ago we wrote about Ryan, a 35 year-old nursing student who was trying to kick a cigarette habit by smoking e-cigarettes. Ryan was ordering his vaping supplies online, as sales were prohibited in Canada and retail outlets were uncommon. While Health Canada hasn’t officially altered their stance in the interim, vape shops have proliferated and Canadians are using electronic nicotine delivery systems more than ever.

At the time, there were still many unknowns. The jury was still out regarding whether e-cigarettes helped people quit smoking traditional cigarettes, and there were questions about the safety and standardization of the product. But in the last two years, several research studies have helped clear the smoke of uncertainty, and experts now believe e-cigarettes to be 95 per cent safer than their combustible cousins. Despite the growing clarity, Health Canada’s 2009 edict that people should avoid e-cigarettes still officially stands. E-cigarettes containing nicotine are not approved for sale in Canada. Nevertheless the governments of Great Britain and the United States, among others, have taken a progressive stance and adopted reasonable safety standards. Hopefully Canada will soon follow, and a standing committee has presented a report to the House of Commons containing 14 recommendations regarding the regulation of these products.

While our government considers its course of action, vape shops are springing up on every corner and our patients are asking us all kinds of questions about e-cigarettes. We turned to the latest evidence to find the right (albeit non-government authorized) answers to their questions. Helpfully, this evidence was recently summarized in a publication by Public Health England, which weighed in on a number of key issues of concern to our patients.

Smokers who currently shiver at building entrances and on their own back steps want to know if e-cigarettes produce volatile chemicals similar to those in second-hand smoke. The evidence from the last two years indicates that it’s not a worry. E-cigarettes do emit small amounts of vaporized nicotine, but the amount is negligible from a health perspective. This air-borne nicotine does eventually get deposited on surfaces, but in minute quantities. One 2014 study concluded that an infant would need to lick over 30 square meters of exposed surface to obtain one milligram of nicotine. And although this is a bizarre visual, one milligram of nicotine is unlikely to be toxic to a small child. The same goes for other chemicals contained in the e-cigarette vapour — there is currently no evidence that they pose a health risk anywhere near on par with tobacco smoke.

A greater concern is the ingestion of the e-cigarette liquid itself by unwitting children, who might be attracted to some of their candy-like flavouring agents. Recent data from the U.S. and U.K. indicates that calls to poison centres regarding e-cigarettes have increased substantially in the last five years, meaning that little ones are getting their hands on the e-liquids. However, manufacturers have been responsive to calls for childproof packaging. If you have children or pets and decide to use e-cigarettes, buy the small 10 millilitre bottles rather than the large super-concentrated bottles available in the U.S., and store them as you would any medication or household chemical.

Patients also want to know if e-cigarettes will actually facilitate smoking cessation, or if it’s just a gimmick. The U.K. report suggests that e-cigarettes are a viable option, especially if other approaches have failed. One research study concluded that using e-cigarettes to kick the habit is 50 per cent more effective than free will alone, but not quite as good as a full-fledged smoking cessation program. For those with no intention of quitting nicotine altogether, e-cigarettes are a far preferable alternative to the tobacco-containing version. Current evidence indicates that e-cigarettes carry a far lower risk of pulmonary and cardiovascular disease with prolonged use. There is also evidence to suggest that tobacco smokers who switch to e-cigarettes without any intention of quitting are more likely to see reduced intake or eventually give up on nicotine entirely.

Parents want to know whether e-cigarettes are a gateway to smoking for adolescents. While teenage experimentation with this novel product is not uncommon, those who have never smoked are unlikely to develop a long-term habit as a result of e-cigarette exposure. The chance of an e-cigarette starting a nicotine addiction is less than one per cent. In other words, e-cigarettes have not affected what is already a steady ongoing decline in cigarette smoking among youth. Finally, the health effects of second-hand vapour are far less harmful than second hand smoke.

We have copious long-term data about the dangers of traditional cigarettes, and by comparison, e-cigarettes appear to be much safer. Despite this seemingly good news, Public Health England recommends that further research look at the safety and long-term consequences of e-cigarettes. While we wait for that evidence, it’s reasonable to conclude that while e-cigarettes feed an unhealthy nicotine addiction, they are much less of a menace than their traditional, non-battery operated predecessors. We don’t recommend that anyone start e-smoking for fun, but if like nurse Ryan you are struggling to quit tobacco cigarettes, you might consider a trip to your local e-cigarette shop. But don’t tell Health Canada we said that.
This column does not represent a substitute for advice from your regular physician.

© Copyright (c)  The Calgary Herald

source: http://www.vancouversun.com/health/...und+cigarettes/11690134/story.html?rel=797049 (except the pic, which I changed)

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