Electronic cigarettes (E-cigs)

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Specializes in Family Practice.

Hello everyone,

So I saw this old clip today for the first time:

and at the 3:23, Letterman's guest begins to suggest that nicotine is not harmful to one's health. Clearly, advocating this E-cigarette device is part of her agenda while on Letterman's show, and sadly, she sidesteps the real consequences of long term nicotine use.

Before I get too rant-y, I will say that when a smoker friend of mine tells me they're switching to E-cigs I am happy for them as I feel there's a better chance for them to quit altogether. However, most of them are surprised to learn that using these devices will still lead to increased BP, increased risk of heart attack and stroke, and all the other manifestations of arteriosclerosis.

Usually, I just comment by saying, "It'll save your lungs but wreck your heart"

Anyway, I just wanted to bring this topic to discussion. Have people on this board addressed this topic to patients, or other people in the general public? What have been their response? Do you feel most people are aware of the dangers for nicotine?

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I tell my friends whenever they switch that e-cigs are a bigger scam than cigarettes themselves.

There will inevitably be a point in time where an e-cigarette runs out of vapor or loses its charge at an inopportune time for the smoker, and a real pack of cigarettes will be the only option within proximity due to price, cartridge compatibility with the current e-cigarette device, or availability of smokeless alternatives. The smoker will buy 20 cigarettes thinking they just need one, smoke the rest of the pack for fear of "wasting" their money, and either abruptly or eventually return to traditional cigarettes.

When you smoke a cigarette, you start smoking a cigarette when you light it and you (usually) stop smoking a cigarette when it burns down to the butt. With an e-cigarette, there is no butt to tell you that you've had your fix, you can keep puffing and puffing and puffing until you, the addict, decide when to stop. That causes a greater concentration of nicotine to enter the blood each session, which in turn creates a heavier dependence on tobacco and creates more lung damage once the e-cig smoker decides that e-cigs just don't pack the same punch as a traditional cigarette.

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Specializes in ED.

Smoking is such a difficult thing to quit, if I have any patients that are concidering quitting I first recommend the other choices such as the patch, gum or pill, but if they are concidering even the ecigs I applaud their effort, and explain it will be better in time to quit all together but way to go.

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Specializes in pediatrics.

My eyeballs nearly fell out of my head when I saw an elderly patient "smoking" one of these in the hallway a few weeks ago. But I think good on them, it's BETTER than real cigs and hopefully will help them get all the way there.

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Specializes in Med-Surg/Telemetry.

I support this option for those that are much more addicted mentally to the act/behavior of smoking than to the nicotine itself. Additionally, the "e-juice" is available in several strengths, so one can taper down from say 24mg to 16 to 8 to zero nicotine. Thankfully, so far I have yet to hear of any injury from vaporizing veg glycerin.

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You'd be surprised how many people at the mall swear, based on "what some dude said," that these things are completely harmless...

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Specializes in Urgent Care.

As a nurse and small time e-cig distributor I discuss these as a "less harmful alternative" to smoking. There is evidence to support this and also that smokers who begin to use ecigs use less tobacco products and some even quit. No one should start these if they don't smoke.

But be aware that some people can be allergic to propylene glycol which is an ingredient in the nicotine juice. This would be an obvious contraindication. Had a customer scare the bejesus out of me with that one while doing a try n buy.

Btw- my wife and I and several of my customers have quit with these. One guy who smoked 40 cigs a day for 50 years now uses 3-5 cigs day plus some Ecig.

While it is true you can smoke one for hours most only do this the first day or two. In fact, many people will have just a drag or two when the urge gets them when they would otherwise have smoked a whole cig.

The fact that big tobacco has their lawyers out around the world to fight these things should be telling you something.

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"It'll save your lungs but ruin your heart!"

I take it you've never smoked, so don't have any idea that in a smoker's mind, the only alternatives are being miserable or continuing to smoke. People who choose to use e-cigs are making an important step toward better health, one previously seen as impossible. Your friends deserve congratulations, not admonishment. Yes, there are still health risks, they are not a magical cure all. But they're saving their lungs! It sure beats ruining both their heart AND lungs by continuing to smoke, which is probably exactly what they'd do.

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Aside from them having questionable ingredients.... (does anyone really know what is in them?) There are countless stories of them exploding in people's faces. A woman here in Florida had one explode... it blew out her 4 front teeth. There are many other stories across the country.

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Specializes in Family Practice.

"I take it you've never smoked, so don't have any idea that in a smoker's mind"

Smoked for 7 years. When I quit I had been smoking a pack/day for a years, and I remember quite well the smoker 'mindset'. Quit after the second attempt with Chantix.

"Your friends deserve congratulations, not admonishment."

I do express congratulations. Like I said, I'm happy for them , as it may help them quit altogether.

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Specializes in Family Practice.
Aside from them having questionable ingredients.... (does anyone really know what is in them?) There are countless stories of them exploding in people's faces. A woman here in Florida had one explode... it blew out her 4 front teeth. There are many other stories across the country.

I haven't heard about these stories. Thanks for the heads up.

I will say that I think the E-cig is impressive in that it eliminates the danger house/apartment fires. The US Fire Administration reports at least 1000 deaths due to house/apartment fires caused by "cigarettes and other smoking materials"

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Specializes in Family Practice.
Aside from them having questionable ingredients.... (does anyone really know what is in them?) There are countless stories of them exploding in people's faces. A woman here in Florida had one explode... it blew out her 4 front teeth. There are many other stories across the country.

I haven't heard about these stories. Thanks for the heads up.

I will say that I think the E-cig is impressive in that it eliminates the danger house/apartment fires. The US Fire Administration reports at least 1000 deaths due to house/apartment fires caused by "cigarettes and other smoking materials"

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