Task Force Recommendations Address E-Cigs — And Their Role In Quitting Smoking

Jenna Birch May 7, 2015

E-cigs: More helpful than harmful, or the other way around? 

Tobacco use causes 480,000 deaths each year in the U.S., consistently topping causes of preventable death. To that end, it’s no surprise experts say quitting smoking is one of the best things you can do for your health. So, the real question is: How do you do so effectively?

Apparently, the U.S. Preventive Services Task Force‘s updated recommendations on tobacco cessation interventions are a good place to start. This week, the American Lung Association tipped its hat to the new recommendations, which involved having doctors ask patients about their smoking habits and providing resources for helping them quit. And, for the first time ever, the USPSTF also reviewed the influx of recent scientific studies on usage of e-cigarette usage, otherwise known as electronic nicotine delivery systems (ENDS). 

For now, the USPSTF concluded there is not enough evidence to determine whether e-cigs are more helpful or harmful for smokers trying to quit, and prompted doctors to stick with proven smoking cessation techniques.

“E-cigarette companies have been making claims that they can help smokers quit,”Erika Sward, assistant vice president of National Advocacy for The American Lung Association, tells Yahoo Health.“The FDA has not found any e-cigarette is safe and effective to help smokers quit. We’re seeing a lot of dual use, smokers using e-cigarettes when they can’t use other tobacco products.”

Sward says roughly 77 percent of recent e-cigarette users also use traditional tobacco cigarettes. The Lung Association is also concerned with the number of teens dabbling in e-cigarettes. For this demographic, trying these devices out has tripled in one year’s time.

Even though e-cigs are consistently in the news, there’s still a lot of misinformation about what they are and what they do. With nearly 500 brands, it’s impossible to make generalizations about safety — or even tell exactly what’s in a solution, since it varies across devices. As for the “vapor” that supposedly comes from e-cigarettes? “The Lung Association is very careful never to use the word ‘vapor,’”Sward says. “We use aerosol. Vapor implies water, and the substance is not water.”

Much of the confusion surrounding e-cigarettes is due to the lack of regulation, leading to an overwhelming amount of emerging research and lots of opinions on safety. “It’s been compared to the Wild, Wild West out there,”Sward says. E-cig worries range from inhaling substances like metals and propylene glycol; vaping at higher voltages, which increases toxins released; and the effects of secondhand carcinogen emissions, like formaldehyde.

Ultimately, Sward says the confusion will likely continue until the President pushes through the Deeming regulationthat allows the FDA to step in and start overseeing additional tobacco products besides cigarettes.

There have been numerous delays in that legislation, but finally allowing the FDA authority over these products may provide needed clarity. In January, U.S. Surgeon General Dr. Vivek Murthy remained open to the possibility of using e-cigarettes for specific, special cases. Some research, like this 2013 JAMA study, showed certain e-cigs may be as effective as the patch at helping smokers quit.

“There’ve been theories and ideas around the fact that e-cigarettes may be helpful from a harm-reduction perspective in helping people who are already on cigarettes (that) have had trouble quitting actually get off cigarettes,”he said. “If the data indeed bears that out, then I think we should absolutely embrace that and use e-cigarettes in targeted ways.”

While it’s tough to make a final judgment about which ENDS products may or may not be effective for cessation, Sward does say research is indicating they’re not a fully safe solution — even if they might be safer than traditional smoking.

“Using cigarettes is kind of like jumping off a 50-story building,”she says. “E-cigarettes are not a no-risk product. We just don’t know what story [those users] are jumping off.”

While e-cigarettes are not currently recommended to cut out smoking altogether, there are other accepted, science-backed routes to quitting, says Sward —although not one-size-fits-all. A smoking cessation plan begins in the doctor’s office, so talk to your primary-care physician about how you can drop the habit.

“The Lung Association was pleased to see evidence-based tobacco interventions,” Sward says. “Those were affirmed again. People have to have access to all seven FDA-approved medications, combined with counseling. We also need to eliminate the hurdles to helping smokers quit, like copays and step therapies.”

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