Thinking about e-cigs for the Great American Smokeout? Think again

November 19, 2014 | by Nicole White

Are you thinking about switching from traditional cigarettes to e-cigarettes for the Great American Smokeout? Are you thinking that might be a better option than the traditional quit-smoking route? Think again.

For lung expert Brian Tiep, M.D., the dislike and distrust he feels for e-cigs comes down to this: The public has been burned by tobacco companies before.

ecig electronic cigarette With no labeling required for e-cigs, the consumer doesn't know for sure what's in the products.

The same companies that claimed cigarettes were safe, he says, now claim that electronic cigarettes – which aren't regulated by the Food and Drug Administration – are safe.

“I was opened-minded initially,” said Tiep, a physician in pulmonary and critical care medicine at City of Hope. “Then the tobacco companies started buying out the e-cigarette companies. These products have no regulations whatsoever right now. You’re trusting them to do the right thing by you. They claimed tobacco was safe, and it turned out not to be.”

As for tobacco cigarettes, a recent study in the Journal of the American Medical Association tied smoking among U.S. adults to 14 million health conditions. Further, a U.S. District Court judge who in 2006 found tobacco companies guilty of lying to the public about the dangers of smoking, ordered the companies to admit their wrongdoing. The judge ruled they defrauded the public in five key ways: lying about the health damage caused by smoking, lying about the addictive nature of nicotine, marketing “low tar” and “light” cigarettes as healthier with no evidence that they are, deliberately making their products as addictive as possible and hiding the dangers of secondhand smoke.

A deal on these “corrective statements” was reached in January, then appealed by the tobacco companies this fall. Some of these same companies have acquired e-cigarettes – which is one reason that Tiep says he’s reluctant to trust the safety of e-cigs.

That’s not the only reason, though. E-cigs may not contain tar or tobacco, but they do contain a number of chemicals, including nicotine. The amount of nicotine can vary from product to product. Because the products are not required to be labeled, consumers don't really know what they contain. Some products have been found to contain benzene, nickel, lead and cadmium. In addition, e-cigs work when the liquid inside them is heated – and when chemicals are heated, they can become something else.

For example, Tiep says, propylene glycol is one ingredient that has been found in e-cigs. It's been used in many cosmetic and beauty products. When it’s heated, it can become diethylene glycol – a colorless, odorless, poisonous liquid with a sweet taste.

“My concern is simply that there’s no indication they are safe,” he said. “They may be safer than cigarettes, but I’m not absolutely sure about that.”

Tiep says his view of e-cigs may be “extreme.” He acknowledges that some physicians consider e-cigs to  be an option for smokers with cancer who are unwilling to try any other means of quitting.

However, the devices have not been scientifically shown to be effective tools for smoking cessation. And because there are no labeling laws, there’s no way to know how much nicotine is actually in e-cigs.

So if you want to take part in the Great American Smokeout on Nov. 20, go the traditional route: nicotine-replacement therapy. The bottom line for Tiep:

E-cigs should be regulated like tobacco products. Manufacturers should face the same restrictions placed on cigarettes, and e-cig packages should include a complete list of ingredients. Furthermore, vaping should be banned wherever tobacco products are banned.

Quitting smoking is important for everyone’s health – and especially for those being treated for a serious illness. Patients who continue to smoke during cancer therapy have poorer results than those who stop smoking, Tiep said. They have a tougher time getting through surgeries, and they have a higher rate of cancer recurrences. With all of the unknowns about vaping – and lack of evidence it’s an effective tool for quitting – Tiep recommends against it as a way to kick the habit.

Nicotine-replacement therapy is the standard for smoking cessation. Smokers who want to quit shouldn’t settle for less. Quitting “cold turkey” usually has a 3 to 5 percent success rate. Patients have multiple alternatives, however, such as using a nicotine patch in combination with lozenges or gum. Medications, such as varenicline – known under the brand name Chantix – have shown to be very successful in helping people quit. In addition to methods to control withdrawal, psychological support is also important, perhaps through an in-person support group, online forum or by calling 800-QUIT-NOW.

“This is an addiction,” Tiep said. “The brain of a smoker has literally been changed to require the drug. When the person smokes, they inhale a puff of smoke and within seven seconds, it’s working inside the brain. It’s something to be taken very seriously.”


Learn more about lung cancer treatment and research at City of Hope. For more information on lung cancer screening, call 626-218-9410 or email [email protected] to speak with someone from the Lung Cancer Screening Program.

Learn more about becoming a patient or getting a second opinion at City of Hope by visiting our website or by calling 800-826-HOPE (4673). City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.



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