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Alarm Bells over E-Cigarettes

SPH’s Seigel says concerns premature, overblown

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Boston University BU, School of Public Health SPH, rise in e-cigarette use, professor Michael Siegel

Michael Siegel, a School of Public Health professor of community health sciences, suggests that the negative effects of electronic cigarettes have been wildly overblown, clouding the important benefits of e-cigarettes as devices to help people quit smoking. Photo courtesy of Siegal

The headlines were startling: “E-cigarette Use Among Middle and High School Students Skyrockets, CDC Data Show,” from the Washington Post. And this from U.S. News & World Report: “Democratic Senators Pounce on E-Cigarettes After CDC Study Shows Teen Use Spike.”

E-cigarettes, for those who don’t know, are battery-powered devices that look like cigarettes, but don’t burn tobacco. Rather, they deliver nicotine, flavor, and other chemicals in the form of a vapor. The recent media storm was prompted by a report by the Centers for Disease Control and Prevention that found the percentage of high school students who said they had used one jumped from 4.7 percent in 2011 to 10 percent in 2012. Use also doubled among middle school students, according to the CDC. The report raised anew concerns about the long-term effects of these tobacco products. On Tuesday, 40 state attorneys general sent a letter to the United States Food and Drug Administration (FDA), urging the agency to regulate electronic cigarettes in the same way it regulates tobacco products.

Meanwhile, around the same time as the CDC report, a small study of smokers published in the journal Lancet added to growing research suggesting that electronic cigarettes are as effective as nicotine patches in helping people quit smoking.

What to make of the conflicting reports? According to Michael Siegel, a School of Public Health professor of community health sciences, the negative effects of electronic cigarettes have been wildly overblown, clouding the important benefits of e-cigarettes as devices to help people quit smoking.

With only about 6 percent of cigarette smokers successful in quitting the habit, and the tobacco industry free to continue its marketing despite tobacco’s known health effects, Siegel is concerned that the government’s focus on the potential harms from e-cigarettes will detract from their benefits to those who want to stop smoking.

BU Today recently discussed the controversy with Siegel.

BU Today: CDC director Tom Frieden says the findings of increased teen use are “deeply troubling,” deeming e-cigarettes a gateway drug to a lifelong addiction to nicotine and regular cigarettes. Do you disagree?

Siegel: Well, first, it’s important to point out that this alarming conclusion is premature. There is no evidence that electronic cigarettes are serving as a gateway to a lifelong addiction to nicotine and conventional cigarettes.

There is something that Dr. Frieden didn’t mention. The overwhelming majority of the youths who reported experimenting with e-cigarettes were already smokers. So the fact that these smokers are experimenting with e-cigarettes is not really a problem. The concern would be if nonsmokers were using electronic cigarettes, and then moving on to regular cigarettes. But the prevalence of nonsmokers experimenting with e-cigarettes in the CDC study was only 0.5 percent. Moreover, the study did not document any examples of youth starting to smoke as a result of first trying electronic cigarettes.

While there is every reason to be concerned about the potential for electronic cigarettes to become popular among youth, there is no reason to be alarmed at this point. It is essential that we continue to carefully monitor this. It is also important that the Food and Drug Administration (FDA) promulgate regulations that will help prevent the use of electronic cigarettes by youth.

What do we know about the rising number of people who are using e-cigarettes as devices to quit smoking?

We do know that the predominant reason so many people are using e-cigarettes is that they want to quit smoking in order to improve their health. While we don’t have a lot of quantitative studies about the effectiveness of e-cigarettes in smoking cessation, a clinical trial published recently found that e-cigarettes are just as effective as the nicotine patch for smoking cessation. Unfortunately, the e-cigarettes tested were a first-generation product that did not deliver nicotine very well. It is possible that more advanced products could actually surpass the nicotine patch in their effectiveness.

Do you think the intense government focus on e-cigarettes’ potential negative effects is misplaced?

It is certainly reasonable to carefully scrutinize any consumer product like this. However, what I have a problem with is the fact that the FDA has given its seal of approval to the irredeemably toxic regular tobacco cigarettes—while they are doing everything they can to discourage people from switching to the much safer fake ones. That makes no sense from a public health perspective.

Are you worried about reports that big US tobacco companies, such as Altria and Reynolds, are entering the e-cigarette business, given the type of marketing they might do?

There are actually some benefits to having the major tobacco companies become players in the e-cigarette field. For one thing, they have better access to large retail outlets, and it is possible that their entrance into the market may greatly expand the access smokers have to these products.

In terms of marketing practices, it is essential that the FDA allow companies to tell the truth about the intended use of these products—that they are intended to be used for smoking cessation. That would avoid the need for companies to resort to some sort of glamorized marketing campaign that glorifies smoking behavior.

Most scientists believe nicotine, while highly addictive, is not what causes cancer in smokers or people exposed to secondhand smoke. Has there been any scientific research into the negative health effects of e-cigarettes?

It is very true that nicotine is not the main component of the tobacco smoke that is responsible for most of the adverse health effects. Because electronic cigarettes deliver nicotine without most of the tens of thousands of other chemicals—and without the more than 60 known carcinogens—it is clear that electronic cigarettes are much safer than tobacco cigarettes.

The scientific research conducted so far suggests that electronic cigarettes are much safer than regular cigarettes, and that in particular, they carry a greatly reduced risk of lung cancer, other cancers, and chronic obstructive lung disease. Evidence presented just recently suggests that they also likely present a lower risk of heart disease.

We need more research to understand whether there may be long-term adverse effects. But what we can say for sure is that they are much safer than the real cigarettes.

How did you get interested in e-cigarettes?

I have been following the issue of electronic cigarettes since they entered the US market several years ago. My interest was piqued by the response that these products received from public health and antismoking groups.

Rather than embracing these products as a potential way to get thousands of smokers to quit smoking, antismoking groups have attacked these products and discouraged smokers from quitting by using them. This is so contrary to the principles of public health that it caught my attention—and I continue to be puzzled by this inane public-health response.

The only hypothesis I have come up with is that the ideology in the antismoking movement is so strong that the very thought of condoning a behavior that looks like cigarette smoking is just something that these groups are not capable of doing—even though it is likely saving the lives of thousands of ex-smokers.

Listen to Michael Siegel discussing e-cigarettes during an interview with WBUR’s On Point here.

Lisa Chedekel can be reached at chedekel@bu.edu

33 Comments

33 Comments on Alarm Bells over E-Cigarettes

  • Carol Pullen on 09.26.2013 at 12:32 am

    Any risk should be labeled. Minors should not have access. If no third party risk, then no government intervention should be applied.

    • Michael on 09.28.2013 at 3:43 pm

      Having been addicted to cigarettes / tobacco for more than 40 yrs., and having tried every single quit smoking product ever manufactured in an attempt to quit, beginning more than 30 yrs. ago, I think I have a valid opinion. Over a year ago, actually it was a year ago on Father’s day that my Son bought me my first e-cig and I haven’t smoked tobacco cigs. since. In fact, I was so impressed with the e-cig that I joined the industry, accepting employment with a major retailer locally.
      When compared to tobacco products, the e-cig is almost like taking a magical pill that removes tobacco cigs from your life. I base this on the fact that my self, my wife and numerous others I know that have been plagued by tobacco addiction for decades, to which patches, gum, dangerous prescription drugs have had no long term rate of success in quitting tobacco use, yet the e-cig has proved to be nearly 100%.
      How I feel. Since using the e-cig I have been able to reduce nicotine from 24 mg. down to 2 mg. since I started using it. Additionally, I feel my body, my lungs healing more and more as each day passes. I did experience an initial and temporary degree of inhale restriction associated with the e-cig, but it passed rather quickly.
      Success, my Son has been successful in quitting the e-cig after just a year an a half. He is now a healthy young man the result of the e-cig. I am certain my wife and I will soon be joining him as non smoking, non vaping individuals. So my message to those who are attacking e-cigs as the big bad wolf, you have no idea of what you are talking about. The e-cig is truly a smoking cessation product of great value to human wellness in a society that has been plagued by tobacco for centuries.

    • Michael on 09.28.2013 at 3:58 pm

      I worked in the industry, and we did, do not allow minors to even enter the building. As for labeling, oh ya, that has really been successful in preventing minors from gaining access to tobacco products. Wake up, parents are buying cigs. for their precious little tobacco addicted darlings, I know I also worked in that retail industry for more than 25 yrs.. Regulation will only drive the consumer cost up, thus making it that much more expensive to quit smoking. Cost prohibitive factors had much to do with why I was personally incapable of maintaining enough patches for my wife and I to go the full course. Patches are regulated and FDA stamped. You people simply don’t get it, do you? you won’t be satisfied until you’ve turned this affordable and safe smoking cessation product into some gov. regulated cost prohibitive nightmare for those who truly need it.
      Michael

  • Betty J Ruth on 09.26.2013 at 6:01 am

    I wholeheartedly agree with Dr. Siegel, and I laud him for speaking out against the knee-jerk response. As a public health professional who loves some people who are trying to quit, I am grateful for anything that might help! We have to remember smoking is not a moral failing; it’s an addiction. And public health has pioneered other efforts to reduce harms nonjudgmentally with addiction. Let’s apply our same principles to the e-cigarette.

    • John Repp on 04.29.2014 at 6:38 pm

      Yes! Betty, I can’t tell you how many times I’ve heard someone make e-cigs out to be far worse than tobacco cigarettes. I mean, we know the ingredients in e-liquid! It’s been decades and we’re still not sure all the bad stuff that goes in a Marlboro.

  • Sky on 09.26.2013 at 8:22 am

    I think Siegal really pin points the issue with
    “However, what I have a problem with is the fact that the FDA has given its seal of approval to the irredeemably toxic regular tobacco cigarettes—while they are doing everything they can to discourage people from switching to the much safer fake ones. That makes no sense from a public health perspective.” and

    “The only hypothesis I have come up with is that the ideology in the antismoking movement is so strong that the very thought of condoning a behavior that looks like cigarette smoking is just something that these groups are not capable of doing—even though it is likely saving the lives of thousands of ex-smokers.”

    This seems to be another case where our scientific discovery is far outpacing our societies capacity to morally adjust. We need to start addressing these concerns with the human interest in mind. In my opinion, this does not mean forbidding anyone from smoking, but rather respecting their choice and hope they chose the responsible path, but recognize that freedom of choice is paramount.

    As far as I can see the FDA is a huge pile of steaming BS when it comes to tobacco issues. I have the understanding (please correct me if this is incorrect) that tobacco is not legally recognized as a drug because the FDA would have to find that it has no benefit to human health. Meanwhile they bully the emerging marijuana industry (which might actually have some health benefits). I find it impossible to be convinced that drug policies in this county are not being made to cater to the FDA’s generous donors. Let’s be real…tobacco companies don’t lose sleep at night over your lung cancer, they just want business.

  • Don't jump the gun on 09.26.2013 at 10:59 am

    Actually you can’t really say e-cigarettes are much safer than anything until they’re regulated, period! The problem is that because they are not regulated, we don’t know what chemicals manufacturers are using to solubilize the nicotine in the e-cigarette cartridges. While I think it’s absurd to think of them as a gateway to tobacco use, we should not be wholeheartedly supporting their use until they are fully regulated like any other drug that is put in people’s bodies. Nicotine is a drug, but more importantly we need to make sure that appropriate doses are in each cartridge, and that manufacturers are held accountable for the safety of consumers. The delivery of the drug is just as important as well. You wouldn’t want manufacturers to use toxic chemicals in the fillers of your Tylenol, would you?

  • Felicia on 09.26.2013 at 11:16 am

    I agree they should be regulated like tobacco products even though they aren’t the same just to help prevent underage usage. I actually use the e-cigg EGO-twis and love it. I have not had a real cigarette in 9 months I have been a smoker for 10 years and started way too young. I however started with a nicotine level of 32mg and now am down to 12mg. I feel if a smoke truly wants to quit for what ever the reason may be this is a for sure way to do it. You just have to want it bad enough. I am healthier than I was, I no longer smell, and do not have to worry about the horrible side-affects of cigarettes any more. I feel great about my life style change and no I do not use it inside of stores, buildings, or even my college. I have seen people do this ,but that is not for me. Good luck to all the smokers who are really trying. I quit on the first day use to smoke 13+ a day. So it can be done. Just know the withdrawl is not there with the E-cig.

    • robert eldridge on 09.27.2013 at 8:23 am

      And one more thing how is regulation gonna help kids from getting them . How many kids get real cigs now you people are so blind.or just ignorant . fda is gonna help regulate that choice 4 you all too

  • anonmyous on 09.26.2013 at 11:21 am

    Replacing one bad thing with something else is not necessarily good.

    Common adverse effects of oral inhaled nicotine therapy include: dyspepsia, oropharyngeal irritation (e.g., coughing, mouth and throat irritation), rhinitis, headache. Nicotine is not good. While the definitive studies remain to be completed, I think that being in preventive medicione, Dr. Spiegel would be a bit more cautious!

    • Hugh J on 09.28.2013 at 4:36 pm

      So you’d rather have lung, throat, and bladder cancer than a headache? Ya that makes a boatload of sense.

  • mlinky on 09.26.2013 at 11:47 am

    What do you know, a sensible and logical look at e-cigarettes. I’m impressed.

  • Robert Monroe on 09.26.2013 at 11:51 am

    Everything is premature as of today. The industry itself is still in it’s infancy stage meaning that the product lines have really only been available on mass scales for about 10 years but have only really boomed since 2009-10. Since there has only been rising numbers of consumption since then, all research and studies to this point are relevant but do not give the big picture, then will take at least a decade and in most cases longer to get hard facts on long term case studies. The bottom line is that the e-cigarette provides people an alternative that eliminates smoke, tar and tobacco consumption. Even though people do use e-cigarettes as a tool to stop smoking tobacco, it does not necessarily mean they will in fact stop vaping. Some people enjoy it, some people do end up quitting everything altogether. It comes down to the individual in the end and only years upon years of studies will show the actual trends. To say that vaping are a gateway to smoking is just an assumption at this point with no hard evidence to prove that whatsoever.

  • Jon on 09.26.2013 at 1:18 pm

    What apologists for the device seldom point out is dual use: e-cig users who are also smoking cigarettes. This turns out to be most e-cig users. And that turns out to include kids: CDC found 73% of kids grades 6-12 who are e-cig users are also using conventional cigarettes.

    Dual use is the elephant in the room. It suggests that in the real world, e-cigs are not increasing quitting. If anything they’re undermining it. Which is what recent research finds:

    http://www.ncbi.nlm.nih.gov/pubmed/23658395

    The e-cigarette industry is increasingly the cigarette industry. “Blu” is actually Lorillard, maker of Newport. “MarkTen” comes from tobacco giant Philip Morris, maker of Marlboro cigarettes. “Vuse” from Reynolds American, maker of Camel. They have a direct financial interest in keeping smokers smoking.

    E-cigs offer them a great tool to do that: a way around smoking bans. The smoker doesn’t quit smoking; he smokes when he can and vapes when he can’t.

    This is exactly how the cigarette industry markets its other “alternatives”:

    * rides alongside your smokes! Marlboro snus

    * Whenever smoking isn’t an option, reach for Marlboro snus

    * Made for smokers: Marlboro snus!

    It’s great to talk about harm reduction. But that’s not how these products are being marketed or used.

    And this is not to say that no one has ever quit smoking using e-cigs. But the key question: on balance, have these devices enabled more quitting than they’ve undermined?

    The number one way e-cigarettes increase harm is by enabling continued smoking.

    • Peg on 09.26.2013 at 5:56 pm

      Dual use IS an elephant…a straw one.

      Why is it a bad thing that a smoker replaces some of his cigarettes with an alternative that doesn’t involve lighting a carbon-based plant on fire and sucking the smoke into their lungs?

      Every single cigarette NOT smoked is a victory in the quitting arena…this inane all or nothing mentality has smokers dying, instead of quitting.

      Let them have their alternatives, leave them in peace, and you might just find that the smoker does eventually chose the safer one over the regular one.

      • Jon on 09.28.2013 at 2:26 pm

        Sorry, every single cigarette not smoked as a result of e-cigs must be weighed against every ADDITIONAL cigarette smoked as a result of e-cigs. Did you read the item I cited? E-cigarettes reduce quitting. That increases smoking.

        • Brian on 10.07.2013 at 6:40 pm

          Don’t think YOU get it Peg.

          There are two groups of smokers in this world. Those who dont want to give up. And those who do.
          For those who do, e-cigs are a magic wand..

          I smoked for 25 years, tried everything. Nothing worked, I was just too weak to stop and missed the habbit of smoking too much.
          With ecigs it took me exactly 20 mins to stop smoking cigarettes.

          Just stopped a month ago with the ecig, and it was so easy since I no longer connected stopping smoking and stopping ecigs.

          My brother, my dad and uncle has all stopped since with the help of ecigs. If that is not a good success rate I dont know what is.

          • current vaper on 10.16.2013 at 12:45 pm

            Thank you, Brian. This is exactly what happened to me. I didn’t want to quit. I LOVED my cancer sticks. When a family member of mine was diagnosed with stage 4 lung cancer, and 6 months left to live, I decided I had had enough. I was smoking almost 2 packs a day, and I had been smoking for 16 years. Every morning I felt like I was going to die.

            I bought a vape. I never said I would totally quit. I still left the door open for smoking because I did not want to give up my cigarettes. Like you, I tried everything…patches, gum, meds, smoking cessation therapy, cold turkey… BUT I haven’t had a cig since the moment I took a drag off my vape. I was beyond surprised. I didn’t think it would work. It really was a magic pill.

            It has been only two weeks for me, and I’m not even going to think about looking back.

            I feel amazing, I can breathe. I can taste food again. I can smell EVERYTHING. I smell so much better, and the smell of cigs make me sick. My husband was a non believer like I was, and now we vape together. We find all these yummy flavors and we trade and mix and match. It’s become a hobby for us now.

            All of these non profit organizations that are spearheading the anti-ecig attack are being funded by the pharmecutical companies that are peddling drugs like chantix and zyban to help you quit…it’s all about money.

            This is why I do not believe the propaganda against ecigs.

            Vaping is saving my life, and my husband’s….and that’s good enough for me :)

  • Rick on 09.26.2013 at 2:48 pm

    As far as children go, parents need to be parents. I hardly call flavored product of any kind “Marketing to kids”. Also, to those that commented about the liquid being harmful – it plain isn’t. I make the stuff, so I can tell you that the only ingredients are propylene glycol, vegetable glycerin, and GRAS flavoring.

    There are just too many people that are making assumptions that don’t really know what they are talking about and have done zero research on the subject.

  • Elaine Keller on 09.26.2013 at 4:40 pm

    Something else the CDC failed to mention in their press release: The Substance Abuse and Mental Health Services Administration (SAMHSA) has published, “Results from the 2012 National Survey on Drug Use and Health: Summary of National Finding.” According to the SAMHSA report, past month cigarette use among youths aged 12 to 17 fell from 9.1 percent in 2009 to 6.8 percent by 2012 for males and from 9.3 percent to 6.3 percent for females. Furthermore, the rate of initiation of smoking among youths in the same age group fell from 6.3 percent to 4.7 percent for males and from 6.2 percent to 4.8 percent for females.

    CASAA’s Scientific Director, Dr. Carl V. Phillips, pointed out, “Those who want to ban e-cigarettes make up any claim they can think of, regardless of whether there is evidence to support it. If e-cigarette use really caused kids to start smoking and there really was an alarming use of e-cigarettes by youth, we would see an increase in kids smoking, the opposite of the actual trend.

  • D Beabout on 09.26.2013 at 8:01 pm

    I dont understand all the politics of this the anti smoking group should be happy there not exposed to the smoke of a cig that from all the research i have done myself SMOKE is the primary cause of cancer.. after being inhaled in to the smokers lungs the nicotine is significantly depleted so the only thing left is the smoke that is Toxic. As w the vapor from a e-cig the nicotine is mostly gone all that is left for the second hand people is water vapor WATER VAPOR FOG!!! IE FOG moisture in the air condensed.. come on people its way more healthy than reg cigs for the user and for the surrounding people as well.. so get off it and stop the bs the anti smoking group has won WE are not smoking.. Its not even called smoking it is Vaping Safer for us and for you thanks and please BUTT out pun intended..

  • Anonymous on 09.26.2013 at 11:00 pm

    please PLEASE put a trigger warning before you will talk about substances. I am a recovering smoker and it causes images to appear in my mind when I hear of this. please please consider the trauma of other people before writing a sensational article. thank you.

  • Jake @ Cig Buyer.com on 09.26.2013 at 11:19 pm

    Although e-cigarettes have been scrutinized ever since their introduction, the media has had a field day over the last few weeks ever since a study showed an increase in teen usage. It’s nice to hear someone credible like Dr. Siegal finally point out the facts and apply some common sense. The media’s reaction has definitely been overblown and we need more experts to come forward and shed light on the all the positive aspects of e-cigs…

  • David on 09.27.2013 at 9:29 am

    well can anybody say that this could have been the work of big tobacco industry to make you feel like you should smoke cigarettes because its the same thing as e-cigarettes. since the only industry that has been hurt has been them because its a cheaper form of smoking and potentially safer as well as a practical form of kicking a habit.

  • jon dougherty on 09.27.2013 at 1:42 pm

    Hey I smoke the e-cig on a regular basis I have be off cigarettes for a month now. iv smoked since I was in middle school so 10 years now. I think it helps but I also think they should be regulated.

  • Lea on 09.28.2013 at 5:15 pm

    I find it interesting that anyone of any age would go from candy flavored, inexpensive e-cigs to outrageously expensive and nasty tasting cigarettes. They are reaching for any reason to save the tobacco industry. And you have to wonder just how much money tobacco tosses at these people.
    I don’t know of any seller or maker of e-cigs or e-liquids who sells to anyone under 18. Like cigarettes, kids find a way to get them anyway.

  • elektronska cigareta on 10.01.2013 at 6:52 am

    Electronic cigarettes are definitely much healthier than regular cigarettes. If you take a look, you will see that e cigarette manufacturers does not recommend e-cigarettes to minors, moreover do not recommend them either as a means of quitting smoking, they only recommend them as a healthier alternative to regular cigarettes.

  • A.Dawood on 10.09.2013 at 10:28 am

    24 years old, been addicted to cigarettes from over 6 years , week ago i’ve decided to buy the e-cig, only a week , i have reduced the amount of cigarettes from over (40) a day , to less than (10) , so be aware smokers who want to quit , am sure that tobbaco’s company gonna fight this product till death …

  • MSG on 10.22.2013 at 3:02 pm

    I can only speak from my own experience. I enjoy smoking, and have done so for 22 years (I’m 43). I decided to try an e-cigarette, but stated to others and myself that I wasn’t sure if I would quit, but would give the thing a chance. I have now gone 6 weeks without a single cigarette and have only gone through 12 of the chargers (and 2-3 I’m pretty sure I threw away still having nicotine in them but because I misread the signs of a dead battery for a dead cartridge).

    I’m now using the low nicotine and usually only do 2-3 puffs with coffee in the morning, after lunch and after dinner. The exception being if I’m having drinks with people who are smoking, then I’ll puff on the gadget a little more.

    I for one am happy with the result and think I could probably do away with it completely. I may go to the no-nicotine first to see if it is the oral fixation of the thing or the nicotine that I’m enjoying.

    Anyway, I don’t like the idea of chomping on gum all the time or putting a patch on, so this worked and is working pretty good. The first day of not smoking was the only hard one.

    I think that it is either one or combination of the following that has caused a back-lash against the e-cig.

    *for non-smokers, seeing anyone doing the actions that look like smoking is offensive (I remember once on a cooler day where I could see my breath, exhaling and having a woman wave her hand infront of her mouth and cough like I just exhaled a lung full of smoke for crying out loud).

    *Don’t underestimate that big tobacco may be funding counter research to work against something that has the potential to cut profits.

    No one is going to convince me that cutting down 90% of the consumption of bad chemicals of cigarette smoke for only the habit forming drug of nicotine which was being consumed by me to begin with – is a bad thing. I’m sorry that logic doesn’t work. Unless a study proves that turning nicotine into a vapor makes it a worse threat to my health then the proven killer of cigarette smoking – I’m going to say to anyone who want to give it a try – “go for it”.

    It may be that I’m an exception and found switching completely from lighting up to plugging in very easy. When people say “that’s great, I’m proud of you.” I have to admit I feel a little guilty (first, I don’t understand congratulating me on quitting something that was stupid for me to be doing in the first place – how about congratulating the people who never started / the second is I didn’t go through any real difficulty beyond being a little antsy the first couple of days and feeling the need to walk outside like I was going to have a cigarette)).

  • franco-american vaper on 12.04.2013 at 11:45 am

    After being a smoker for 25 years (I’m 51) I bought an e-cig kit at my e-cig convert son’s suggestion. After a month of vaping, I’ve only smoked one regular cigarette. One benefit nobody has mentioned so far is that you can just have a couple of puffs, no need to ” finish this cigarette I lit because it costs so much ” feeling. Here in France the e-cig shops are very strict about the age limit and while it is very common to see under 18s smoking, I have yet to see one vaping!

  • Louise on 02.09.2014 at 5:15 pm

    I quit smoking real cigarettes a week after using the ecig. I am currently 6 weeks cigarette free! I can honestly say I love the flavors and have made the switch and will never take another puff off a real cigarette again. Not to mention I have not needed my inhaler in weeks. I use to use everyday.

  • Espana on 02.25.2014 at 5:47 am

    This seems to be another case where our scientific discovery is far outpacing our societies capacity to morally adjust. We need to start addressing these concerns with the human interest in mind. In my opinion, this does not mean forbidding anyone from smoking, but rather respecting their choice and hope they chose the responsible path, but recognize that freedom of choice is paramount.

  • Ed on 05.07.2014 at 9:50 am

    Let’s be honest – we don’t fully know or understand the long term effects of e-cigarettes.
    However, what we do know and can say with absolute confidence is that e-cigarettes have become a much “healthier” alternative to cigarettes for many people across the world…
    Reading through the comments above, long term smokers haven’t even thought about real cigarettes. Amazing.

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