Do e-cigarettes help people quit smoking?

Electronic cigarettes, known as E-cigarettes, are not comparable to FDA-approved nicotine-delivery devices that have been shown to help people quit smoking. At this time, their dosage, manufacture, and ingredients are not consistent and the products are not clearly labeled, thus making their use by smokers wanting to quit an uninformed proposition.

More importantly, the manufacturers of e-cigarettes have not submitted the requisite applications for FDA approval of these products for smoking cessation. Only one small clinical trial, funded by an e-cigarette manufacturer has been published on their efficacy as a smoking substitute (but not as a cessation aid). The FDA has rejected claims by e-cigarette makers and distributors that their devices are safer than real cigarettes and mitigate the harm of smoking. While some distributors have implied that their products help people quit smoking tobacco products, the FDA views them as unapproved synthetic nicotine delivery devices with unknown safety and efficacy.

In 2008, the World Health Organization (WHO) noted that, “Contrary to what some marketers of the electronic cigarette imply in their advertisements, the WHO does not consider it to be a legitimate therapy for smokers trying to quit. WHO knows of no evidentiary basis for the marketers’ claim that the electronic cigarette helps people quit smoking. Indeed, as far as WHO is aware, no rigorous peer-reviewed studies have been conducted showing the electronic cigarette is a safe effective nicotine replacement therapy.”

Whether e-cigarettes can safely help people quit smoking also is unknown, but with their fruit and candy flavors, they have a clear potential to entice new smokers, especially teens. In addition, because of the unregulated dosing of nicotine, they clearly can be addictive. It is evident from what little information we have that the concentration levels of the nicotine and other compounds are variable, and that there are toxins and carcinogens present. Thus, controlled trials and test market studies are needed to determine if they are safe and effective as a smoking cessation device as is being reported in the media and on the manufacturers’ Web sites.

Similar to concerns regarding the manufacture and sale of tobacco products, the actual content, performance as a nicotine delivery device, safety, and purity of e-cigarettes is largely unknown. Due to the lack of rigorous chemical and animal studies, as well as clinical trials on commercially available e-cigarettes, neither their value as therapeutic aids for smoking cessation nor their “safety” as cigarette replacements is established and remains speculative.

Read the AMA Council on Science and Public Health Report on “Use of Electronic Cigarettes in Smoking Cessation.” http://www.ama-assn.org/resources/doc/csaph/a10csaph6ft.pdf

Russell W.H. Kridel, M.D.

What are some easy steps I can do to lose weight and reduce sugar in my diet?

Here are 6 simple and easy steps you can take right now to lose weight and get started on a healthier lifestyle.

  1. Drink 1 less sugar based drink a day — with the goal of no longer having it as part of your daily diet.
  2. Downsize your drink.  Ask for a small instead of a large.  For example, a super-size soda contains the equivalent of 4 or 5 regular 12 ounce cans, which contains about 48 packets of sugar and has 720 calories.
  3. Replace one sugary drink with water every week. Substituting water for one 20 ounce sugar-sweetened soda will save you about 240 calories.
  4. Switch from fruit juice to real fruit.  Fruit juice has added sugar.
  5. Stop drinking energy or sports drinks.  Water is all you need to stay hydrated, even when you exercise.
  6. If you are a parent, don’t buy sugar-sweetened drinks.  It is a lot easier to avoid drinking sodas and sugary drinks if they are not in the cabinets at home.

Reducing intake of sugar-sweetened beverages is one of the simplest ways to reduce intake of added sweeteners.  And, given the strong association of sugar-sweetened drinks with body weight and obesity, it is also a very simple way to reduce calorie intake and therefore lose weight.

Certainly, it is most optimal to cut out sugar-sweetened drinks entirely.  However, just by eliminating one sugared sweetened beverage (SSB) a day, you will be well on your way to better health.

Read the AMA Council on Science and Public Health Report on sugar-sweetened drinks.

Russell Kridel, MD