E-cigarettes: Too many unknowns


Quitting smoking dramatically reduces your risk of developing heart disease. As a cardiologist at UT Southwestern Medical Center in Dallas, I’m always encouraging my patients who smoke to kick the habit.

Electronic cigarettes – or e-cigarettes for short – have been marketed as a way for smokers to quit, and that’s one reason sales have skyrocketed in recent years. But the truth is, there is a lot we don’t know about the devices.

One of the biggest unknowns is exactly what chemicals are inside e-cigarettes. The products are not regulated by the Food and Drug Administration, so manufacturers don’t have to reveal all the ingredients in e-cigarette liquids.

My goal is to help my patients achieve the best outcomes. While the benefits of quitting smoking are well documented, we know there are risks associated with certain methods. Because of the uncertainty surrounding e-cigarettes and other vapor products, I have not recommended them to my patients.

Are e-cigarettes safe?

E-cigarettes were developed in the early 2000s by a Chinese pharmacist. There are several different devices available, but most consist of a vaporizer system that uses battery power to heat up an “e-liquid.” In more advanced e-cigarettes, you can customize the taste and smell.

The most common questions my patients ask about e-cigarettes are:
  • Are they safe?
  • Will they help me quit smoking?
Unfortunately, we don’t have a clear answer to either question. While some studies have shown no adverse effects to e-cigarette users in the short-term, the long-term risks are not yet known.

Traditional cigarettes contain tobacco, which includes several chemicals that can cause cancer. E-cigarettes do not contain tobacco, but they do contain nicotine, a highly addictive drug, and other potentially dangerous chemicals.

Two reports published in January 2015 questioned the safety of e-cigarettes. One study found that e-cigarettes could contain 5 to 15 times the amount of formaldehyde as a traditional cigarette. This is alarming news because formaldehyde, a chemical used to make building materials and many household products, can cause cancer.

Officials in California labeled e-cigarettes a public health threat a few days after that study was published. Texas is one of just nine states that allow the sale of e-cigarettes to minors, but lawmakers are considering a ban.

Similarly, there is no concrete evidence that e-cigarettes will help someone quit smoking. Thousands of people have reported they used e-cigarettes to help them quit smoking, but no scientific studies have proven that the e-cigarette specifically made the difference. We don’t have randomized data that show e-cigarettes are more helpful than any other method of quitting.

Tips to quit smoking

To quit smoking, you first have to be willing to quit. Along with the countless health benefits of quitting, I remind patients they’ll save money and won’t have the odor of cigarette smoke following them around.

Several nicotine replacement methods are available to help people quit smoking, including gum, patches, and prescription medication. All of these have varying side effects and have been shown to be only marginally effective. The safest way to quit is with no aid at all – often called quitting “cold turkey.”

Some smokers can return to be as healthy as a person who never smoked. Here are some tips that can help you quit smoking:

Set a quit date: Pick a day within one month from today. Setting a date six months down the road will not be as effective.

Prepare for your smoke-free life: What will you do in place of smoking after you quit? Smoking establishes a habit of having something in your mouth or in your hand. Some people chew gum and/or hold a pen to replace those feelings.

Have a plan before the urge:
Some people decide they will exercise whenever they have the urge to smoke. This can limit the weight gain often associated with quitting smoking.

Surround yourself with support: Tell family, friends, and others in your daily life that you’re going to quit so they know not to smoke around you. Try to avoid others who are smoking. Smartphone apps are available to help analyze nicotine consumption, track cravings, and more.

Let us help you: UT Southwestern offers free classes to help you quit smoking. Call our Cancer Answer Line at 1-888-980-6050 or visit this website for more information. For a full risk assessment and counseling, request an appointment to our Preventive Cardiology Clinic. Free counseling and support also is available via the Texas Tobacco QuitLine at 1-877-YES-QUIT (1-877-937-7848). It may be helpful to program those numbers into your phone as you start your journey toward a smoke-free life.