There is a new challenger to Joe Camel on the block and his name is El Cig. Electronic cigarettes are a relatively new development and are being used by some smokers as a substitute for tobacco cigarettes. They resemble cigarettes but contain a cartridge of liquid nicotine which is then vaporized and inhaled. They do not contain tobacco or tobacco byproducts like tar, and are felt by some to be a “healthy” alternative to regular cigarettes or even a pathway to quitting smoking. A recent study in Lancet comparing e-cigarettes, nicotine patches, and placebo e-cigarettes found a slightly higher (but not statistically significant) rate of abstinence with e-cigs compared to the other groups (7.3% vs 5.8 vs. 4.1). They recommended more studies.

Many adults believe e-cigarettes have helped them quit or at least reduce the risk of tobacco-related illnesses. The concern is that youths and adolescents are trying them in increasing numbers. Because e-cigs are not regulated by the FDA, it is unknown what chemicals they contain and harm they could cause.

Surprisingly, most states have no restrictions on selling e-cigs to minors. Many health advocates worry they will be a gateway to cigarettes as multiple studies have shown smoking initiation in adolescence is more likely to lead to long-term tobacco use.There are complaints about the marketing of e-cigs, like adding flavors such as Gummi Peach Ring, Bubble Gum, or Tootsy Roll to appeal to children. In addition, nicotine causes alterations in the developing adolescent brain. The CDC also recommends further studies for this age group.

The FDA recently announced it will release new potential restrictions for e-cigarettes in October. One article claimed they were considering a complete ban on online sales which was later denied by the FDA.

Jeff Ribordy, MD