According to current data, there is no proven long-term benefit of using e-cigarettes for smoking cessation. The switch to electronic substitutes is merely a shift in addictive behavior and poses health risks of unknown proportions, experts warn.
Contrary to the opinion of some addiction researchers, e-cigarettes are not a suitable tool for people who want to quit smoking altogether, concludes the German Society for Pneumology and Respiratory Medicine.
Call for a ban on advertising of electronic smoking products
Several studies have shown that students who use e-cigarettes are also more likely to use conventional cigarettes [1]. In the USA, cases of acute respiratory failure and death have been published after the use of e-cigarettes [2]. Therefore, the DGP warns against the use of e-cigarettes, especially by adolescents. Young people are a popular target group for advertising campaigns by the cigarette industry, in which smoking is portrayed as a lifestyle factor. For reasons of youth protection, too, the expert therefore calls for a complete ban on advertising for both traditional tobacco and e-cigarettes.
It is a widespread misconception that electronic vaporizers are significantly less harmful to health than conventional tobacco cigarettes. What is not mentioned: depending on the type of e-cigarette and the composition of the liquid used, harmful substances can be inhaled, such as propylene glycol (irritating to the respiratory tract), formaldehyde (carcinogenic) or lead, chromium and nicotine. In addition, the flavoring substances used pose a variety of health hazards [3,4]. In a recent review, the acute potential adverse health effects, which particularly affect the lungs and respiratory tract, are noted [5]. “The long-term effects of e-cigarette use cannot be fully assessed at this stage. However, the findings to date show that these devices pose a considerable health risk. It is therefore negligent and irresponsible of the cigarette industry to sell e-cigarettes as a harmless, modern alternative,” Prof. Michael Pfeifer, MD, President of the DGP. “The industry is focusing on the lifestyle factor in its advertising, appealing primarily to young people for whom e-cigarettes represent a low-threshold entry point into nicotine addiction.” – Prof. Pfeifer.
Cessation programs instead of e-cigarette
In a recent statement, the European Respiratory Society (ERS) also opposes the downplaying of the dangers of e-cigarettes [6]. In addition, the ERS also disagrees with the repeated claim that e-cigarettes have a positive benefit in helping smokers quit. Although a meta-analysis of several longitudinal studies on the efficacy of e-cigarettes had shown that they had a short-term positive cessation effect under controlled clinical conditions. However, in the long term and under real-life conditions, they make smoking abstinence more difficult. The most sensible way to get permanently without nicotine is through structured cessation programs, according to Prof. Tobias Welte, MD, past-president of the ERS.
Literature:
- Morgenstern M, Nies A, Goecke M, Hanewinkel R: E-cigarettes and initiation of conventional cigarette use – A cohort study in grade 10 adolescents. Dt. Physicians Journal 2018; 115: 243-248.
- Layden JE, Ghinai I, Pray I, et al: Pulmonary illness related to e-cigarette use in Illinois and Wisconsin – preliminary report. N Engl J Med 2019, Sep 6; DOI: 10.1056.
- Jabba S, Jordt SE: Risk analysis for the carcinogen pulegone in mint- and menthol-flavored e-cigarettes and smokeless tobacco products. JAMA Intern Med 2019, Sep 16. DOI: 10.1001.
- Bitzer Z, Goel R, Reilly S, et al: Effect of flavoring chemicals on free radical formation in electronic cigarette aerosols, Free Radic Biol Med 2018; 120: 72-79.
- Gotts JE, Jordt SE, McConnell R, Tarran R: What are the respiratory effects of e-cigarettes? BMJ. 2019 Sep 30; 366: l5275. DOI: 10.1136/bmj.l5275.
- European Respiratory Society, Tobacco Control Committee: position paper on tobacco harm reduction (translated by DGP). August 2019.
HAUSARZT PRAXIS 2019; 14(11): 34
