E-cigarettes have frequently become the topic of acrimonious debate. They represent a dilemma for public health. On one hand they offer a less harmful alternative for smokers. On the other hand they are an addictive risk for young vulnerable non-smokers. They may also have risks associated with longer term use or risks that manifest themselves later in a person’s life. There is very little control of quality and therefore safety of many of the different types of e-cigarettes.
Using e-cigarettes is generally known as vaping. I strongly support making e-cigarettes more easily accessible to smokers than smoked tobacco. It is better that smokers quit entirely but many smokers report that vaping has helped or reduce their smoking. There is mixed evidence from clinical studies on how effective they are at helping cessation. However there is one study from the University of Auckland that demonstrates they are as effective as nicotine replacement therapy.
At the moment, I do not support making e-cigarettes more highly regulated than smoked tobacco. That just seems weird and ridiculously inconsistent. However I think what does need stringent monitoring and restriction is how we promote and advertise e-cigarettes, particularly in countries where tobacco advertising in most mainstream media is banned.
Communications about e-cigarettes need to emphasise our lack of knowledge about risks and that if used with nicotine they will be addictive and potentially tie the user to a life-long obligation/burden with unknown risk to health. Non-smokers need to be strongly discouraged. However we also need to make it clear that a switch to vaping if you can’t quit smoking is vastly preferable to continued smoking based on current knowledge.
Finally I’m a scientist and my thoughts and positions are both fallible and subject to change based on good data and research. 🙂
Journal of Outrageous Speculation 
A couple of points that may need to be addressed in your blog post.
Your statement about e-cigs being addictive when containing nicotine may be incorrect. According to the FDA, NRT products have a low risk for abuse and I fail to see the difference when ecigs use the same pharmaceutical grade nicotine.
Also ecigs do not contain the thousands of chemicals that combustible tobacco produces including MAOI which is likely the major cause of nicotine addiction from smoking.
I also do not think we should regulate the advertising as strictly as tobacco is. To do so will only slow down the uptake from current smokers who would switch if they knew the actual risk reduction potential. The unintended consequences should be thoroughly examined before regulating.
Nice post, but I take exception to this “that if used with nicotine they will be addictive “. You make that sound like it is well known that e-cigarettes are in fact addictive. I do not believe that is as yet proven, and in fact may be wrong.
Very nice post but I do agree with the previous two comments. Everyone is entitled to their opinion and I very much respect yours. Thank you for your acceptance of vapor products as a less harmful alternative to combustible tobacco.
USA – Texas
A thoughtful and pragmatic position, many thanks for this Janine
Two areas I wish to comment ,
You mentioned the Chris Bullen et al RCT that used now defunct and outdated Generation 1 cigalikes that compared similarly as well as NRT. The latest Generation types (as recently reported by McNeill et al) are vastly better devices than the earlier models http://www.ukctas.ac.uk/ukctas/documents/hitchman-et-al-ntr-2015.pdf this paper discusses ‘tank’ systems ,but huge further advances have been made since the original research was done that produced this ukctas paper . High wattage,temperature controlled(for safety and avoiding ‘dry-hits’ that can produce the aldehydes) devices along with the latest ‘sub-ohm’ tank systems have meant that the user has even more effective + safe devices . The reason why I emphasise the evolution and progress in the devices is that the ‘research’ science is usually at least 12-18 months behind what the latest technology is offering. This obviously is an unsatisfactory state of affairs but as you know the likes of K Farsalinos is a very prolific researcher in this area and his research is usually amongst the most topical and relevant when referring to devices and how they perform. This is not meant to devalue the fantastic work that a great many researchers are involved in, but it is the very strong desire that Vapers can collaborate with researchers to produce worthwhile studies and data that demonstrate ‘real-world’ results.
Secondly the addictive or reliance properties of ‘pure’ nicotine(but diluted to relatively low % ie <4% appears to be another relatively contentious area where good science and data is lacking . Users will all universally but anecdotally state they feel less dependent but this is largely subjective Etter + Eissenberg produced this http://www.ncbi.nlm.nih.gov/pubmed/25561385 stating that e-cigs are no more dependent forming than nicotine gum, but this whole area needs far more research to satisfy regulators and doubters . Interesting blogs from Jacques Le Houzec and Bernd Mayer exist but that is insufficient to satisfy such bodies as the WHO
The last point you make is especially topical regarding public perception of the relative harm of e-cigarettes, this is steadily worsening due to the relentless efforts of some organisations and the corresponding media coverage. This really is a tragic state of affairs that must have influenced many smokers from switching
~Here in the UK an interesting number was published this week. Over the last 12 month, despite a constant barrage in the media of negative, grossly misleading, reports, another 500,000 smokers started the transition to electronic cigarettes. There are now 2,600,000 regular users in the UK.
It gets even more interesting when you look in more detail. The number of non smoking users
has taken an even more dramatic jump, up from 700,000 to 1,100,000 – a rise of 400,000.
That is a remarkable number of new non smokers in just one year, far more than has ever been achieved previously. It’s such an impressive number I’m going to repeat myself: 400,000 new non smokers in 12 months!
When clinical trials attempt to extrapolate efficacy, but fail to mirror the real world measured effect, why would anyone think the trials were being conducted appropriately, or of any meaningful use. When calculations persist in telling you the sky is green, throw away those calculations, look out the window instead.
I like the fact that you state that you are open to change. This is a most sensible position to adopt. Alan Beard above makes some very good comment and there are others who have knowledge and insight into the topic. May I implore you to open a dialogue with Alan beard or any of the health professionals and fellow scientists listed here in https://sciencecig.wordpress.com/supporters/
Hi there brainyfurball 🙂 Yes Alan and I have been communicating via twitter for a year or so and have already added my name to the list – I’m under New Zealand. Thanks for taking the time to comment on my blog.
That is good. I am not a scientist, just someone who stopped smoking after 50+ years of trying to stop thanks to e cigarettes. I am one of those who wish my good fortune for others. I write and try to promote vaping. Keep in mind, I have no scientific training whatsoever, and to that end, I suppose, I am representative of the ordinary, but when it comes to vaping, my passion shows through. Here is my blog… https://brainyfurball.wordpress.com/
…and if you can see past my sometimes aggressive stance, and with an open mind, you will, you should be able to identify the nature of so many vaping enthusiasts world wide – unlike so many scientific commentators the truth is my truth but I do not try to disguise that fact.