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E-Cigarettes approved as Cessation Devices and Harm Reducers

The American Heart Association recently released a policy statement regarding Electronic Cigarettes in their journal, Circulation. The American Heart Association, or AHA, has long been a proponent of tobacco control, and reports great success with their efforts of reducing the number of youth and adolescents who become active smokers. The AHA published their policy and guidance on e-cigarettes, and while they stressed the importance of more research and regulation, they also reaffirmed how electronic cigarettes can be an effective, and a safer, method of nicotine replacement therapy that can aid users in their battle to quit smoking.

The AHA provided recommendations for policy on the manufacturing, use and distribution of e-cigarettes in their report published on August 25th, 2014. Their policy stresses how they believe we as a society should move forward in the new and ever-changing market of electronic nicotine delivery systems. Stressing the absolute importance of more research was one of the objects at the top of their list.

The full effect of using electronic cigarettes on people’s health has yet to be established as e-cigs are a relatively new device and long term effect studies simply do not yet exist. Though there is only limited research at this time, the studies that do exist primarily seem to agree that the electronic method of delivering tobacco to your system is significantly safer than the traditional method of combustible smoking, which exposes the user to noxious smoke and tar.

The AHA policy statement read: “To date, relatively little research has been conducted on the human health effects of e-cigarettes.” They go on to cite a study by the American Journal of Preventative Medicine, in which they found that, “no serious adverse effects have been reported in clinical trials with less than 6 months of use compared with nicotine patches.” Users who are trying to quit smoking and using nicotine replacement often report having more success with e-cigarettes as a cessation method for a variety of reasons. Not only do vapor cigarettes deliver the nicotine in a safer way, they also allow the user to have an enjoyable experience, one that is similar to traditional smoking, which many smokers agree is often just as much of a part of their addiction as the nicotine itself.

The AHA, while recognizing the effectiveness of e-cigarettes for cessation, does not recommend e-cigarettes as a quitting method for someone who is trying to kick the habit for the first time. However, for a person who has tried to quit and failed before, e-cigarettes can be a highly effective cessation method. The AHA policy cites a study published by the Society for the Study of Addiction just this August in which, “A large cross-sectional study showed that smokers who wanted to quit without professional help were significantly more likely to report abstinence using e-cigarettes than with traditional cessation aids or going ‘cold turkey.’”

Even in light of a lack of official health studies, the AHA, as well as many other health care professionals can’t deny the use of e-cigarettes as a harm reducer. The policy from the AHA states: “E-cigarettes either do not contain or have lower levels of several tobacco-derived harmful and potentially harmful constituents compared with cigarettes and smokeless tobacco. In comparison with NRTs, [Nicotine replacement treatments] e-cigarette use has increased at an unprecedented rate, which presents an opportunity for harm reduction if smokers use them as substitutes for cigarettes.”

While their position is still strongly in favor of more regulation, the AHA recognizes the therapeutic aspect of electronic cigarettes as well as their ability to offer much safer options for tobacco use than the old fashioned models. They also noted the overall public health benefit of reducing secondhand smoke with the use of e-cigarettes instead of the more hazardous combustible cigarette smoke that is already proven to be dangerous to others.

The AHA’s need to issue a policy statement on e-cigarettes comes in response to the skyrocketing use of these devices. As of early 2014, there were an estimated 466 brands and 7764 different flavors of e-cigarette products. With all of these products in the marketplace, critics are concerned with the danger of youth use, often citing that the flavors and packaging of these devices and e-liquids are making nicotine use more attractive for kids & teenagers. In 2012 data from the National Youth Tobacco Survey showed that only 2.1% of kids in grade 6-12 use e-cigarettes, however this number is up from the previous year. Seventy-six percent of youth who have tried e-cigarettes also smoke traditional cigarettes. This seems to suggest that despite many critics’ concerns, e-cigarettes aren’t necessarily the “gateway” to smoking that some people originally thought.

Regardless, the AHA considers e-cigarettes that do “contain nicotine to be tobacco products and therefore supports their regulation under existing laws relating to the use and marketing of tobacco products.” They suggest regulation in the areas of youth marketing, smoke-free air laws, and manufacturing, in order to make sure e-cigarettes don’t encourage nicotine use, which no matter what the delivery method, does present health dangers to its users.

One thing both opponents and proponents of e-cigarettes agree on is the need for more research. As electronic devices become more prevalent and users have prolonged exposure to vapor cigarettes scientists and health organizations can study the effects and present more clear positions on e-cigarette use. For now, e-cigs are quite obviously a safer method for nicotine delivery than the inhalation of smoke.

The AHA concluded their report by recognizing how e-cigarettes are changing the landscape of tobacco control. The policy and guidance they provide is developed from the current evidence compiled from the United States and international studies. The AHA will continue to monitor the impact of e-cigarettes and their newly developed technologies paying special attention to how it impacts cardiovascular health and the effect these devices has on youth and adolescents. As more research emerges, the AHA, and other health organizations, will clearly evolve their position on electronic cigarettes as we all watch this ever changing marketplace continue to grow.

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