E-cigarettes: Miracle Cure or Overnight Wonder?

Donald NorfolkI stopped smoking at the age of eleven, probably because it was no longer a daring thing to do. By that time many of my chums at school were congregating behind the bicycle sheds to have a quick drag on roll-ups they’d made from discarded cigarette butts. Since that time I haven’t smoked, chewed of sniffed a single leaf of nicotinia. This lifetime’s abstinence doesn’t make me feel in any way virtuous. Every community has its favoured psychedelic drug. If it’s not nicotine it may be peyote or heroin. People of all races and generations have found it therapeutic to escape their everyday cares and woes and escape into a psychedelic haze and reverie.

So I’m not judgemental about those who choose to smoke. We all have the right to choose the way we live and the way we die. Nevertheless, as a health educator, I’m forced to admit that tobacco is the most lethal of all the world’s ‘switch on, turn off’ drugs, causing vastly more premature deaths each year than all the other recreational ‘life style’ drugs combined. Every year, according to the World Health Authority, 5.4 million from smoking-related disorders.

In view of this I welcome any new technique which offers help to people who want to kick the nicotine habit. One such device was launched five years ago by Ruyan, a Beijing electronics firm, which produced an artificial, electronic cigarette. When held between the lips, this cartridge-filled tube looked reasonable like the genuine article. It glowed at the tip, and gave off a puff of smoke with every drag, using the same process used to generate smoke on stage and during pop concerts. What’s more the aid provides the user with a shot of nicotine with every suck, a dose which by switching cartridges can be varied in strength from high, to medium, low and zero.

This device has now been dubbed the e-cigarette, and hailed as this year’s major health promotion breakthrough. But is there anything to justify this claim? Each e-cigarette costs just over £1 pound each, which means they provide a relatively cheap way of delivering shots of nicotine, especially as the cigarettes don’t burn down and only release the drug when a drag is taken. As gaspers go they’re economical, because a normal cigarette lasts for a mere 15 puffs, whereas an e-cigarette provides an average of 300 puffs before its cartridge expires. But there are doubts about their safety, since they release a certain amount of acetaldehyde, a chemical which plays a part in causing hangovers and can be carcinogenic if allowed to build up in the body.

It’s possible that some tobacco addicts might use the ersatz cigarettes as a crutch to help them reduce their overall intake of nicotine. This they could achieve this effect if they puffed less frequently, or bought cartridges of progressively lower strength. On the other hand, since it’s known that cost is one factor which directly influences the level of cigarette consumption, it’s quite possible that addicts will step up their nicotine intake when it’s available in a cheaper form. Then there’s the question of user friendliness. Some folk who’ve tried these gizmos find they don’t give the same satisfaction as real cigarettes. Others have suffered because from a distance they’re too realistic, which means that if they flaunt them in a public place they’re constantly being hassled by bystanders who think they’re being subject to ‘passive smoking’. For that reason the patrons of many clubs, bars and restaurants try to avoid arguments and misunderstandings by insisting that e-cigarette users should be banished to the areas set aside for conventional cigarette smokers.

At present there’s no consensus of opinion about the long-term value of these gadgets, 300,000 of which were sold last year. Nobody knows for certain whether they’re effective or safe, and so far there’s no concrete evidence that they have a useful role to play in smoking cessation programmes. The jury is out. Later this year the World Health Authority will be publishing a report on the safety and use of e-cigarettes, and insiders believe that one of its major recommendations will be to advise that their sale should be limited to registered pharmacies, who may well prefer to sell nicotine patches which serve a similar function in a less conspicuous way. We’re content to sit on the fence while waiting for this report, which is never the most comfortable posture to adopt. To ease our discomfort we’d be very pleased to hear from anyone who has actually smoked an e-cigarette. Did they come up to your expectations?

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