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Electronic Cigarettes

"The rise of vaping"
By: Mel Mordeno Beluan, MDElectronic Cigarettes

What are e-cigarettes? An electronic cigarette, e-cigarette, or e-cig for short, is an electrically operated device, usually in the shape of a cigarette, cigar, or pipe. It allows the user to imitate the experience of smoking tobacco by creating out of a solution a mist or aerosol, which resembles smoke (it’s not smoke; recall the aerosol produced by a nebulizer or a perfume atomizer). Then the user inhales or “vapes” the resulting aerosol. The solution can be customized to contain levels of nicotine and fragrant substances to the user’s specification.

At first light, it’s a eureka moment. You easily see why smokers who badly need to quit smoking resort to the fashionable e-cigs. The alternatives seem off-putting, uncool, or clumsy to some. They require extreme resolve.

  • Quitting cold turkey (that is, quitting right away), along with experiencing withdrawal symptoms, is uncomfortable.
  • Taking meds, such as varenicline and bupropion, or applying a nicotine patch to help you quit may be unwieldy and have side effects.
  • Gradually reducing the number of cigarettes per day or per week requires mind-numbing willpower.

In other words, e-cigs reportedly help smokers to wean off smoking by gradually reducing the addictive nicotine content of the e-cig solution to zero while still allowing their psychological addiction to “having a cigarette” to continue.

Ecigs, however, do not only serve the end of quitting tobacco. Different companies and advocates emphasize different scenarios. It’s also for those who don’t want to quit smoking. Ecigs can also be for smokers who want to get away with “smoking” in non-smoking areas. What’s more is that since the e-cig solution can be tailored to contain nicotine only, e-cigs are said to be a safer alternative to traditional tobacco, which harbors other poisons like cyanide, benzene, formalin, ammonia, acetone, tar, carbon monoxide, arsenic, nitrosamines, and a thousand other chemicals. E-cigs also don’t produce the smelly smoke of smoked tobacco.

The first problem is that while there’s a lot of anecdotal evidence about electronic cigarettes or e-cigs helping people to quit smoking, there is a need to validate these anecdotes scientifically for the benefit of the general public. This is also to help e-cig companies adhere to good manufacturing practice (GMP) procedures.

There are four related questions here.

  • Are there independent, scientifically sound, and large-scale studies on the efficacy and safety of e-cigs?
  • If there are such studies, are the results being replicated by other studies?
  • If there are several studies, is there a scientific evaluation of multiple studies (such as a meta-analysis)?
  • What’s the current expert scientific opinion?

The next problem is that e-cigs can be a way for smokers to become more addicted to nicotine, as you can still get e-cigs with certain amounts of it. It’s a way for smokers to smoke in non-smoking areas and to possibly pass on secondhand nicotine to nonsmokers, children, and pregnant women.

  • Are we now going to put up with nicotine addiction on a large scale because e-cigs are supposed to be safer than tobacco?

The third problem is that, is there an independent scientific agency in the country dedicated to regulate and approve or disapprove the e-cig brands that are currently in the market?

  • Are there relevant laws based on scientifically sound studies? I don’t know.

In the case of e-cigs:

  • How do we know when a company says that a vaping liquid has 0 or 4 mg of nicotine and not 20 mg plus hazardous impurities? Do we take the salesman at his word?
  • Are the devices BPA-free? PVC-free?
  • Are they properly labeled?

While FDA Philippines does its part, it’s not fool-proof in its procedures. The same applies to well-meaning self-regulating e-cig companies or their associations.

Moreover, many products right now are bootlegged and sold without the government’s approval. You don’t want your e-cig exploding in your face because it shorts out, or poisoning you because it’s laced with arsenic, do you?

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