See also the editorial by Stanbrook on page 1379 and at www.cmaj.ca/lookup/doi/10.1503/cmaj.131469
Electronic (e-) cigarettes are cigarette-shaped canisters used to simulate the action of cigarette smoking
Batteries within the canisters heat up fluid-filled cartridges that contain varying concentrations of flavouring agents, propylene glycol, glycerine, water and other chemicals.1,2 Not all e-cigarettes contain nicotine. The cartridge content varies widely according to the manufacturer and distributor. The act of smoking an e-cigarette is called “vaping,” because the user inhales vapour, not smoke.
E-cigarettes are not regulated or approved for sale in Canada
Although not approved for sale in Canada, e-cigarettes are readily available online and through retail outlets. A recent 4-country survey of current and former smokers showed that 40% of the 1581 Canadians surveyed were aware of e-cigarettes and 10% had tried them.3 Although the prevalence of cigarette smoking has decreased over the past few decades,4 consumer interest in e-cigarettes is rising.5
Although perceived by cigarette smokers as a safer alternative to tobacco smoking, e-cigarettes have not been evaluated for their safety
It is unknown whether inhalation of the mixture of chemicals found in the vapour of e-cigarettes is safe.5 Available literature suggests that e-cigarettes contain trace amounts of impurities and carcinogenic tobacco-specific nitrosamines.6 Concerns exist regarding the potential to maintain nicotine dependency in current smokers or induce addiction in nonsmokers.3
E-cigarettes have not been fully evaluated for their efficacy as smoking cessation aids
To date, one 6-month randomized controlled trial has investigated the efficacy of nicotine-containing e-cigarettes as a smoking cessation aid; statistical power was insufficient to conclude that e-cigarettes were superior to nicotine patches.7
Effective smoking cessation interventions are available for smokers wishing to quit
Several pharmacologic and behavioural interventions have been found to improve smoking cessation rates (see Appendix 1, available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.130806/-/DC1). These strategies help patients manage nicotine withdrawal symptoms, learn behavioural self-regulation skills and provide instrumental social support.
Footnotes
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This article has been peer reviewed.
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Competing interests: None declared.