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Do e-cigs help you quit smoking? Science is still hazy

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http://www.omaha.com/article/20120716/L ... /707169927


By Rick Ruggles
WORLD-HERALD STAFF WRITER
« Live Well - Health & MedicineShare
Janelle Jensen's smoking habit has gone up in vapor.
For the past six weeks, the Omahan has used electronic cigarettes, metal devices that deliver flavored nicotine but don't contain smoke or tobacco.
Jensen

Jensen tried the nicotine patch. It stopped her craving for nicotine, but she still wanted cigarettes. She likes the smoke in her mouth, exhaling it, holding cigarettes and using them at predictable times — when she climbs in the car, for instance, or after a meal.
“A lot of it is just a compulsion,” said Jensen, who will soon be 55.
For Jensen, banana-flavored e-cigs have replaced smoking. They produce a vapor that looks like smoke but doesn't foul the breath, hair, clothing or living room. “They're very satisfying,” she said.
Sellers of electronic cigarettes, or e-cigs, for several years have struggled with regulators such as the Food and Drug Administration and agencies such as the World Health Organization. The fight may intensify as e-cigs attract more users. An organization estimates that the number of American users has grown more than 30 percent in the past year.
Some scientists and users say that if e-cigs can help people quit, health organizations should promote them. But other scientists and government agencies decry the minimal clinical testing to which e-cigs have been subjected. There is no proof they help people quit, many say, and e-cigs may come with their own ill effects.
“They're different from cigarettes, but you're inhaling nicotine, and nicotine is a poison,” said Mohammad Siahpush, a professor in the College of Public Health at University of Nebraska Medical Center.
Click here to learn how electronic cigarettes work.

Siahpush speculated, though, that e-cigs are “probably a whole lot better than smoking.”
Dr. Michael Siegel, a physician in the Boston University School of Public Health, has reviewed what few studies have been done concerning e-cigs. Siegel said they are “much safer than regular cigarettes.”
As smoke-cessation tools, e-cigs appear to be better than nicotine gum or patches, he said, because e-cigs address the behavioral aspect of the addiction. They satisfy the desire to hold something in the hands and mouth.
Siegel said it's true that nicotine, which is found in most juices used in e-cigs, is harmful because it's addictive and may contribute to cardiovascular disease. The juices in e-cigs also generally contain trace levels of nitrosamines, which are cancer-causing contaminants.
The federal Centers for Disease Control and Prevention says tobacco kills 443,000 Americans per year. Experts say that a year after trying patches or gum, only about one in five people remain smoke-free.
In his living room in west Omaha, Sam Salaymeh keeps hundreds of small vials and dozens of thin metal e-cig devices.
The vials contain flavored liquids that taste like pineapple, licorice, berries, coffee, cigar and other flavors when inhaled through the metal stem.
E-cigs may cost $40 to $150 or more for the initial outlay, then $7 to $15 a week for juices and cartridges. Regular cigarettes cost about $6 a pack, so a pack-a-day habit costs $40 or more a week. Salaymeh, who sells e-cigs from his home, says the initial expense of e-cigs drives off many young smokers. Over the long run, though, e-cigs are cheaper, he said. E-cigs also may be purchased at mall kiosks, some gas stations and some drugstores.
Salaymeh

Salaymeh doesn't claim to have proof that electronic cigarettes help people stop smoking. He doesn't want the FDA on his case for making false assertions. After the next puff on his own e-cig, however, he says it has helped him and others quit or reduce their smoking.
“Life changer,” Salaymeh said.
Most e-cig juices contain varying levels of nicotine, but some have no nicotine at all. It's up to the user to decide how much nicotine he uses.
The battery-operated e-cig device includes a heating element and cartridge containing the juice, which is vaporized by the heat.
The product is fairly new, and an American group promoting it says business is starting to boom. Ray Story, CEO of the Atlanta-based Tobacco Vapor Electronic Cigarette Association, estimated that 4 million Americans use e-cigs, up from 3 million last year. He admitted that the estimates are rough, given the minimal regulation of them.
A Chinese scientist developed the modern e-cig about 10 years ago. The Chinese began exporting the device in the mid-2000s.
The World Health Organization calls them “electronic nicotine delivery systems” and says their safety and smoke-cessation potential have not been scientifically proven. The WHO says that until they are shown to be safe, people “are strongly advised not to use” them.
The FDA three years ago sought to block Chinese e-cigs from being imported into the United States. The Chinese are the main manufacturers of the product. The FDA also hoped to classify them as “drugs or devices,” which would have required years of clinical testing of the products.
However, the e-cig industry fought back, and a judge in Washington, D.C., halted the FDA measures and found that e-cigs should be regulated as tobacco products.
A spokeswoman for the FDA said through an email: “Further research is needed to assess the potential public health benefits and risks of electronic cigarettes.” The FDA, which warns e-cig sellers not to promote them as smoke-cessation devices, intends to develop regulations for e-cigs in the near future.
Some scientists have studied e-cigs, but the sample sizes have been small or the duration short.
One European study of 30 smokers found that e-cigs caused inflammation and constriction of a person's airways after only a few minutes' use. Two Italian studies, on the other hand, found that even among smokers who weren't trying to quit, the use of e-cigs led to completely replacing cigarettes with e-cigs close to 10 to 20 percent of the time. Others replaced cigarette smoking with e-cigs at least part of the time.
The federal Department of Transportation has proposed to ban the use of e-cigs on most or all aircraft, but restaurants appear to have taken a more lenient view for now. The state restaurant associations in Iowa and Nebraska haven't taken a stand against them.
Marty Conboy, city prosecutor in Omaha, said e-cigs don't use tobacco, are not lighted and aren't smoked and therefore don't fall under city ordinance or state laws governing smoking. “I've never had a complaint,” Conboy said.
Janelle Jensen said her reasons for switching to an e-cig were simple. “Health, cost, smell.”
Her husband, Leo, has switched, too, but their son is a holdout. He still smokes.
“We're gonna work on that,” Janelle Jensen said.
Contact the writer:
402-444-1123, [email protected]



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