GASO; Going there with electronic cigarettes.

Today is the Great American Smoke Out and many e-cigarette and vapor outlets are promoting themselves as a way to quit. E-cigarettes are very interesting. If you want to understand them more thoroughly from a group of dedicated experts, I’ll refer you to this article, so you could skip my rant.

Here’s what I think. If you have tried to quit smoking every which way and have never been successful, please give them a try, because they are “better” than combustible tobacco products, which will definitely make you feel bad and could easily kill you.

But, I wrote the previous sentence very carefully, because before going the e-cig route, you would go here or here or here or here or maybe even here to get help quitting.

Here are the caveats to my statement. I mean “you”, as in one person, not the population of people, as in population or public health. I also mean “tried to quit smoking every which way” literally; until you’ve talked to your doctor and used proven effective methods (e.g. telephone-counseling and NRT or other helpful medications), you have not yet “tried to quit smoking every which way”. Careful, too, with “never been successful” because it often takes 7 or 8 or 9 quit attempts with known effective methods until you are permanently quit. And I should say “better than combustible products” in quotes because, they are “better” than combustibles, but let’s be real, inhaling an unknown mixture of heated chemicals many, many, many times a day can’t possibly be “good”. It might be “better” but, “better” than WHAT? (For the record, this is a horrible oversimplification not really fit for a student researcher.)

The problems with e-cigarettes are many. First, e-cigarettes have an incredible potential to renormalize a hand-to-mouth-breathe-in-breathe-out-get-a-nicotine-fix behavior that is no longer socially acceptable — a shift, which has contributed to great reductions in tobacco use (we call this ‘changing social norms’). Second, we don’t know what’s in them because they aren’t regulated (Even cereal has an ingredients list!). Today, all across America, we have e-cigarette baristas, mixing very toxic nicotine (Kills kids! And dogs!) with flavors and other liquids in their back rooms and giving it to desperate/curious want-to-be-ex-smokers or cool-kids-who-vape (or ?). It’s a bit like an undergraduate chemistry lab. Third, scientists don’t really know how they are used among population subgroups or what role they play in health behaviors/tobacco use/health outcomes over time (e.g. Still smoking combustibles? Ever smoked combustibles?) because, quite frankly, they’re not that ‘old’ as devices and good studies by good researchers who use good methods who pass the test of peer-review take time.

The biggest problem: There are too many unknowns. When things are too unknown, thinking people shy away.

What we do know is that they have TERRIFICALLY divided the public health community and that is super sad. Back the article I recommended at the top of this post: If you’re interested in what a group of smart, open-minded experts have to say about e-cigarettes, this is a really helpful summary article of what we know and what we don’t know and what we should try to do as we move ahead.

My last note: I really want everyone to quit smoking combustible tobacco products, and to never use e-cigarettes either. If you yell at me, remember it’s karmic. Please let’s be nice. I do the work I do, for real, to promote good in the world and improve lives. A whole lot of e-cigarette fans would say they do their work for the same reason. I trust that someday it’ll all work out.

aem

2 thoughts on “GASO; Going there with electronic cigarettes.

  1. Great piece! A good friend tried them to quit tobacco cigarettes, which she’d been smoking for 30+ years. The problem she encountered was that it *increased* her desire for the nicotine fix and made it more accessible. Instead of having many places where it was impractical, illegal, or unsafe to smoke — which lowered her usage — she suddenly could “smoke” most anywhere. Now, she was doing it in her home (in which she’d stopped smoking for several years), at work, in the store, at certain restaurants, and elsewhere. What shocked her most was the realization she was smoking them in her sleep! Because they aren’t flammable, she kept one by her bedside on the nightstand. She found herself toking from it a few times during the night and woke up many times with the e-cig in her hand, completely unaware she’d even been using it. Like you, she’s convinced they are — at best — a last resort. After a few months, she ditched them, took a different approach, and has been smoke-free for 13 months (her serious attempt over the years).

    1. Glad you like it Andrew! The story you shared doesn’t surprise me… because there is a transition to trying to get your nicotine fix from a different source, and because there is no standardization between vaping devices, batteries, heating elements, e-juice — you have to sorta work it out yourself, and may end up getting more addicted. It’s possible that they’ll get way better over time, and will be “programmed” to help people quit rather than to maintain the constant high and low nicotine levels in the blood that trigger such crazy craving.

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