With a vapor that manufacturers claim to have dramatically lowered chemical contents compared to tobacco fumes—not to mention the absence of secondhand smoke, cigarette ash, and encumbrances such as the need for a lighter or ashtray—electronic cigarettes may indeed seem like a promising exit point for smokers who want to quit while retaining the behavioral tic of inhaling and puffing a stick in one's mouth.
As fleeting as the vapor of an e-cigarette, the touted benefits of the device also seem to dissipate behind the mountain of criticisms rising in conjunction with the growing popularity of the device.
Fears of the unknown
Fear and hostility toward e-cigarettes stem mainly from a gaping information vacuum. Several quarters in the public discussion, including the World Health Organization, often point out the lack of rigorous peer reviewed studies and clinical trials on electronic cigarettes that could establish the efficacy and possible side effects of the device.
Asked about the issue, Food and Drug Administration deputy director Ronald de Veyra's comment was tellingly short. "Nothing has yet been established. There is not enough information yet at this point," de Veyra informs HealthToday.
Abroad, a number of regulatory agencies and health groups have already publicly stated their apprehension and opposition to e-cigarettes. In the U.S., this includes the Food and Drug Administration (FDA), the American Cancer Society, the American Heart Association, and the American Lung Association.
Understandably so, data is insufficient because the device is a relatively recent invention. E-cigarettes were marketed in China only in 2004, following their invention the year before. Shortly after, it was exported to offshore markets in 2005-06, with the international patent given a year after. E-cigarettes have only been in existence in the last eight to nine years, and their popularity, on the other hand, has only gained global traction in the last two to three years.
As the device is a relatively contemporary invention, a surveillance study on its long-term effects on a wide sample of users is practically nil. Recent preliminary analysis done by some regulatory and research agencies also does not help the case for electronic cigarettes. The U.S. FDA, for instance, has reported that it found certain toxic chemicals in a small sample of cartridges to be "toxic to humans," with "detected carcinogens" found in "several other samples." In a study reported early this year in Greece, researchers reported immediate adverse effects on users of e-cigarettes: After five minutes, breathing tests conducted on users showed signs of airway constriction and inflammation.
Quality control is also said to be lacking among the different variants of the product in the relatively young industry. The uneven quality of the different types of e-cigarettes in the market could be gleaned from the widely disparate price levels of the device, which could range from a few hundred pesos at street-side stalls, to over a thousand pesos at the mall.
Some studies have shown that advertised and actual nicotine levels on some e-cigarettes are not the same. In the U.S., concerns were also raised on unsubstantiated claims in some websites and print materials.
On the other side of the debate, advocates cite segments in existing scientific literature said to support the claimed benefits and harmlessness of e-cigarettes. Some have alluded to research on vaporized medical marijuana, said to be similar to e-cigarettes, which claimed negligible exposure of toxic combustion toxins in users.
In a paper published in the Journal of Public Health Policy, 16 studies regarding the contents of e-cigarettes were reviewed and analyzed. The paper stated that the level of harmful chemicals in the device were just at par with those in nicotine patches and, most importantly, hundreds of times lower than what's found in ordinary cigarettes.
Apart from the scholarly data, the number of anecdotal testimonials for the product has also been deeply resonant. Word of mouth advertising is slowly gaining ground locally, as tales of smokers quitting with the help of the device slowly spread.
"I started after it was given to me by my brother, who also quit with the help of the device," shares activist lawyer Argee Guevarra, who has been using e-cigarettes for about three weeks. He adds, "With the help of e-cigarettes, wala na ako ngayong craving sa ordinary cigarettes."
E-cigarette users distance themselves from conventional smokers, and they’ve coined a separate term to set it apart from smoking: “vaping.”
In a survey published in 2011 by the American Journal of Preventive Medicine, it was said that nearly one-third of those who tried e-cigarettes quit smoking within six months of use. This sets the device a cut above other quitting mechanisms such as nicotine gums and nicotine patches, which have a reported success rate of 20 percent. If using e-cigarettes could indeed shepherd just a fraction of the total smoking population toward quitting, it may well be an unassailable victory.