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E-Cigarettes

November 5, 2019 | Lucas Cannon: Love Oak Pharmacist Intern

Electronic cigarettes, also known as e-cigarettes or e-cigs, have increased in popularity over the last few years especially in teenagers and young adults. E-cigarettes are battery powered devices that come in many different sizes and shapes, ranging from looking like a USB/flash drive to emulating a real cigarette.1

The e-cigarettes heat up a liquid (called e-liquid) which turns it into a vapor that can be inhaled. E-liquids have two to three main ingredients including a bulking agent, usually propylene glycol or vegetable glycerin, and a flavoring which can range from menthol/mint to birthday cake. The third main ingredient that is common in a lot of e-liquids is nicotine. When nicotine is present in e-liquids the amount can range from less than that of a cigarette to 5 to 6 times more than a cigarette. 

Nicotine, in both cigarettes and e-cigarettes, raises blood pressure and causes the heart to have to work harder than it normally would.2 This leads to an increased risk of stroke and heart attack. Nicotine also works in the brain to cause addiction and is one of the main reasons why it is so hard to quit. Less than 10% of smokers who attempt to quit actually succeed. However, there are a few medication options to help patients who are attempting to quit. The most common option is Nicotine Replacement Therapy (NRT) in the form of  patches, gums, or lozenges and can be picked up here at Love Oak at any time. These products help to taper off nicotine and limit withdrawal symptoms, including agitation and cravings. Other options that need to be prescribed by your doctor include bupropion (Zyban®) and varenicline (Chantix®).

Many people who are using e-cigarettes do so as a way to quit smoking cigarettes. This practice is backed by a scientific study published earlier this year that compared Nicotine Replacement Therapy to e-cigarettes for the use of smoking cessation.3 When the study was complete, it was found that patients who used e-cigarettes were almost twice as likely to quit smoking than those who used Nicotine Replacement Therapy. Specifically, 18% of the patients using e-cigarettes had stopped smoking versus about 10% of patients using Nicotine Replacement Therapy. 

However, e-cigarettes are not free from potential risks. Most recently, the Centers for Disease Control and Prevention (CDC) has reported over 1600 lung injuries and 34 deaths associated to e-cigarettes.4 Most of these cases involved e-liquids that contained tetrahydrocannabinol (THC) and were obtained off the street or from informal sources. 

For more information, talk to your healthcare provider.  


Resources:

  1. Current Cigarette Smoking Among Adults in the United States | CDC. Centers for Disease Control and Prevention. 

  2. Barua RS, Rigotti NA, Benowitz NL, et al. 2018 ACC Expert Consensus Decision Pathway on Tobacco Cessation Treatment. JACC. 2018;72(25):3332-3365. doi: 10.1016/j.jacc.2018.10.027 https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm. Accessed October 3, 2019.

  3. Hajek P, Phillips-Waller A, Przulj D, et al. A randomized trial of e-cigarettes versus nicotine-replacement therapy. N Engl J Med. 2019;380(7):629-637. doi:10.1056/nejmoa1808779.

  4. Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html. Accessed September 29, 2019.

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