E-Cigarettes: Do they work? Are they safe?

e-cigarettesE-Cigarettes, personal vaporizers, PVs, or “vapes” were introduced in the US market in 2007.  The number of people who are using this electronic nicotine delivery device is growing at such a rate that dental professionals are taking a closer look at the potential health risks, the safety and effectiveness of the smoking method.

In 2009, the Food and Drug Administration banned the importation of these devices on the grounds that they are classified as a drug delivery device for therapeutic use. The FDA performed tests for impurities that pose potential health risks.  One such impurity, Diethylene glycol used in anti-freeze, was found in some of the e-cigarette devices. Tobacco-specific nitrosamines, a known human carcinogen, were present in half the samples tested. All but one of the device cartridges labeled as containing no nicotine had low levels of nicotine present. Ultimately, the classification of e-cigarettes as therapeutic drug delivery devices was overruled on the grounds that the device is not specifically marketed for therapeutic use, i.e., to help people quit smoking, and therefore is not subject to regulation as a drug delivery device. Currently the devices are subject to regulation under FDA jurisdiction as tobacco products. The regulation of tobacco products is much less stringent than those applied to medical devices.

Because e-cigarettes are widely available in convenience stores and on the internet, the FDA states that the safety and efficacy of the device has not been fully tested and warns that no studies have been done to determine if the device is effective as an aid for smoking cessation.

The policy of Baylor Tobacco Treatment Services (Texas A&M University Baylor College of Dentistry) is not to recommend the use of the e-cigarette for smoking cessation.  However, for individuals who have independently elected to use the e-cigarette for cessation, use is not discouraged.

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