Don’t recommend e-cigarettes to patients as part of their smoking cessation efforts, advised researchers from the University of North Carolina at Chapel Hill in a commentary published in the latest issue of the Annals of Family Medicine. The reasons for this are three-fold, they added, and include the fact that existing therapies are more effective for smoking cessation, providers may incur professional ethical concerns by recommending e-cigarettes, and the safety of e-cigarettes is not supported by any strong evidence.
“Providers should not routinely recommend e-cigarettes to patients until we have far more data on their safety and effectiveness compared to established, FDA-approved medications,” said Adam O. Goldstein, MD, MPH, a UNC Lineberger Comprehensive Cancer Center member and professor in the UNC School of Medicine. “There are very few therapeutic devices that we recommend that aren’t regulated, that have potential and real side effects, and that are addictive. There are safer and more effective smoking cessation products for the same condition.”
In May, the FDA extended its authority to include e-cigarettes, and thus, these products will be subjected to greater regulatory oversight. This, noted researchers, will ensure that these products meet higher safety standards.
“We need more data on effectiveness, we need more data on safety, we need technology that’s safe so the products don’t explode, we need to ensure they’re childproof,” said Dr. Goldstein. “Right now, we don’t know the different amounts of ingredients in these products. We don’t know about the nicotine levels that patients are getting.”
This article was published as a counterpoint to another article in the same issue written by Ann McNeill, PhD, professor of tobacco addiction at King’s College in London, in which she suggested that e-cigarettes may be a less harmful way for smokers to use nicotine or quit smoking.
“Though e-cigarettes are likely not as harmful as conventional cigarettes, a growing number of studies report that they are by no means harmless,” said Clare Meernik, MPH, a research specialist in the UNC Department of Family Medicine. “Short-term effects include exposure to toxins, reduced respiratory and lung function, and burn-related injuries from exploding devices.”
Dr. Goldstein and Meernik analyzed all existing research on e-cigarettes, and drew from their experience in running the UNC School of Medicine Department of Family Medicine Nicotine Dependence Program, designed to help tobacco users.
“The emergence of any intervention or product promoted as a smoking cessation aid excites many providers, but such tools need to be proven safe and effective before providers routinely utilize them. Debates such as this can help clarify the evidence for providers and ensure that patients are receiving the highest quality treatment,” Meernik concluded.