They are referred to as "ENDS," which stands for electronic nicotine delivery systems. Healthcare officials have hoped these e-cigarette devices would facilitate "ends" to smoking addiction. Unfortunately, they may be bringing about faster "ends" to optimum health and leading to increased rates of smoke-inhaled tobacco.
Research shows the use of e-cigs among adolescents seems to lead to the use of cigarettes, not curtail it. The effectiveness as a cessation aide among adults is not clear.
A recently published study in Tobacco Control examined longitudinally how adolescent use of e-cigs related to later smoking behaviors. Thomas A. Wills, M.D., from the Prevention and Control Program at the University of Hawaii Cancer Center and his colleagues investigated e-cigarette use, tobacco cigarette use and factors related to psychosocial influences such as demographics, parental involvement, rebelliousness and sensation seeking.
The flavoring used in e-cigs has already been linked to health problems. Wills and his team wanted to determine whether e-cig use influenced later smoking in those adolescents who had never smoked cigarettes or to see if the e-cigs caused a decrease in smoking in those adolescents who had already undertaken smoking.
They found an increased likelihood to smoke if the adolescents who had never smoked started using e-cigs. The use of e-cigs among those who already smoked did not change the frequency of smoking and thus did not facilitate quitting.
The potential of e-cigs being a successful means to facilitate quitting the smoking habit is not without controversy. A meta-analysis study reviewing 569 publications (of which five fit criteria for the analysis) found e-cigs did contribute to cessation of smoking when compared to placebo e-cigs, but this was a trend and not statistically significant. The analysis concluded that larger better controlled studies were necessary.
The disparate opinions are evident in how different countries are responding to and advocating for the use of e-cigs. Health groups in the United Kingdom think e-cigs should be recommended for smoking cessation and harm reduction as a low-cost intervention, particularly in groups where smoking is so prevalent.
Epidemiologist Sharon Green, MPH from Columbia University in New York City and her colleagues commented on this conclusion: "In England, where leading medical organizations regard nicotine alone as relatively benign, the pressing need to reduce the risks for current smokers frames the debate. The overwhelming focus in the United States is abstinence. It is in this broader context that the focus on children and nonsmokers must be viewed."
But for Vince Willmore, vice president of communications for the organization National Center for Tobacco Free Kids, marketing of e-cigarettes is a major concern.
"These products are being marketed using the same tactics once use to sell cigarettes to kids, including celebrity endorsements, slick magazine ads and sponsorship of auto racing and concerts," Willmore told MedPage Today. "We need the FDA to take action to prevent the marketing and sale of these products to kids and to evaluate the evidence to help determine if e-cigarettes can really help smokers give up cigarettes."
What is clear from the study of adolescents in Hawaii is that kids are vulnerable to the media messages about e-cigs. This was demonstrated to lead to smoking of other products. E-cigs cannot yet be considered a good thing.
