Expert Opinion: 3 Things a Philly Doc Thinks You Should Know About E-Cigs



You’ve probably heard the term “vaping” a lot recently. It’s used to describe the use of e-cigarettes and experiencing the inhalation of the “vapors”  from the product. Vape shops are cropping up everywhere in Philly, allowing customers to use e-cigarettes in their venues and tapping into the now billion dollar industry.

No doubt, sudden prevalence of these cafes is strengthening the marketing strategy for e-cigs, but it raises some questions, too. As a physician, it’s important for me to understand lifestyle habits of patients that may place their health at risk. I’ve added e-cigarettes to my history-taking list of questions. From a public-health perspective, here are some answers to some of the concerns:

Are e-cigarettes safe?

The companies manufacturing them say they are, but they are currently unregulated by the FDA. (It should be noted that last month, the FDA took the first steps toward e-cig regulation.) Many in the medical community have called for their ban, stating that although the nicotine may be synthetic, inhaling the vapors of this chemical has unknown health effects. Physicians will need to expand their lifestyle history-taking questions to include use of e-cigarettes, when querying about smoking habits.

Some companies are claiming e-cigarettes aid in smoking cessation. Is this true?

Currently there is no evidence to support this claim for the products, and in fact, a recent small study found the opposite to be true: that e-cigs don’t help you quit at all. In general, non-therapeutic e-cigarette products are not a proven smoking cessation aid and should not be marketed or used in this fashion.

Can minors purchase these products?

It varies from state to state, and even city to city. Last month, Philadelphia mayor Michael Nutter signed into law a bill which bans the sale of e-cigs to minors, and also bans the use of e-cigs in public places, like stores, movie theaters, schools and more. The state of Delaware is close to passing a ban on sales to minors, while the PA State Senate has been kicking around a similar bill, currently stuck in the appropriations committee, since last summer.

We have made great strides in promoting smoking cessation and improving warning labels on packaging indicating the health consequences of smoking, but I’m worried e-cigarettes is setting us back. Why sensationalize putting a nicotine-containing stick back in the mouths of all those who have given up smoking or in to the mouths of young adults, knowing what we don’t know about them?

By sending a consistent message, vaping should be banned in public places and we should enforce the same restrictions on access to e-cigarettes that currently exist for conventional products, at least pending the research we need to better understand the consequences of its use.


Bindu Kumar, M.D., is a Philadelphia-area physician with expertise in primary care and occupational medicine. She maintains her family medicine board certification in both the United States and Canada.

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  • Nate

    A doctor telling people they shouldn’t quit smoking. Brilliant.

  • SongsOfKensington

    The thing with vaping is that it’s well know what’s NOT in it – tar, and over 60 other carcinogens. This could be a revolutionary harm reduction tool and disruptive technology. And the claim about “e-cigs” not helping quitting may be quite true. The problem is, these studies are not congruent to the products actually being used. The link cited above was a study of first generation “e-cigs.” I had tried a first-gen for several days and did not quit smoking (“Proof” that they don’t work). With a second generation personal vaping device, I quit overnight and have been smoke-free for 7 weeks now, with absolutely no desire to go back to tobacco (this is an understatement). It could very well be that the research is behind the technology; this would not be the first time. And even if the devices do emit formaldehyde ([UCSF] which they apparently do, when heated to unrealistically high temperatures), compared to tobacco, there are still FAR fewer toxins. Additionally, when names of various noxious chemicals are being bandied about, please don’t forget to ask at what levels the measurements are showing, and then at what percentage of toxic threshold. “We don’t know” isn’t science. There are many things in actual day-to-day life that “we” do not know. When making judgments. let’s stick to what we do know. I, for one, wholeheartedly welcome all future research.

  • SongsOfKensington

    “Currently there is no evidence to support this claim for the products…”
    That’s not what the Royal College of Physicians (UK) research shows. The evidence may vary and be open to interpretation (as is all evidence), but it’s not “no” evidence.