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Smoking Cessation Health Center

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E-Cigarettes: Expert Q&A With the CDC

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Q: But is it bad if people use electronic cigarettes as a nicotine replacement product, a way to quit smoking?

A: It’s illegal for e-cigarettes to be marketed as a smoking cessation aid. A [U.S. District Court of Appeals] judge said if they make medical claims, like the product helps people quit smoking, they’d need to go through a formal FDA process.

In the meantime, there are implied claims and a lot happening in social media, but most of the marketing is taken from the cigarette marketing playbook of 40 years ago -- as sexy and glamorous, a form of rebellion, and as a way to get around secondhand smoke laws. It’s working, unquestionably, because we’ve seen the doubling of use among adults. We certainly think we have enough evidence that if someone switched from a pack of cigarettes to e-cigarettes, it would likely be an improvement in their health. However, it’s important to realize the majority of smokers in the U.S. who experiment with these e-cigarettes continue to smoke and use e-cigarettes sporadically in social situations where they can’t smoke.

Q: The CDC says e-cigarettes have far fewer toxins than conventional cigarettes, so why issue warnings?

A: There are 250 brands of these e-cigarettes and they’re completely unregulated, so what is in one may be different than another. Some have small levels of cancer-causing chemicals, some don’t.

The more important thing is that people will be exposed to nicotine. ... Nicotine is addictive. ... It’s not a benign chemical.

Q. Is nicotine by itself a harmful substance?

A: Nicotine is not the main ingredient in cigarette smoke that is harmful.

Nicotine’s main “harm” is that it is a psychoactive chemical that is the primary driver of a smoker’s desire to continue smoking cigarettes. Smokers become addicted to it, and continue to crave smoking and suffer withdrawal symptoms when they stop.

Nicotine does have some direct harms that we know about. In general, these are less-well understood than the effects of tobacco smoke, because until recently most people got their nicotine from cigarettes. However, we know that nicotine contributes significantly to the harms to the developing fetus, probably through direct effects on the placenta as well as from passing across the placenta into the fetus. Some of this is likely related to how nicotine acts to constrict blood vessels.

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