Should E-Cigarettes Be Heavily Regulated?

There seems to be little consensus among researchers about the health risks associated with e-cigarettes, but new research suggests that heavily regulating them may do more harm than good.

In a recent study published inAddiction, a team of 7 international tobacco control experts analyzed the use of both vaporized nicotine products (VNPs) and combustible cigarettes in an effort to better understand the effects of e-cigarettes on public health.

The researchers agreed that VNPs should be regulated, but they also noted that because VNPs are generally considered to be less harmful than combustible cigarettes, e-cigarettes are often used by smokers who are attempting to either reduce the health risks associated with cigarette use or transition away from tobacco altogether.

As a result, they encouraged legislators to carefully weigh the risks of VNPs against their potential benefits in helping smokers quit.

“While we favor common-sense regulations that will protect nonsmokers, especially children from using any tobacco product, we also don’t want to make it so costly and difficult for addicted smokers to get safer nicotine products that have the potential to help smokers quit,” said study author K. Michael Cummings, PhD, MPH, in a press release.

The researchers also distinguished between VNPs manufacturers that also sell combustible cigarettes and those that exclusively sell e-cigarettes, and they warned against imposing sweeping restrictions that may inadvertently benefit the former.

“Cigarette companies that have entered the smokeless tobacco market have encouraged dual rather than exclusive use and are likely to do the same with VNPs,” the study authors wrote. “By contrast, VNP companies that are unaffiliated with cigarette manufacturers want smokers to switch completely from cigarettes to VNPs.”

Meanwhile, many health organizations remain unconvinced of e-cigarettes’ reliability as a smoking cessation aid.

For instance, the American Lung Associationreportedthat 76.8% of e-cigarette users also smoke combustible cigarettes, indicating that many patients aren’t necessarily using VNPs to replace conventional smoking.

Additionally, the American Heart Association (AHA) has cautioned against the use of VNPs as primary cessation aids. Although the AHA acknowledged that “it is reasonable to support the attempt” to transition from combustible cigarettes to e-cigarettes among patients who refuse or don’t respond to conventional treatment, the organization emphasized that complete smoking cessation should always be recommended.

Fortunately, retail clinicians are well placed to help patientsachieve this goal.

Bill Blatt, MPH, director of tobacco programs for the American Lung Association,previouslysuggested that providers should use any clinic visit as an opportunity to ask patients whether they smoke, and then emphasize the importance of quitting if they do.

Clinicians can also recommend the use of an OTC nicotine replacement product or prescribe 1 of 2 available prescription drugs: Pfizer’s varenicline (Chantix) and GlaxoSmithKline’s bupropion (Zyban).

Retail clinicians can also educate patients about thehealth benefitsassociated with smoking cessation, such as improved circulation and lung function, as well as a reduced risk of coronary heart disease, lung cancer, chronic obstructive pulmonary disease (COPD), stroke, peripheral vascular disease, and premature death. Patients taking certain medications to treat COPD should also be warned that smokingmay decreasethe effectiveness of these drugs.