ELECTRONIC CIGARETTES - THE RESEARCH

CURRENT MEDICAL RESEARCH IN PEER-REVIEWED JOURNALS

Presented by Humaira Khan, MBBS, MCPS, MHSc, Physician and Epidemiologist

PLOS One

Efficiency and Safety of E-Cig - a 1 Year Randomized Trial

“In smokers not intending to quit, the use of e-cigarettes, with or without nicotine, decreased cigarette consumption and elicited enduring tobacco abstinence without causing significant side effects.”

Oxford University Press

E-Cigarettes: A Disruptive Revolutionary Technology

“When asking vapers about expectancies…ENDS [e-cig] were rated as superior to NRT [nicotine patch, gum etc.] for taste, satisfaction, health risks, negative physical feelings, cost and reduction of craving, negative effect and stress.”

Int J Env Res Public Health

Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers

“ECs are mostly used to avoid the harm associated with smoking. They can be effective even in highly-dependent smokers and are used as long-term substitutes for smoking.” “Side effects are minor and health benefits are substantial, especially for those who completely substitute smoking with EC use.”

Tests for the Chronic Toxicity of Propylene Glycol and Triethylene Glycol on Monkeys and Rats by Vapor Inhalation and Oral Administration

“…monkeys and rats were exposed continuously to high concentrations of these vapors for periods of 12 to 18 months.”

“Examination at autopsy…failed to reveal any differences between the animals kept in glycolized air and those living in the ordinary room atmosphere.”

Journal of General Internal Medicine

E-Cigarettes vs. Nicotine Inhaler

“The e-cigarette was more acceptable, provided more satisfaction, and had higher perceived benefit than the inhaler during this trial. E-cigarettes have the potential to be important nicotine delivery products…”

The Lancet

E-Cigarettes for Smoking Cessation - a Randomised Controlled Trial

“Verified continuous abstinence at 6 months after quit day was highest in the nicotine [16mg] e-cigarettes group…” “…because they have far greater reach and higher acceptability among smokers than NRT [nicotine patch], and seem to have no greater risk of adverse effects, e-cigarettes also have potential for improving population health.”

Informa Healthcare

Comparison of the Effects of E-cigarette Vapor and Cigarette Smoke on Indoor Air Quality

“For all byproducts measured, electronic cigarettes produce very small exposures relative to tobacco cigarettes. The study indicates no apparent risk to human health from e-cigarette emissions based on the compounds analyzed.”

Toxicology

Non-clinical safety and pharmacokinetic evaluations of propylene glycol aerosol in Sprague-Dawley rats and Beagle dogs.

“Aerosolized propylene glycol (PG) was generated…”

“There was no apparent tissue toxicity of the lung, liver and kidney in these studies”

BMC Medicine

E-Cig Potential Huge Public Health Benefit

“There is now a sufficient body of evidence available on several aspects and effects of EC for recent reviews to conclude that health care professionals and public health bodies should encourage smokers who cannot stop smoking using available treatments, or do not want to do so, to switch to EC.”

International Journal of Environmental Resaerch and Public Health

E-Cigarettes in Schizophrenics - a 12 month Pilot Study

“…e-cigarette substantially decreased cigarette consumption without causing significant side effects in chronic schizophrenic patients who smoke not intending to quit. This was achieved without negative impacts on the symptoms of schizophrenia…”

Eur Addiction Res

Estimating the Harms of Nicotine-Containing Products Using the MCDA Approach

“Cigarettes are the nicotine product causing by far the most harm to users and others in the world today. Attempts to switch to non-combusted sources of nicotine should be encouraged as the harms from these products are much lower.”

Regulatory Tox & Pharm

Effect of variable power levels on the yield of total aerosol mass and formation of aldehydes in e-cigarette aerosols

“One device [Device 5] produced less than 1% of the aldehydes delivered from 20 combustible cigarettes per day and the OSHA
workplace exposure limit.”

“The extreme levels of aldehydes produced by Device 1 indicate that the coil may have overheated due to lack of liquid in the wick.”

NIH Public Access

Clinical Laboratory Assessment of the Abuse Liability of an Electronic Cigarette

“Electronic cigarettes can deliver clinically significant amounts of nicotine and reduce cigarette abstinence symptoms and appear to have lower potential for abuse relative to traditional tobacco cigarettes…”

BMC Public Health

Chemistry of Contaminants in E-Cigarettes

“…there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns…Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern.”

BMC Public Health

Effect of an Electronic Nicotine Delivery Device (e-Cigarette) on Smoking Reduction and Cessation: a Prospective 6-Month Pilot Study

“Combined sustained 50% reduction and smoking abstinence was shown in 22/40 (55%) participants, with an overall 88% fall in cigs/day.” “The use of e-Cigarette substantially decreased cigarette consumption without causing significant side effects in smokers not intending to quit.”

We are not permitted by current Canadian regulations to make any claims that e-cigarettes are proven to be effective smoking cessation or harm reduction tools.  However, the current medical research sends a strong, clear and consistent message! We encourage you to review the literature and form your own opinion. One of our roles as medical experts is to educate the public. A sample of the current research is provided here. Full text articles are available by clicking the medical journal titles. In some cases the articles are not freely available online. For those, only the abstracts are provided.

Akbar Khan, MD

Medicor Director, Medicor Cancer Centres

As you can see, over the last several years, extensive research has been conducted on e-cigarettes. Despite the mounting evidence supporting the effectiveness and superiority of these devices, we continue to see a negative stance of certain large organizations who favour “approved” smoking cessation strategies over e-cigarettes. From our years of work with “unapproved” therapies, we know that approval does not mean a drug or therapy is the most effective or safest. We encourage you to read the research for yourself and form your own conclusions. We believe that understanding the research will allow you to start working on your own cancer prevention strategy today!

Humaira Khan, MBBS, MCPS, MHSc

Epidemiologist and President, Medicor Cancer Centres

For completeness, we mention the fact that there are a small number of studies that demonstrate some negative findings of electronic cigarettes. An example includes the findings of potentially harmful chemicals found in the vapour. We have critically reviewed these studies and find that they are not applicable to high quality e-cigarettes that used properly. Some cheaply-made e-cigarettes have been found to contain impurities, which is why we recommend using only a high quality premium brand. Also, if any e-cigarettes are used improperly, it can result in burning of the flavoured liquid contained within them. This will result in the production of a small amount of harmful chemicals that may be inhaled. This is easily prevented by following the manufacturer’s instructions for proper use of your premium e-cigarette device.

The issue is very similar to cooking food: if cooked properly at the right temperature, cooking is safe. However, if food is burned or heavily smoked, it can become carcinogenic.

Certain premium e-cigarette brands now have precise temperate-controlling batteries which prevent the burning of flavoured liquids due to improper use. These devices address the concerns related to overheating the flavoured e-liquids.

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