Marc Siegel, MD
Marc Siegel, MD

Smoking is still a big problem in the U.S., with 43 million people, or 19% of all adults, using cigarettes. I have tried many approaches to get my patients to quit, but none of them are effective across the board. Most people quit cold turkey, some respond to nicotine patches or gum, and another group to the anti-depressant wellbutrin, which decreases the compulsion to smoke. I find the nicotine blocker Chantix to be the most effective smoking cessation agent overall, but I'm often afraid to utilize it because it can provoke anxiety.

So, many physicians, myself included, are still on the lookout for the best aid to help most of our patients stop smoking. E-cigarettes, battery-operated devices which provide nicotine vapor, are very promising. The FDA is monitoring them, and has raised concerns about not knowing the amount of nicotine that is released, as well as whether they are completely safe. There have been cases of burns and explosions from electronic cigarettes.

But it looks like the momentum is now moving in the direction of e-cigarettes. Several studies have now shown this method to be highly effective, and an Italian study just released by PLOS ONE showed that 13% of participants were not smoking a year after starting to use e-cigarettes.

Don't get me wrong, there are still concerns. Other studies have shown that e-cigarettes may contain toxic ingredients and may impede lung function. Uniformity of safety information and precautions are lacking. And though e-cigarettes appear to be an effective short-term bridge to stopping smoking, the FDA has also raised concerns that they could lead to longer term nicotine addiction in some people.

One thing's for sure. We need more effective methods to help people stop smoking before they develop heart disease, strokes, lung cancer or emphysema. E-cigarettes may need refining, but the promise is there, even if the news media, as usual, has done an uneven and ineffective job at reporting this promise.
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