Published April 23, 2013
In January, I wrote here about my clinical experience that electronic cigarettes, or e-cigarettes as they are known, seemed to help my patients quit smoking, by transitioning them to an alternate form of nicotine delivery.
E-cigs simulate smoking, while not simulating it so well as to become addictive itself. In other words, the electronic cigarette served as a kind of “bridge” that helped people stay away from the real thing, then abandon the electronic cigarettes, too—leaving them smoke-free and nicotine-free.
At that time, patients were reporting these experiences to me, and I was taking note.
In the aftermath of that piece on FoxNews.com, two companies made its electronic cigarettes available to me so that I could offer them to patients who expressed a desire to switch from real cigarettes. Those two companies were LOGIC and NICOmate.
I am reporting now on three patients who received these products and benefited tremendously.
I have not been paid anything by either of these companies.
Patient #1 was a man in his 40s who was smoking a pack of cigarettes per day. Using electronic cigarettes dispensed to him during the course of two months, he gradually transitioned from cigarette smoking, to smoking fewer cigarettes and using electronic cigarettes, to using electronic cigarettes only, then to using no electronic cigarettes and being nicotine-free. He remains a nonsmoker.
Patient #2 was a woman in her 60s with chronic obstructive pulmonary disease, who was smoking two packs of cigarettes a day, despite her illness. She switched immediately to electronic cigarettes and abandoned those about three weeks later. She remains smoke-free today.
Patient #3 was a woman in her 30s who was overweight and suffering with depression. She used cigarettes (a pack a day) as a mood enhancer, which is common, due to nicotine's influence on one's mood. She transitioned to electronic cigarettes in place of tobacco and remains an electronic cigarette user, but tobacco-free, months later. Her use of electronic cigarettes has dramatically declined.
Mind you, these are not studies conducted with stringent structure. I have no way of knowing if my patients were being entirely honest with me about their tobacco use. But they seemed forthcoming and genuine and very excited about being able to quit tobacco.
The Food and Drug Administration currently prevents electronic cigarettes from being marketed as tobacco-cessation tools. While electronic cigarettes do contain carcinogens, they contain hundreds fewer than tobacco products.
And while it is not known precisely how safe they are, I conclude the following from my clinical experiences:
1) It is time for the National Institutes of Health to fund a large-scale study to determine if electronic cigarettes as a form of nicotine delivery help people stop smoking. Asking electronic cigarette companies to fund such research themselves is a needless roadblock to getting much-needed answers. Cancer kills too many Americans and people around the world to wait.
2) It is time for doctors to consider whether to recommend electronic cigarettes to their patients, as smoking cessation tools or even longer-term nicotine delivery systems, in advance of findings from any study undertaken by the NIH. I believe most doctors would agree they would happily have a child of theirs transition (hopefully, temporarily) to electronic cigarettes in a (possibly successful) effort to quit tobacco. If it is good enough for our families, it ought be good enough for any family.
Cancer, hypertension, heart attack, lung disease, dental disease and all manner of afflictions are ascribed to tobacco. With that scourge on our nation, holding up needed research on electronic cigarettes is indefensible and holding up their dissemination, in advance of that research, is, almost certainly, unwise.