Doctors should embrace e-cigarettes as a method of smoking reduction

The health risks associated with cigarette smoking have been documented for decades. According to the U.S. Centers for Disease Control and Prevention, 480,000 Americans die every year from cigarette smoking. Fewer than 1 in 10 adults who smoke cigarettes succeed in quitting each year. Traditional smoking cessation methods and incentives fail for over 90% of smokers. To reduce negative health outcomes and save lives, we need to use every available tool to maximize smoking cessation results and improve public health.

As a retired head and neck ENT surgeon for over 30 years, I’ve treated countless patients suffering the consequences of cigarette smoking. While some will continue to use tobacco regardless of medical recommendations, many smokers are trying — and failing — to quit. We need to consider less harmful alternatives.

There is strong evidence e-cigarettes expose the user to far fewer and lower levels of toxicants than tobacco cigarettes. While long-term effects of e-cigarette use are unknown, the current science supports that reduced cigarette exposure will result in reduced harm. While the initiation of any tobacco-related product is greatly discouraged, the transition of a population who smoke cigarettes to e-cigarettes is expected to significantly improve public health and health costs. 

Drs. Karin Kasza and Andrew Hyland at the Roswell Park Comprehensive Cancer Center have examined five years of data from the U.S. Population Assessment of Tobacco and Health (PATH) study, a long-term study of tobacco-use patterns and health outcomes. The study examined 1,600 adults who smoked cigarettes daily, did not use e-cigarettes, and were not planning to quit smoking at the beginning of the study. The study compared quit rates between those who took up e-cigarettes and those who did not. The study concluded that smokers who initiated e-cigarette use daily were eight-fold more likely to quit cigarettes altogether and almost 10-fold more likely to quit smoking cigarettes daily.

Nancy Rigotti, professor of medicine at Harvard Medical School and director of the Tobacco Research and Treatment Center at Massachusetts General Hospital, recently stated in the New England Journal of Medicine: “The available evidence indicates that switching completely from smoking combustible cigarettes to vaping nicotine e-cigarettes substantially reduces a person’s exposure to tobacco toxins, reduces respiratory symptoms, and reverses smoking-related physiological changes.”

Another study found that the presence of vapor products did not increase the likelihood of smoking among young people, and actually encouraged more adult tobacco smokers to quit.

Researchers from Georgetown and Yale universities found that the continued use of nicotine vapor products would save 1.8 million lives by 2060. They conclude that the continued presence of e-cigarettes/vaping products is a net positive on public health outcomes because they are helping transition people away from harmful traditional cigarettes.

Study after study proves that nicotine alternatives, including vaping products, are significantly safer than cigarettes. It’s the tar and other cancer-promoting chemicals in traditional cigarettes that cause the majority of tobacco-related health problems.

If we want to greatly reduce tobacco-related deaths, we need to approve and encourage e-cigarettes in the tobacco-abusing population as a cessation tool.

Both state and federal policymakers should further advance public health policies through recognition of e-cigarettes/vaping as an alternative in tobacco-cessation policies. It’s time for the United States to recognize what leading scientists and innovative public health experts have demonstrated. Moving smokers away from cigarettes to less harmful alternative options like e-cigarettes will save millions of lives.

Dr. Timothy Tolan is a retired head and neck surgery otolaryngologist in Henderson.