Electronic cigarettes are worth trying as a last option for smokers seeking to quit, the biggest U.S. heart health advocacy group said.
The American Heart Association, in a policy statement released today, said physicians shouldn’t discourage e-cigarette use as a last resort to drop a smoking habit.
E-cigarettes have leaped in popularity and the U.S. Food and Drug Administration is weighing regulations for the devices in a market that could total as much as $5 billion next year. Doctors are uncertain what advice they should offer about the products, said Aruni Bhatnagar, lead writer of the policy statement from the Dallas-based nonprofit group and a professor of medicine at the University of Louisville in Kentucky.
“If people cannot quit at all and have tried everything in the field, we would not discourage them,” Bhatnagar said of e-cigarettes. “It’s not something that we would suggest.”
“We do not know for sure and the jury is still out whether or not these e-cigarettes are safe to use, so we do not say that they’re safe,” he said in a telephone interview.
E-cigarettes typically contain nicotine and none of the tobacco or tars, arsenic and other chemicals found in traditional cigarettes. The devices are battery powered and produce a vapor to mimic smoking. Lorillard Inc. (LO) agreed to sell the popular Blu e-cig brand to Imperial Tobacco Group Plc (IMT) as part of its proposed acquisition by Reynolds American Inc. (RAI)
Mitch Zeller, head of the FDA’s Center for Tobacco Products, said the agency is keeping an open mind about whether the devices have a health benefit, such as helping someone stop smoking.
The heart association said e-cigarette use should be supported as a quitting mechanism only if smokers are intolerant of, fail at, or refuse other options.
“However, subjects should be informed that although e-cigarette aerosol is likely to be much less toxic than cigarette smoking, the products are unregulated, may contain low levels of toxic chemicals, and have not been proven as cessation devices,” according to the heart group’s policy statement.
Cigarette smoking has been linked to coronary heart disease, which can lead to heart attacks; increased blood pressure; and a higher risk of blood clots, according to the heart association. Nicotine can cause a short-term increase in blood pressure and heart rate, the group said.
The National Heart, Lung and Blood Institute gave the University of California at Riverside, almost $34,400 last year to study the health effects of e-cigarettes on developing embryos and adults, according to a database of National Institutes of Health research. The study is slated to end in December 2016.
The National Institute on Drug Abuse also gave the university $205,200 to study whether electronic cigarettes are less harmful than traditional smokes.
Research so far hasn’t shown electronic cigarettes work better than other products as a cessation device.
“Current evidence suggests at best a modest effect on cessation, likely equal to or slightly better than that of nicotine patches without behavioral support,” according to the heart association’s policy statement.
Because of the lack of long-term data on e-cigarette use, the organization suggests smokers who use them to quit set a date to terminate their e-cigarette use and not rely on the devices indefinitely. The policy statement still advises tobacco use surveys at doctor visits and workplace health screenings to include questions on e-cigarette smoking.
While sales of the devices could reach $5 billion next year, up from $1.5 billion in 2013, according to Kenneth Shea, a Bloomberg Intelligence analyst, their use appears to have stalled as traditional smokers reject the products and competition increases from generic vaporizers that can be refilled with liquid nicotine.
Sales of electronic smoking devices declined 2.9 percent in the four weeks ended May 18 compared with the previous year and slid twice as fast the following month, according to data from Chicago researcher IRI.
The dip also comes after the FDA proposed in April to expand its regulation of cigarettes to the electronic versions and cigars. The agency would restrict sales to minors, ban free samples and require nicotine addiction warnings for the products though it didn’t prohibit TV advertising or flavored products.
The American Heart Association was part of a joint response to the FDA’s proposal calling on the FDA to ban flavors and marketing to youth. The heart association also said e-cigarettes should be included in states’ smoke-free laws that prohibit smoking in certain places to limit second-hand exposure.
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