Chinese pharmacist Hon Lik had good reasons for inventing the first commercially viable electronic igarette. His father died of smoking-related lung
cancer, and Hon himself tried unsuccessfully to quit using the
nicotine patch. One night in 2003 he dreamed he was drowning
in a sea that turned into a cloud of vapor, and awoke inspired
to create a safer product based on liquid vapor, rather than
combusted smoke. He received a patent for the device in 2007.
Since then, an estimated 250 e-cigarette brands have become
available in the United States alone. Use nearly doubled among
adults from 2010 to 2011 — from 3. 3 percent to 6. 2 percent in
Web-based surveys, or about 15. 5 million people — and more
than doubled among minors from 2011 to 2012, according to the
Centers for Disease Control and Prevention. Wells Fargo Bank
tobacco analyst Bonnie Herzog has predicted that e-cigarette
sales will outstrip regular cigarette sales within a decade.
But are e-cigarettes safe? So far, that question remains
unanswered. On the individual level, they appear to be much
less harmful than traditional cigarettes, and as such, have the
potential to serve as a relatively healthy substitute for people
who smoke — provided they quit smoking, say tobacco experts,
including Johns Hopkins University School of Medicine
psychologist Jack Henningfield, PhD, who also is vice president
of Pinney Associates, a consulting firm that addresses issues
related to the science of tobacco and pharmaceuticals. (In
January, the company signed an agreement with Sottera,
which manufactures the e-cigarette NJOY, to provide them
with scientific, regulatory and policy support to encourage
regular adult smokers to adopt these devices as an alternative to
But concerns remain. Among them is a lack of regulation,
since there are no specific quality control standards on
e-cigarettes, except those that apply to all consumer products.
Relatedly, critics are worried about contaminants. And there are
questions about e-cigarettes’ long-term health effects and the
potential dangers of second-hand vapor.
More to the point for psychologists are behavioral concerns
and how to minimize them. Studies to date have not shown
regular use among non-smokers, but how can researchers and
policymakers make sure e-cigarettes won’t act as “gateways”
However these questions are answered, one thing is certain:
Because of the lack of appeal of nicotine replacement products
like gum and patches — they’re expensive, available only in
pharmacies and often not used as directed — e-cigarettes hold
a lot of promise as a new way to help smokers quit or reduce
“It’s the first time in 100 years that we’ve had a real harm-reduction alternative,” says psychologist David Abrams, PhD,
of the Schroeder Institute for Tobacco Research and Policy
Studies, Johns Hopkins’ Bloomberg School of Public Health
and the Georgetown University Lombardi Comprehensive
Cancer Center, who expands on the topic in a Jan. 8 editorial in
the Journal of the American Medical Association. “There’s every
indication that e-cigarettes may be both a safe and appealing
way to get your nicotine.”
What are e-cigarettes?
E-cigarettes — also known as ENDS, or electronic nicotine delivery systems — look and act a lot like regular cigarettes. They’re
plastic or metal rods that can light up at the end and release vapor that looks like smoke when puffed — an action popularly
called “vaping.” When users inhale, they get a nicotine hit.
Unlike combustible cigarettes, though, they have a battery-operated heating element and cartridge that contains nicotine,
water, glycerol, propylene glycol, flavorings, and in some cases,
trace amounts of other potentially dangerous ingredients,
like metals. Puffing on the device activates the heater, which
vaporizes the nicotine solution.
They are believed to be safer than conventional cigarettes
largely because they don’t deliver toxic elements like tars
and carbon monoxide through burning. (While nicotine is
addictive, it does not harm adult health at the amount delivered
in smoking or vaping.) But it’s their design that makes them
Black electronic cigarette (e-cigarette) with e-liquid bottle.