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It's still too early to tell the long-term impact of e-cigarettes

Jennifer Sprouse and Nathan Baker - Press Staff Writers • Sep 29, 2013 at 8:33 PM

There are a lot of differences between cigarettes and electronic cigarettes –– size, shape, smell –– but local medical experts say it’s hard to predict what the long-term health impact will be for current users.

E-cigarettes, fairly new products to the U.S. market, are “metal or plastic battery-powered devices resembling traditional cigarettes that heat a liquid nicotine solution, creating vapor that users inhale,” according to an Associated Press article.

Dr. Mirle Girish, a Mountain States Medical Group pulmonologist and a clinical associate professor at the East Tennessee State University Quillen College of Medicine, said the electronic alternative was introduced in the early 2000s as a way to help smokers break their smoking habit, but said the product’s long-term effects are still too early to tell.

He said the vaporized nicotine has proven to help patients wanting to quit smoking to combat their withdrawal, but said the vapor is not chemical-free.

“The vapor contains a few chemicals, namely glycerin and polyethylene glycol,” Girish said. “Studies have not shown (those chemicals) to be carcinogenic, but ... there’s not sufficient data to say that. We don’t know the long-term effect of this as of now.”

Some users, according to Girish, have seen a few medical problems associated with using the product, which include having lipoid or lipid pneumonia, a type of pneumonia where lipids enter the bronchial tree.

“It’s (the nicotine) a stimulant, so it can cause heart-rate increases, it can cause some GI, gastrointestinal, side effects,” he said. “Cigarettes ... have about 6,000 chemicals, which (are) carcinogenic. Compared to the cigarette ... it’s a whole lot ... safer.”

Girish said one area of concern with e-cigarettes, though, is that youths are beginning to using these products.

According to an AP article, a National Youth Tobacco Survey by the Centers for Disease Control said, “1.8 million middle and high school students said they had tried e-cigarettes in 2012, mirroring increases in the use of the product by adults.”

Dr. Hadii Mamudu, assistant professor in East Tennessee State University’s Department of Health Services Management and Policy, said around 76 percent of the people who reported using e-cigarettes are also using regular cigarettes.

“We don’t know what to do with it (e-cigarette),” Mamudu said. “It produces nicotine and nicotine is the key chemical in the tobacco product. The science is still not certain, but I don’t think that the e-cigarette has any positive health impacts.”

He said a study conducted in Germany found that the level of toxicity in e-cigarettes was lower than that of a regular cigarette, but said it still emits chemicals.

According to the AP, 40 attorneys general, including Tennessee Attorney General Bob Cooper, have written to the U.S. Food and Drug Administration to encourage the regulation of e-cigarettes and to regulate the products the same as other tobacco products.

Cooper said in a Knoxville New-Sentinel article that there is concern when a product that could turn out to be harmful is sold unregulated to the public, as well as that same product’s companies targeting youth through advertising.

Local users of the e-cigarettes say they help in the effort to quit smoking and also help to save money.

Keith Coffie said he has smoked cigarettes for around 40 years and said since switching to e-cigarettes in an effort to quit, he’s seen a change in his smoking habits.

“I’ve cut way back and ... everyday I’m cutting back more and more,” Coffie said. “They don’t taste exactly like a cigarette, but if you’re willing to quit they will help you. They help calm me down like a cigarette would.”

Coffie said he shopped around for starter kits at a discount tobacco store and said the cartridges used for smoking the e-cigarette seem to last a while.

“They’re cheaper than the cigarettes because I only paid like $32 (for the kit) and they’ve already lasted two weeks and that would’ve been probably $60 in cigarettes.”

At Shamrock Beverage & Tobacco on West Walnut Street, manager Robbie Turner said sales of e-cigarettes increased the past two years after a slow start.

The store offers a kit that includes a rechargeable unit and the liquid solution for about $40 and disposable units that cost about $8.

With the rechargeable vaporizer, users purchase the heating element only once and then buy more liquid solution as needed.

The disposable e-cigarettes don’t have rechargeable batteries or liquid refills, and are designed to be thrown away once they are empty. Still, even the disposable product lasts about as long as two packs of standard cigarettes.

“When they first came out, most people were going for the starter kits with the rechargeables,” Turner said. “Lately though, it seems like more people are getting the disposable kind.”

He said most customers buy the e-cigarettes saying they’re using them to help quit smoking.

Some buy a pack of smokes and a disposable unit, reasoning that they can use the e-cigarette in many places that don’t allow smoking.

Now that the novelty has worn off, Turner said sales are starting to slow, with a defined set of regular e-cigarette customers who tried them and liked them.

“A this point, there aren’t a whole of people who haven’t tried them,” he said. “Most people have decided that they’re going to keep buying them or they tried it and decided that they weren’t really for them and have gone back to regular cigarettes.”

But he said some people seem to have success using the e-cigarettes to help them quit smoking.

“I’m sure it’s better, because it’s just vapor, there aren’t as many carcinogens,” he said. “But we don’t really know what effect the chemicals in the juice will have or what inhaling water vapor regularly will do to you.”

In north Johnson City, on Princeton Road, Nola Edwards, a clerk at Cheap Cigs USA, said e-cigarette manufacturers seem to be creating products to help individuals quit smoking.

The blu e-cigarette, a popular brand at most stores, can be used with liquids that have differing levels of nicotine.

“They have lower and lower levels, and then they have some that don’t have any nicotine at all,” Edwards said. “A lot of people will come in here and say they’re trying to quit and ask questions about the e-cigarettes.”

Other customers buy the cigarettes to use in relatives’ homes that are sick or use bottled oxygen to breathe.

“There’s really not any kind of smell, and if there is, it’s mild,” Edwards said. “You can use them in a lot of places that you can’t normally smoke in.”

Both merchants said they didn’t see the need for tougher regulation on the products.

“You already have to be 18 to buy them, like tobacco products,” Turner said. “I think before they start changing the regulations on them they should at least study them more carefully to find out exactly what the risks are.”

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