Thank you for Not Smoking

How well does e-smoking approximate the real thing?

Hope you had a pleasant Thanksgiving. GlassHospital was on the road again, taking the kids to visit the hometown of Cleveland, health mecca of the eastern Midwest.

E-cig smoked by a stunt double for my Uncle Ron.

Had Thanksgiving dinner at my aunt and uncle’s. My aunt is a culinary master; she loves to pull out all the stops, including the homemade apple pie that helped define my youth.

I came away feeling a bit gluttonous. Fitting, I suppose, for the holiday.

But gluttony is not the sin for today. No, today’s sin is smoking.

There has been a convergence of recent news stories regarding the nasty habit that have grabbed my attention:

First, a Lancet article (subscription required) claiming that secondhand smoke kills–to the tune of six hundred thousand lives per year worldwide. The study was done by the World Health Organization (WHO?), and compiled statistics from 192 countries. A data set that broad is not too shabby. [Readers from almost that many countries have enjoyed reading GlassHospital, if we’re to believe Google Analytics.]

Secondly, a recent commentary written under the heading “Ideas and Opinion” in the Annals of Internal Medicine introduced me to something that I’d never seen before Thanksgiving: the electronic cigarette (the “e-cig”).

Oddly enough, in our post-Thanksgiving stupor, what do you think I saw? My Uncle Ron, a longtime smoker, proceeded to sit in the comfy TV room chair and “light up” cigarette after cigarette.

I was surprised, because Uncle Ron’s smoking has been shunned by the rest of the family to the point where he’ll usually go outside or hide in his room if he’s going to light one up. I was also surprised since even though he’s an inveterate smoker, I’d never seen him chain smoke one after the other like that.

And with kids in the room!

Then I noticed the strange glow from the tip of the cigarette. Orange. Bright orange. Perfectly bright orange with a blue halo. And the way the smoke seemed to come out in a consistent volume whether he was puffing on it or not.

Uncle “Smoke” (as my niece and nephews affectionately used to refer to him) was smoking an e-cig!

Coincidence? I think not.

My cousin had introduced his Dad to the e-cig in the hope that he’d use the device(s) to help himself quit.

The e-cig is an aerosolized nicotine delivery device that uses a battery to deliver the “medicine” and create the “vapor” that emanates from the cigarette’s tip to simulate the controlled burn of tobacco and paper in a real cigarette.

As the title of the Annals piece states, e-cigarettes are “a rapidly growing internet phenomenon.” As such, it behooves us to treat this phenomenon with a healthy degree of skepticism. The Annals piece concludes by making the unsurprising claim that more research needs to be done into the products, their effects, and their unintended consequences. For example, just how “safe” is that vapor for non-users in the vicinity of an e-cigarette? And, is there any compelling evidence that absorbing nicotine in this way really helps hard core smokers to cut down or quit?

My first impression was that my uncle was actually “smoking” more, since he no longer was leaving the room to smoke.

After Thanksgiving, my curiosity about e-cigarettes grew. If they’re so “safe,” could they be smoked in hospitals so that addicts could get their fix of nicotine in a way non-harmful to others?

Indeed, a quick internet search turns up this. But take it with a boulder of salt, since it’s a press release from a manufacturer. They do not identify the Tampa hospital that purportedly permits this, nor do they give other examples of accommodating hospitals, even though the headline boasts of e-cigarettes being accepted in “many hospitals.”

For his part, Uncle Ron seems to like the products. He’s “present” more at work, since he now doesn’t need to go outside to smoke. As to whether the e-cigs are helping him quit his tobacco habit, he (and those around him) remain uncertain.