Demystifying Medicine One Month at a Time

Tag: e-cigarettes

To Vape or Not to Vape

Chances are these have sprouted up in your city.

Chances are shops like these have sprouted up in your city.

This e-cigarette thing is getting interesting.

Proponents: They’re an alternative to smoking. They’re acceptable in public, even indoors. They have no tar, tobacco, or carcinogens. They help people QUIT smoking. [They’re cool.] They’re collectible. They will do to cigarettes “what the computer did to the typewriter.”

Opponents: Nicotine, whether in an e-cig or a tobacco cigarette, is still bad for you—and addictive. There’s no EVIDENCE [yet] that e-cigarettes are safe. There’s no EVIDENCE [yet] that they help people quit smoking—that’s just marketing hype. The vape (yes, verb form of “vapor,” gerund form: “vaping”) industry has already been co-opted by Big Tobacco and it’s marketing muscle, and e-cigs are already being marketed at kids, to get them hooked early.

We’re living in the Wild West, as far as vaping is concerned. Enjoy all the rhetoric around vaping for another year, until scientific evidence builds. Trust that it will. There’s a lot of money at stake.


Congratulations to the Simpsons on achieving 500 episodes. Twenty-three years is multiple generations in TV time.

Like a bit from the show [maybe an Itchy and Scratchy cartoon, a Homer invention, or a plot attempt against Fat Tony], there was a news story last week that bears further comment.

I’ve written before about my awakening to the phenomenon know as e-cigarettes. Just including that very word in this blog post insures I will be flooded with spam before the day is out.

A man in Florida (where else?) was smoking an e-cigarette when it blew up in his mouth.

According to the AP story, the explosion

[left] him in a hospital with severe burns, missing his front teeth and a chunk of his tongue…[The patient] was at…home…when the device exploded, leaving behind burned carpet, chair cushions, pictures and office equipment.


A rather steep price to pay for quelling an oral fixation.

The debate about these things swirls around their efficacy as tools to quit smoking vs. their safety (or lack thereof) as nicotine-delivery machines.

The FDA attempted to regulate e-cigarettes as drug delivery devices, and on that basis block their import (from China). Manufacturers sued, and a federal district court issued a stay on the reasoning that e-cigarettes are tobacco products and not medical devices. A Court of Appeals upheld the lower court’s ruling, thereby blocking the FDA from blocking importation.

Got that?

Now we have a flood of these things on the market, and all kinds of claims about them.

If you read the comments at the bottom of the CBS story I linked to above, you’ll get a flavor for it. Some see this news story as nothing more than a propaganda piece to help the FDA in its attempt to ban e-cigarettes. Other commenters share their beliefs about how effectively e-cigarettes helped them quit smoking.

But the best comment was this:

. . . he should have smoked a doob. A seed or two might pop, but he wouldn’t have ended up in the hospital.


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.

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