Smoking cessation experts weigh in on e-cigarettes

MD Anderson News Release August 14, 2013

E-cigarettes not yet proven safe; potential gateway to tobacco for youth

MD Anderson News Release 08/14/13

With the third and largest of the U.S. tobacco companies planning an e-cigarette product launch this fall, this next frontier for “Big Tobacco” provides renewed presence in a declining marketplace. It’s also a potential gateway to new smokers, particularly among teens and in emerging/foreign markets, according to behavioral scientists at The University of Texas MD Anderson Cancer Center.

E-cigarettes are battery-powered devices that provide inhaled doses of nicotine vapors and flavorings. The Centers for Disease Control and Prevention estimates that about 6 percent of adults have tried e-cigarettes, a number that has nearly doubled since 2010. Absent of tobacco, e-cigarettes have been promoted as a possible aid in getting people to stop smoking and thereby reducing their lung cancer risk.

However, MD Anderson cancer prevention experts Paul Cinciripini, Ph.D., director of the Tobacco Treatment Program, and Alexander Prokhorov, M.D., Ph.D., head of the Tobacco Outreach Education Program, caution that more research is needed to understand the potential role of e-cigarettes in smoking cessation.

“Independent studies must rigorously investigate e-cigarettes, as there’s considerable potential benefit in these products if they’re regulated and their safety is ensured,” says Cinciripini. “But promoting the e-cigarettes already on the shelves as ‘safe’ is misleading and, if looked at as a harmless alternative to cigarettes, could potentially lead to a new generation of smokers more likely to become tobacco dependent.”

With the impending introduction of another e-cigarette, Prokhorov and Cinciripini urge consumers to know the following information.

  • E-cigarettes are unregulated and there’s little research on their safety or efficacy as smoking cessation tools. “These products are not approved by the Food and Drug Administration and this is concerning because it’s impossible to know what you’re really getting or if it’s safe. In one analysis nicotine levels have been shown to vary widely among e-cigarette products,” says Prokhorov. For now, he recommends that those looking to quit stick with approved devices, such as nicotine inhalers.
  • Switching from tobacco to e-cigarettes could help smokers avoid approximately 6,000 chemicals, some of which are human carcinogens. “Reduced exposure to harmful chemicals warrants research of these products as a smoking cessation vehicle,” says Cinciripini. “Unbiased studies, free from the ethical and legal challenges of ‘Big Tobacco’-sponsored trials, are needed.”
  • Branded as “safer,” available in a variety of colors and flavors and promoted by celebrities, e-cigarettes could be a hook for future smokers. “E-cigarettes are a novel way to introduce tobacco smoking to young people, and their potential ‘gateway’ role should be a concern for parents and health officials alike,” adds Prokhorov.

“Once a young person gets acquainted with nicotine, it’s more likely that they’ll try other tobacco products. E-cigarettes are a promising growth area for the tobacco companies, allowing them to diversify their addictive and lethal products with a so-called “safe cigarette,” says Prokhorov. “Unfortunately, there’s no proof that e-cigarettes are risk-free.”

Cinciripini has more than 30 years’ experience conducting basic and clinical research in smoking cessation and nicotine psychopharmacology. Prokhorov is the principal architect of MD Anderson’s ASPIRE program, a teen-focused website and, Tobacco Free Teens, a smartphone app – both are new approaches to keeping young people free from the grips of nicotine addiction.

MD Anderson is home to one of the largest tobacco research programs in the nation, part of the cancer center’s Cancer Prevention division. The Tobacco Treatment Program, funded by State of Texas Tobacco Settlement Funds, offers in-person behavioral counseling and tobacco-cessation medication treatments free to MD Anderson patients who are current tobacco users or recent quitters. The program also works with patient families and the general public.