Researchers from the University of North Carolina at Chapel Hill have taken issue with the suggestion that doctors should routinely recommend e-cigarettes as an alternative to cigarettes for their patients who smoke.
The researchers point out in a commentary published in Annals of Family Medicine that existing treatments are more effective than e-cigarettes to help people quit smoking, there are professional ethics concerns about providers who recommend them, and there is no strong evidence that e-cigarettes are safe.

The researchers described notable safety and health concerns about e-cigarettes. Batteries inside e-cigarettes have caught fire or exploded, and particulate matter from e-cigarettes, which has been shown to be present in similar numbers to cigarettes, can increase the risk of cardiovascular and respiratory diseases.

The UNC researchers’ commentary served as a counterpoint to a paper in the same journal issue by Ann McNeill, PhD, professor of tobacco addiction at King’s College London, that suggests e-cigarettes are a less harmful way for smokers, including those trying to quit, to use nicotine.

“Though e-cigarettes are likely not as harmful as conventional cigarettes, a growing number of studies report that they are by no means harmless,” wrote Clare Meernik, MPH, a research specialist in the UNC Department of Family Medicine. “Short-term effects include exposure to toxins, reduced respiratory and lung function and burn-related injuries from exploding devices.”

The researchers also noted that e-cigarettes have been less effective than existing treatments to help people quit smoking.

The Food and Drug Administration (FDA) announced it was extending its authority over all tobacco products, including e-cigarettes. Greater regulatory oversight of e-cigarettes, the researchers said, will be a significant step forward toward ensuring higher safety standards.

The article, “Should Clinicians Recommend E-cigarettes to Their Patients Who Smoke? No,” was written by Clare Meernik, MPH and Adam O. Goldstein, MD, MPH and published in the Annals of Family Medicine.

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