Health Column: The tobacco industry rears Its ugly head again with e-cigs |

Health Column: The tobacco industry rears Its ugly head again with e-cigs

Phil Mohler, M.D.
Free Press Health Columnist

The Oxford Dictionary recently named “vape” its “Word of the Year” for 2014.

E-cigarettes have come a long way, baby, since their humble beginnings in China just six years ago. Eight percent of the United State’s general population and 30 percent of smokers report trying e-cigs by 2012. Our nation spent $11.7 billion on vaping in 2013.

An electronic cigarette (e-cig) or electronic nicotine delivery system is a battery-powered vaporizer which has a similar feel to tobacco smoking. Electronic cigarettes do not contain tobacco, although they do use nicotine from tobacco plants. They do not produce cigarette smoke but rather an aerosol. In general, they have a heating element that atomizes a liquid solution.

What are benefits and liabilities of this new form of nicotine?

It is likely that vaping e-cigarettes is safer than smoking regular cigarettes. The heated liquid in the e-cig device is primarily nicotine obtained from tobacco leaves, without the dozens of cancer causing chemicals that tobacco contains. Unfortunately, tests of e-cigs liquid nicotine products have often revealed significant contamination with various toxins, including diethylene glycol, a component of antifreeze. The lack of regulation in our country makes it difficult to determine the true risk to those who vape. From a second smoke risk, e-cigarettes represent less of a threat than exposure to traditional cigarettes smoke.

The e-cigarette manufactures claim that their devices offer a tool to help tobacco smokers quit smoking, but most studies, to date, do not support this premise. The approach of the e-cig manufacturers has been to add flavoring agents, like kiwi, chocolate and watermelon to enhance and reinforce the experience. Third-generation delivery devices use microchips to ensure small particles in a fine cloud for deep lung deposition. It sounds like attempts to increase pleasure and addiction.


A major pediatric public health concern is that e- cigarettes represent a gateway device to smoking for kids. Adolescents are a major target for e-cig marketing. In a study of 1,900 high school aged teens in Hawaii, 29 percent had tried e-cigs, but only 15 percent had smoked regular cigarettes. It is one issue for a heavy smoking adult to experience “risk reduction” by switching from cigarettes to e-cigs. It is a totally different event for a non-smoking, innately curious adolescent who is short on judgment to start vaping.


Unlike tobacco leaves, liquid nicotine can be lethal. It can cause harm when it’s inhaled, but it can also be harmful when ingested or absorbed through the skin. Only a small dose is dangerous — less than one tablespoon of many of the e-liquids on the market is enough to kill an adult, and as little as a teaspoon could kill and recently did kill a toddler. The number of calls to poison control centers regarding e-cigarette nicotine-infused liquids rose sharply every month between September 2010 and February 2014. Over half of these calls are about kids 1-3 years of age who ingested the liquid.


As Yogi Berra would offer,” it’s deja vu all over again.” The tobacco industry once more is promoting and defending its products on flimsy pseudo-science and hype. Their targeting of youth again is unconscionable. There may be a tiny niche of heavy smokers whose health will benefit from switching to e-cigs. The FDA needs to shed their reluctance and regulate the e-cigarette industry as it does the tobacco industry. Finally, Congress and the President need to act on U.S. Senate Bill 2581 that would require e-cigarette manufacturers to place liquid nicotine in child-proof containers.

Free Press health columnist Dr. Mohler has practiced family medicine in Grand Junction for 39 years. He has a particular interest in pharmaceutical education. Phil works part-time for Rocky Mountain Health Plans. Email him at

Read another health feature on vaping here.

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