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The electronic cigarette to quit smoking?

The electronic cigarette to quit smoking?

Quitting smoking:not easy but possible! There are many methods and many specialists to help you quit smoking. The most complicated thing is to find the method that suits you and the right time to apply it! Is the electronic cigarette, adopted by 3 million French[1] a safe alternative? We take stock!

Can e-cigarettes help quit smoking?

The electronic cigarette (vaping, more appropriate term because it is in no way a cigarette) is not officially recognized as a method of quitting smoking. However, in May 2017, the High Authority for Health (HAS) specified that "its use will not be discouraged but the patient will be supported in his or her process of stopping or reducing smoking. »

It therefore remains a commercial product, the long-term safety of which has not been demonstrated to date, and which even seems to expose its users to toxic substances (irritants and carcinogens), disproportionate to tobacco smoke. The lack of hindsight on its use makes it impossible to know the long-term health risks.

This is why its use is not recommended, especially for non-smokers, minors and pregnant or breastfeeding women.

Nevertheless, the toxicity of the vaporizer being a priori lower than that of the traditional cigarette, certain medical tobacco specialists believe that it could constitute an aid to quitting smoking for heavy smokers:exclusively, that is to say without smoking tobacco (cigarette, pipe, cigar etc.).

Recently, the French Society of Anesthesia and Resuscitation (SFAR) advocated the use of vaping in the preoperative period:"the use of electronic cigarettes, while the population of smokers and ex-smokers who use them continues to to increase, must be considered by anesthetists in intensive care as a very positive aid in the preoperative period, the latter being clearly identified as very favorable to the decision to quit smoking. »

How does an electronic cigarette work?

An electrical resistance, powered by a battery or a battery, heats and vaporizes a liquid contained in a rechargeable tank.

The user inhales the vapor released by the mouthpiece of the electronic cigarette.

The liquid to spray contains:

  • propylene glycol and/or glycerol,
  • nicotine (but its presence is not mandatory),
  • a little water (about 5%),
  • flavors:there are more than 7764 according to the World Health Organization (WHO).

Since April 2016, there have been standards governing the composition of liquids to be vaped in France. On the website of the French Association for Standardization AFNOR):"Published on April 2, the first two voluntary standards, in the world, on electronic cigarettes and e-liquids, establish criteria of safety, quality and promote a better consumer information. They will contribute to the stabilization of the vape market. ". We can therefore now be certain of their exact composition.

What are the risks of electronic cigarettes?

  • nicotine :she has the greatest power addictive among legal and illegal drugs. While not carcinogenic, it may act as a "tumor promoter" observed in animals. Some electronic cigarettes deliver significant amounts of nicotine and they help manage physical addiction, while maintaining behavioral addiction:the smoker continues his "cigarette breaks", he vapes while waiting for his bus, etc. The choice of the right dosage of nicotine by the vaper is difficult:distributors, who are above all traders, base themselves on the number of cigarettes smoked. However, it is also necessary to take into account the dosage of carbon monoxide (CO) and the nicotine dependence score (Fagerström test). A tobacco specialist doctor will be able to determine these elements with precision and certainty,
  • electronic cigarettes can release irritating substances , even carcinogenic (especially the first generation of electronic cigarettes, which could contain nitrosamines), but in much lower quantities than in cigarette smoke,
  • passive vaping :in the vapor samples from electronic cigarettes, there are residues of propylene glycol, glycerine (about 75%), water (18%), sometimes some traces of flavors (less than 7%), nicotine in small quantities (less than 2%). We also discover some traces of toxins but which are those that are usually found in the ambient air. This demonstrates that electronic cigarette vapor does not bring toxic elements to the air and is therefore harmless...

A prospective study (cohort of 449 pregnant women) was conducted in 2017 in a maternity hospital in Dublin, Ireland (McDonnell et al., 2020). The birth weight of vapers is identical to that of non-smokers (3470 ± 535 grams vs 3471 ± 504 grams), while it is higher than that of tobacco smokers (3470 ± 535 grams vs 3166 ± 502 grams).

No difference between the four groups, in terms of duration of pregnancy, Apgar score at birth and stay in the intensive care unit.

The opinion of the experts on the electronic cigarette

In the absence of conclusive studies on the interest and safety of e-cigarettes in the context of smoking cessation, a debate among experts is causing trouble among smokers and vapers.

In its report published at the end of August 2014, the World Health Organization (WHO) recalls that the haze given off by electronic cigarettes "is not simple 'water vapor' as often claimed by the strategies marketing these products" and that "Most electronic nicotine delivery devices have not been tested by independent scientists". It also states that "the few tests performed reveal wide variations in the nature of constituent toxicity and emissions". The WHO recalls that "the marketing strategy of these devices risks giving an attractive image of smoking, attracting children and non-smokers" and therefore recommends in particular to strengthen the regulations governing the composition of e-fluids, and to prohibit the sale of electronic cigarettes to minors, considering that their consumption poses "serious threats" for teenagers.

Tobacconists and addiction specialists dispute the conclusions of this report. They believe that the WHO exaggerates the risks and underestimates its value as an alternative to tobacco. “The use of electronic cigarettes could save millions of lives in this century and have the most significant public health impact in the history of tobacco use" , says Dr. Jacques Le Houezec, a French smoking specialist and one of the authors of the article.

During the congress of the French Society of Tabacco in Paris in 2014, a plenary session was devoted to the eCigarette. Thus, it was recalled that if the electronic cigarettes of 1 era generation could contain nitrosamines (carcinogenic substances), those of 2 th and 3 th generation no longer contain any. In addition, the use of electronic cigarettes is an alternative to nicotine replacement therapy , as part of risk reduction, provided you completely stop smoking . Indeed, continuing to smoke, even by reducing tobacco consumption, and vaping does not lead to a reduction in health risks:total cessation of smoking is therefore necessary for vapers.

Source

[1] French Public Health