Gov. Mary Fallin signed an executive order banning the use of e-cigarettes on state-owned and state-leased properties starting Jan. 1, citing chemicals in the vapor that could affect state employees and visitors.
“There's a lot we still don't know about e-cigarettes,” said Eliza Chakravarty, M.D., an Oklahoma Medical Research Foundation scientist. “Compared to smoking or chewing tobacco, e-cigarettes are almost definitely safer. But saying something is healthier than tobacco isn't exactly clearing a high bar.”
According to the Centers for Disease Control and Prevention, tobacco use accounts for more deaths each year than HIV, car crashes, illegal drug use, suicides and murders combined. People who smoke cigarettes are at a higher risk for diabetes, heart disease, stroke and cancers of the lungs, stomach, pancreas, kidney, bladder and more.
E-cigarettes are battery-powered devices that convert nicotine-infused liquid into a vapor the user inhales. They don't contain the harmful chemicals associated with smoking tobacco, including carbon monoxide and tar.
“The problem with e-cigarettes is there's no regulation. Very little research has been done, and we don't know what's in them,” Chakravarty said. “And the lungs are an incredible delivery system, which means if there's something dangerous being vaporized, it can be distributed throughout the body very easily.”
Nicotine isn't harmless itself, she said. In addition to being addictive, it can adversely affect people with heart problems and, over the long term, it could cause an increase in low-density lipoproteins (LDL), also known as the “bad” cholesterol.
The ease of use and lack of oversight could also lead e-cigarette users to overindulge, she said.
Nicotine overdose and poisoning are dangers. Even if e-cigarettes only contained nicotine, it could be dangerous to those with heart or respiratory diseases. But studies by the Food and Drug Administration show that the “nicotine juice” is sometimes poorly labeled and contains other chemicals.
One study found cancer-causing compounds in some e-cigarette cartridges, including diethylene glycol — a toxic chemical used in antifreeze.
“Nicotine is used by doctors in patches and gum to help ease smokers into quitting,” Chakravarty said. “But patches and gum are also low-profile. No one knows you're using them. E-cigarettes, which often look just like real cigarettes, are fighting the hard-won stigma against tobacco use.”
E-cigarettes aren't used solely as a tobacco-cessation aid but are marketed as a cool new product for everyone, Chakravarty said. Instead of helping people quit, she worries they could be introducing a new generation of smokers to nicotine addiction — a worry shared by Thomas Frieden, M.D., director of the Centers of Disease Control and Prevention.
“As they're being rolled out now, I have grave concerns that they're doing more harm than good,” he said.
Chakravarty said the simple truth is more research needs to be done.
“Ideally,” he said, “we'll reach a point where people won't be using real cigarettes or e-cigarettes.”
Greg Elwell is a public affairs specialist for the Oklahoma Medical Research Foundation.