Electronic Cigarettes: Perhaps the Devil Unknown Is Better Than the Devil Known
Authors: M. Bradley Drummond
Journal: Annals of Internal Medicine (2015)

In the Balance7 July 2015Electronic Cigarettes: Perhaps the Devil Unknown Is Better Than the Devil KnownM. Bradley Drummond, MD, MHSM. Bradley Drummond, MD, MHSFrom Johns Hopkins Hospital, Baltimore, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0361 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The introduction of electronic cigarettes (e-cigarettes) into the nicotine delivery marketplace represents the embodiment of William Osler's 19th century aphorism, “Medicine is a science of uncertainty and an art of probability.” Uncertainty exists about e-cigarette population effects, individual harms, and efficacy for smoking cessation. Increasing e-cigarette awareness and use among U.S. adults and among youths who had never smoked (1, 2) has led to a well-founded concern that e-cigarettes represent a gateway to lifelong nicotine addiction among persons who otherwise may have never used nicotine-containing products. Studies demonstrate that e-cigarette vapor does contain toxic and carcinogenic compounds; thus, this vapor ...References1. King BA, Patel R, Nguyen KH, Dube SR. Trends in awareness and use of electronic cigarettes among U.S. adults, 2010–2013. Nicotine Tob Res. 2015;17:219-27. [PMID: 25239961] doi:10.1093/ntr/ntu191 CrossrefMedlineGoogle Scholar2. Bunnell RE, Agaku IT, Arrazola RA, Apelberg BJ, Caraballo RS, Corey CG, et al. Intentions to smoke cigarettes among never-smoking U.S. middle and high school electronic cigarette users: National Youth Tobacco Survey, 2011–2013. Nicotine Tob Res. 2015;17:228-35. [PMID: 25143298] doi:10.1093/ntr/ntu166 CrossrefMedlineGoogle Scholar3. 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[PMID: 25426653] MedlineGoogle Scholar7. Cahill K, Stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2013;5:CD009329. [PMID: 23728690] doi:10.1002/14651858.CD009329.pub2 CrossrefMedlineGoogle Scholar8. Flouris AD, Chorti MS, Poulianiti KP, Jamurtas AZ, Kostikas K, Tzatzarakis MN, et al. Acute impact of active and passive electronic cigarette smoking on serum cotinine and lung function. Inhal Toxicol. 2013;25:91-101. [PMID: 23363041] doi:10.3109/08958378.2012.758197 CrossrefMedlineGoogle Scholar9. Drummond MB, Upson D. Electronic cigarettes. Potential harms and benefits. Ann Am Thorac Soc. 2014;11:236-42. [PMID: 24575993] doi:10.1513/AnnalsATS.201311-391FR CrossrefMedlineGoogle Scholar10. McRobbie H, Bullen C, Hartmann-Boyce J, Hajek P. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev. 2014;12:CD010216. [PMID: 25515689] doi:10.1002/14651858.CD010216.pub2 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins Hospital, Baltimore, Maryland.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0361.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer.Corresponding Author: M. Bradley Drummond, MD, MHS, Johns Hopkins Asthma & Allergy Center, 5501 Hopkins Bayview Circle, JHAAC 4B.70, Baltimore, MD 21224; e-mail, [email protected]edu.Author Contributions: Conception and design: M.B. Drummond.Drafting of the article: M.B. Drummond.Critical revision of the article for important intellectual content: M.B. Drummond.Final approval of the article: M.B. Drummond.Administrative, technical, or logistic support: M.B. Drummond.This article was published online first at www.annals.org on 12 May 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoElectronic Cigarettes: Aggregate Harm Thaddeus Bartter Celebrating the ACP Centennial: From the Annals Archive—Smoking Cessation Deborah Cotton Celebrating the ACP Centennial: From the Annals Archive—Smoking Cessation Deborah Cotton Electronic Cigarettes: Aggregate Harm Thaddeus Bartter Metrics Cited byTobacco-specific nitrosamines: A literature reviewQuantifying population-level health benefits and harms of e-cigarette use in the United StatesCelebrating the ACP Centennial: From the Annals Archive—Smoking CessationDeborah Cotton, MD, MPH, Deputy Editor 7 July 2015Volume 163, Issue 1Page: 61-62KeywordsCohort studiesDisclosureDrug therapyElectronic cigarettesHeavy metalsNicotineTobacco controlToxicity ePublished: 7 July 2015 Issue Published: 7 July 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...