Dr. Ablow writes: "Since many of my patients have reported using electronic cigarettes to successfully stop smoking, I now recommend the devices to anyone who has tried to quit smoking cold turkey and failed. And I think it is time that other doctors do, too."
Dr. Ablow also comments on the reason that electronic cigarettes appear to be effective for many smokers: "The reason my patients tell me electronic cigarettes work better than the patch or nicotine gum is that they simulate the act of smoking, but not perfectly. They are good enough to substitute for real cigarettes, but they aren’t good enough to become an addiction, in and of themselves. An analogy in the arena of food addiction would be something low calorie that fills you up enough to prevent bingeing on sweets, gives you some distance from that addiction, but then becomes forgettable, because it isn’t really all that compelling.
It is, of course, imperative that the electronic cigarette be a good-enough fake."
While acknowledging that there are some potential health concerns, Dr. Ablow emphasizes that these products are undeniably much safer than tobacco cigarettes: "There is certainly controversy about whether electronic cigarettes are harmless. Critics note that they do, of course, contain nicotine (which is the whole idea, after all). And critics have also found other substances in the vapor released by electronic cigarettes—even cancer-causing substances, but in tiny, tiny amounts that proponents of the devices claim would have no negative effect on well-being at all. What no one seems to argue about is that electronic cigarettes—from LOGIC or Blu or any leading brand—are not nearly as dangerous as smoking real cigarettes. LOGIC claims its device avoids 4,000 toxins that are found in cigarettes."
Dr. Ablow concludes: "Given my experiences and those of numerous clinicians I have spoken with, it would seem to be a good time to conduct large scale clinical trials in which patients who smoke are given electronic cigarettes by their doctors, encouraged to use them and then quizzed on their use of real tobacco weeks and months and years later. If the data generated support the product, then it may be wise for medical insurance companies to offer electronic cigarettes to smokers for free. My bet is they would save lots of money—from the costs of treating heart disease and cancer—down the road."
The Rest of the Story
It is refreshing to read an insightful, balanced, and evidence-based perspective on the potential role of electronic cigarettes in tobacco control, rather than the kind of biased, ideologically narrow, and scientifically misguided missives against electronic cigarettes that we are seeing so much out of anti-smoking advocates these days.
It seems beyond argumentation that electronic cigarettes should be recommended as an option for smokers who want to quit but have failed using other "established" methods. Why wouldn't anti-smoking advocates want to encourage such smokers to try to quit smoking with a device that has been so successful for literally tens of thousands of smokers across the country?
As Dr. Ablow points out, electronic cigarettes occupy a niche that is perfectly situated: they simulate smoking closely enough to be effective substitutes for smokers trying to quit, but not so closely enough to be an attractive option for youths.
Large scale clinical trials of electronic cigarettes should become a research priority for NIH and other government agencies.