Physician Urges Public Not to Use Electronic Cigarettes, Claiming that They Involve Combustion

In an article about electronic cigarettes at the KTLA (Los Angeles) web site, a physician is quoted as cautioning the public about the use of these products because they involve combustion.

According to the article: "some doctors say not enough is known about the cigarettes to determine if they pose a health risk. 'We don't know if they offer any potential health risk or not,' said Dr. Clark Fuller of Saint John's Health Center. 'What we do know is it involves a combustion and a release of a vapor that is inhaled in the lungs. The chemical makeup of that vapor is unknown.'"

The Rest of the Story

Wrong on both accounts.

First of all, electronic cigarettes do not involve combustion. The juice is heated with an electric element to vaporize the nicotine, but there is no combustion. You do not "light" an electronic cigarette. Since there is no combustion, there is no smoke. Most importantly, there is no tobacco involved.

Second of all, we do know the chemical makeup of electronic cigarette vapor. There are a number of laboratory studies in which the composition of electronic cigarette vapor was analyzed using gas chromatography mass spectrometry. I have summarized the major findings of these studies in the review article I co-authored with Zachary Cahn, which was published in the Journal of Public Health Policy.

This story illustrates two important points.

First, there remains a great deal of misinformation, even among health professionals, about electronic cigarettes. These products have now been on the market for more than four years. Much has been written about them, both in the lay press and in scientific journals. Yet so many health professionals are apparently so eager to criticize the product and discourage smokers from using it to quit that they have not taken the time to research the basic facts about electronic cigarettes.

Second, the story illustrates that many health care professionals have a deeply rooted bias against the idea of an alternative nicotine delivery system that resembles a cigarette, even if it may be much safer. Clearly, this physician has very little knowledge upon to which to make a statement to the media that will be carried internationally. He doesn't even know whether electronic cigarettes involve combustion or not, nor does he know, apparently, whether there are any laboratory studies on the composition of electronic cigarette vapor. Nevertheless, he is willing to make (factually incorrect) public statements to the media about the product. This suggests to me that he (and many other health care professionals) have an inherent bias against these products, and that their statements are being guided purely by ideology, and not by science.

This physician has made not one, but two factual errors in his statement to the press. In my opinion, you really should be an expert on an issue, or at least know a moderate amount about it, before you make public statements that could have national implications for the public's health. In this case, the implication could be to discourage people from using the product, and therefore to dissuade many smokers from quitting who might have otherwise been successful.