Intended for healthcare professionals

Observations Yankee Doodling

The poisonous “juice” in e-cigarettes

BMJ 2014; 348 doi: (Published 01 April 2014) Cite this as: BMJ 2014;348:g2504
  1. Douglas Kamerow, senior scholar, Robert Graham Center for policy studies in primary care, and associate editor, BMJ
  1. dkamerow{at}

Yet another reason to oppose their unregulated use

Since we last tuned in,1 electronic cigarettes have continued to grow in popularity and sales. They are widely available in convenience stores and, increasingly, in specialty “vaper” shops. Although e-cigarettes are now regulated in Europe, we are still awaiting national regulation in the United States by the Food and Drug Administration (FDA).

One can envisage three possible scenarios in which e-cigarettes are used: one good, two bad. Potentially, they could be useful to help tobacco smokers quit, replacing cigarettes and slowly dialing down nicotine levels, much as other nicotine delivery devices (gum, patches, inhalers, and so on) do. That would be a good thing, although the research that is starting to accumulate about this therapeutic use of e-cigarettes is so far not promising.2

Secondly, e-cigarettes could be used to maintain a tobacco habit by allowing smokers nicotine intake in tobacco free areas, such as the workplace or home, because the vapor emitted from e-cigarettes is odorless and presumed to be not toxic. This is not so good for public health, as one of the most important incentives for quitting smoking has been …

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