What is an electronic cigarette or e-cigarette?
It is a small electrical device that simulates the act of smoking by producing a vapor resembling smoke. It was invented by a Chinese pharmacist in 2003, then marketed in 2004 in China. Since 2006, it has been sold in Europe and the United States.
If the first looked like real cigarettes, today we find many models of different shapes, sizes and colors. Some are disposable, others refillable… The smoker’s gestures are preserved since a vapor produced from a liquid (called “e-liquid”) heated by an atomizer is sucked through the mouth. This vapor is inhaled and then exhaled, giving the sensation of spitting out smoke.
What is the composition of “e-liquid”?
This liquid is generally composed of propylene glycol (PG) and / or vegetable glycerin (VG), food flavors, a little water and alcohol. Nicotine is optional and available in different strengths (up to 19 mg / ml). PG and VG are liquid substances, slightly viscous, colorless, odorless and used for a very long time in the food, cosmetic and even pharmaceutical industries, but not for inhalation.
Packaging and labeling have improved considerably since 2008. Some manufacturers have opted for higher quality PG and VG (called USP grade), that is, of the same quality as those used for the products. pharmaceuticals. As for the flavors, some are validated by the European Food Safety Authority (EASA) or the Food and Drug Administration (FDA), but not for inhalation.
Is it a drug, a nicotine replacement?
Unlike conventional smoking cessation treatments, the e-cigarette does not have a marketing authorization (AMM). It cannot therefore be sold in pharmacies. Considered as “a product of everyday consumption”, it is subject to trade legislation. The National Agency for the Safety of Medicines and Health Products (ANSM), the World Health Organization (WHO) and the Ministry of Health are unanimous: it is not a method of withdrawal.
The WHO declared in 2008 that it “has not proven itself as a nicotine replacement therapy”. However, the organization did not rule out “the possibility that it could be useful as a means of withdrawal, the only way to find out is to perform tests.” Since then, few tests have been carried out. And, in November 2012, the WHO called for its ban. The reason ? It would “normalize smoking”.
Does it allow you to smoke fewer cigarettes?
According to the results of user surveys, it helps to reduce or even reduce stop smoking, now nicknamed “killer” or “cancerette” by “vapers”, the community of e-cigarette consumers.
In Italy, a comparative study carried out by Dr Polosa suggests that the e-cigarette doubles the chances of quitting smoking after one year. An observational study on 100 people, led by Dr Jacques Granger, pulmonologist, shows that the e-cigarette allows 72% of smokers to reduce their consumption and 11% to quit smoking altogether. Encouraging figures and at least equivalent to those of conventional weaning means. For the latter (Champix®, Zyban®, inhalers, patches, nicotine gums and lozenges, etc.), the success rates vary between 10 and 20%.
For Professor Jean-François Etter, of the University of Geneva, “it undoubtedly helps to reduce tobacco consumption. And it is probably more effective than nicotine substitutes”. He explains that the e-cigarette has the ability to diffuse a lot of nicotine at a slower speed than that of the cigarette, but a little faster than that of nicotine substitutes. For him, “it is undoubtedly a good way to respond to nicotine dependence, the dangers of smoking and less.”
Is it really safe for health?
It is difficult to answer this question because of the lack of perspective, the small number of studies and divergent opinions. For Jacques Le Houezec, “nicotine is not dangerous in itself, at least not at the doses transmitted by a tobacco or electronic cigarette. If it is responsible for tobacco addiction, it is not responsible for the diseases caused. by the other constituents of the smoke (tars, oxidizing gases, etc.) “.
Regarding the very controversial PG (not to be confused with diethylene glycol, which can be dangerous), it is not a toxic substance, according to the National Research and Safety Institute (INRS). In May 2011, the Medicines Agency (ANSM) declared that “no adverse effects or cases of intoxication related to the presence of these solvents in electronic cigarettes have been reported”. However, this information is only valid in the event of ingestion, cold inhalation or skin contact with these substances (PG and VG).
For the moment, “we do not know their long-term effect when they are heated before being inhaled,” says Tabac-Info-Service. It is the same for the food flavors present in the e-liquid, whatever their quality.
Is it less harmful than a classic cigarette?
If we don’t know his long term effects, Dr Granger recalls that “the electronic cigarette releases much less toxic substances than a real cigarette (more than 4000, of which about fifty are carcinogenic)”. He was also interested in the e-cigarette to the growing demand of his patients. According to his study, after three months of use, the heart rate of ex-smokers decreased, their breathing capacity remained stable or improved. Finally, the level of exhaled carbon monoxide has decreased in all cases and it has even become zero for those who only use the e-cigarette.
According to a study conducted last August, presented by the European Society of Cardiology, electronic cigarettes have no adverse effect on heart function (apart from a slight increase in blood pressure), unlike conventional cigarettes. Prof. Etter does not recommend it to people who want to quit smoking. On the other hand, he advises ex-smokers who already use it to “continue to use it rather than resume smoking, because it is undoubtedly less toxic than tobacco”.
And for the entourage?
The exhaled vapor is less toxic than tobacco smoke (5,000 deaths per year are believed to be due to passive smoking), which contains thousands of carcinogens. According to an American study published in the “Journal of Public Health Policy”, an electronic cigarette would release 500 to 1,400 times less nitrosamines than a “real” one.
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