Battery-Powered Cigarettes Deliver a Low-Cost Nicotine Fix. Is That Good or Bad?
Tuesday, April 7, 2009
I had lunch, a cup of coffee and a smoke the other day at the offices of the American Legacy Foundation in downtown Washington. I puffed away for a good 15 minutes, savoring the irony.
Here I was, surrounded by zealous anti-smokers -- Legacy is among the nation's most influential and well-funded tobacco-fighting organizations -- yet I had been invited over to partake in all the nicotine I could handle.
Of course there was a catch: What I puffed on wasn't a Marlboro or any other combustible cancer stick. I didn't need an ashtray. The "smoke" was more accurately fog -- small, vaporous clouds. I was trying out a controversial new nicotine-delivery device that somewhat resembles a cigarette but is actually a plastic tube with a glowing LED at its tip.
"If you just suck on it, it should work," scientist David B. Abrams said, handing me an Njoy brand e-cigarette. (That's "e" for electronic; nothing to do with the Internet, except that the devices are sold there in abundance.) Inside the tube is a lithium battery that warms and aerosolizes a nicotine solution; Njoy says it works like a vaporizer.
After a few puffs, I found myself wreathed in a fine mist of nostalgia. An e-cig supplies none of the flavor or warmth of a real smoke ("Joy of the palate, delight of the nose!" as one forgotten poet put it), yet I was transported back to the days when smoking didn't equal social opprobrium, when hacks like me hammered on typewriters with nicotine-stained fingers, inhaling madly as deadline loomed.
In a word, I got a buzz.
True, you might be sucking on plastic, but the experience is, as Abrams said, "close to the real deal."
As the Legacy foundation's resident expert on addiction and smoker behavior, Abrams and other researchers are intrigued by the devices but also deeply concerned. Could they become another weapon in the smoking-cessation arsenal? Or could they hook more young people on nicotine and serve as a gateway to tobacco use? The products are unregulated, untested in this country and not approved by the Food and Drug Administration, which has sanctioned other nicotine-supplying substitutes such as patches and gum.
Late last month, Sen. Frank Lautenberg (D-N.J.), author of the law that banned smoking on airplanes years ago, sent a letter urging the FDA to take "immediate enforcement action against manufacturers of 'electronic cigarettes' and take these products off the market until they are proven safe." FDA is beginning to get on the case: Although the devices are available online and in scattered retail outlets, the agency says it has halted some imports and is evaluating whether sales require FDA approval.
E-cigs supply nicotine via the lungs -- albeit without the tar, carbon monoxide and other nasties in tobacco smoke -- and thus provide the almost instantaneous "hit" that smokers crave. They offer that "exquisite regulation of brain chemistry that makes smoking so powerful and rewarding," said Abrams, a PhD health psychologist who has studied addiction for 30 years.
"People don't realize that we know of no other way to finely tune the brain than puffing on a cigarette," he told me.
Later, as I sat dragging on the vapor tube, I thought about that. Nicotine truly is a remarkable drug, because it seems to span the spectrum of psychological effects: Some people relax with tobacco products (a fine cigar after dinner); others get an instant boost that helps them focus. One of my editors swears she never wrote better headlines, faster, than when you could smoke in The Post's newsroom.
Abrams, who smoked as a teenager and has tried e-cigs in the name of science, is no knee-jerk foe of nicotine. "I see no problem with giving people lifetime medicinal nicotine," he said. But he certainly doesn't endorse e-cigs, especially since studies have only begun on their safety and efficacy.
Scientists also worry that e-cigarettes may de-motivate hard-core smokers from quitting, by allowing them to stave off nic fits by "smoking" in offices, restaurants and other places where they can't normally light up. Thus the e-cigs become what Abrams calls a "bridge product."
In a joint statement, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association and the Campaign for Tobacco-Free Kids blasted e-cigarettes for being "marketed towards young people, who can purchase them in fruit flavors and online, without having to verify their ages."
Njoy literature claims that one of its cartridges (which contain water, flavoring, propylene glycol and nicotine) will last the equivalent of a half-pack of real butts. Unlike those 10 cigarettes, though, which burn down and get stubbed out one at a time, the e-cig doesn't go "out." There's a danger of sucking down too much at one sitting: Nicotine affects heart rate and blood pressure. At least one controlled study is underway, at Virginia Commonwealth University in Richmond, to find out the impact of e-cigs on nicotine levels in the blood.
"I'm not necessarily saying these products are dangerous," said psychology professor Thomas Eissenberg of VCU's Institute for Drug and Alcohol Studies. "I just think we ought to know what people get when they use them before we sell them."
His study of 40 smokers, supported by the National Cancer Institute, endeavors to determine how e-cigarettes deliver nicotine and whether they actually suppress withdrawal symptoms.
"For example, if you wake up in the morning craving nicotine, will this take care of that craving?" Eissenberg asked "If it doesn't, then it's a failure. If it makes you go back to your own brand, it's a failure."
Well, at least a failure as a smoking-cessation product. But evidently trying to avoid government regulation, Njoy and other distributors don't make any claim to helping people quit.
"Our target market is the legal-age smoker looking for a product to partake of their dependency in places they cannot smoke -- and to save a few dollars," James Leadbeater, chief executive of Njoy, said from company headquarters in Scottsdale, Ariz. "We are not breaking the nicotine habit, just giving people a better way to get the nicotine."
Given that federal taxes on cigarettes rose significantly on April 1, cost may push some smokers toward alternatives. On the Internet, the Njoy "starter kit," including batteries, a charger and four cartridges, goes for $75. Leadbetter estimates that after the initial investment in hardware, use of his product costs the equivalent of $2.50 per pack. (A pack of smokes runs something like $5 to $9, depending on brand and sales location.)
But "one of the issues that the smoker has to get over is to get used to the taste," said Leadbeater, adding that he has never smoked. (As an ex-smoker, I'd have to agree: The Njoy doesn't taste anything like the real deal. Its vapor delivered a moist, fruity flavor, reminiscent of a hookah session more than anything else.) "They have to make a trade-off so they can use it as an alternative in places that they can't smoke now."
I haven't heard of any celebrity e-cig endorsers, but at least one politician is an aficionado. Rep. Cliff Stearns (R-Fla.) said he uses the device -- but chooses a nicotine-free cartridge. "Frankly, I enjoy 'vaping' as a relaxing way to enjoy 'smoking' without nicotine and the harmful effects of smoke and combustible tobacco," he told us in a statement.
The congressman says he's such a fan, "I hope to send a package to President Obama to help him quit or to meet with him and enjoy a harmless, carcinogen-free smoke." Such bipartisanship is touching, and I can't help but steal a friend's joke about why cigarettes are such a great social cohesive, transcending race, religion and class: We smokers are all black on the inside.
As for me, I found "vaping" too, well, plastic to be enjoyable. After I left the Legacy Foundation -- established through proceeds of the great tobacco settlement of 1998 and dedicated ever since to saving lives -- I walked past smokers clustered under the eaves of nearby buildings. A tantalizing wisp of tobacco smoke wended its way through the gentle rain, reaching my nostrils. I inhaled. It smelled delectable.
The old genie beckoned.
Just then there developed a burning in my mouth and an accumulation of phlegm in my throat -- the aftereffects, I realized, of liquid nicotine and just a whiff of secondhand smoke. I walked on, resisting the addictive draw of nostalgia.