KIRTLAND AIR FORCE BASE, N.M. — Electronic cigarettes have become very popular over the last few years. Five percent of U.S. adults currently use e-cigarettes. The largest increases in use are seen in adolescents. According to data from the Centers for Disease Control and Prevention, 20.8 percent of high school students use these devices.

An increase in e-cigarette popularity is also observed in active duty populations. In the Air Force, e-cigarette use increased from 4.3 percent in 2017 to 5.4 percent in 2018. Kirtland is no exception to this trend with a 4.6 percent use in 2017 increased to 6.7 percent use in 2018. Some squadrons at Kirtland have e-cigarette usage rates of greater than 15 percent.

Nicotine is a highly addictive drug comparable to cocaine or heroin. That is the main reason users find it so hard to quit. We also know that genetics play a role. Individuals who rapidly metabolize nicotine find it much harder to quit than individuals who metabolize nicotine slowly. Nicotine has a variety of negative health effects. These include increases in blood pressure and heart rate, plus an increased risk of heart failure, heart attack and stroke. In addition, nicotine increases the risk for Type 2 diabetes, erectile dysfunction and may increase the risk of heart disease.

Studies have shown that when subjects use nicotine-free e-cigarettes, the same negative cardiovascular effects observed when nicotine-containing e-cigarettes are used did not occur. Electronic cigarettes produce some of the same toxic compounds recorded in regular cigarettes.

However, the amounts produced are far smaller than seen in regular cigarettes and it is unclear whether inhalation of such low levels is associated with increased health risk.

Two studies have examined the effects of smokers with chronic obstructive pulmonary disease who switched to e-cigarettes. In both studies, COPD exacerbation rates significantly declined when the subjects switched to e-cigarettes. Though rare, there have been two documented cases of death associated with use of e-cigarettes. In both cases, death was the result of lithium batteries that exploded, which sprayed the victims with shrapnel.

A big question that people want to know is, “Can the use of e-cigarettes help regular smokers quit?” Studies have produced mixed results. For example, two studies found that e-cigarettes did not appear to improve quit rates in smokers, whereas a third study did find positive associations between e-cigarette use and quit rates of regular cigarettes.

A recent study provides the clearest picture to date on this question. The study consisted of 886 subjects, and lasted for one year.

One group used e-cigarettes and the other group used a variety of nicotine replacement therapies such as patches, gum, lozenges and nasal sprays. Both groups also regularly attended behavioral counseling sessions. Among subjects who were tobacco-free at the end of one year, the abstinence rate for e-cigarette users was 18 percent, significantly higher than the nicotine replacement group at 9.9 percent.

In adults, the research to date suggests the negative health effects of e-cigarette use are primarily associated with nicotine, and not with the devices themselves. E-cigarettes can be used as a smoking cessation tool, though many individuals continue to use e-cigarettes after quitting regular cigarettes.

Electronic cigarettes are not completely safe but do appear to be significantly less toxic than regular cigarettes and could be an option for reducing harm. Regardless, the healthiest option is still to quit nicotine delivery products of any kind.

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