Do You Counsel Your Patients About e-Cigarette Use?

May 25, 2017

Electronic cigarettes (e-cigarettes) pose a conundrum for physicians. Some studies suggest they may be a useful "off ramp" to help tobacco users kick the habit. Other studies suggest they may be an "on ramp" to tobacco use, especially for teens and young adults.

Adding to the confusion, safety data for the battery-operated nicotine inhalers are still evolving. Although some research indicates that using e-cigarettes, or "vaping," is safer than smoking combustible cigarettes, a recent University of Pittsburgh study found two known carcinogens, otoluidine and 2-naphthylamine, in the urine of e-cigarette users but not in nonusers. This is a concerning finding for patients, who may be susceptible to developing bladder cancer, urologist and lead author of the study Thomas Fuller, MD, told Medscape Medical News.

e-Cigarettes have become increasingly popular in the United States. More than nine million Americans vape on a regular basis, and that number is increasing each year. Almost half of current cigarette smokers and more than half of former cigarette smokers have tried an e-cigarette. In 2013, more than a quarter of a million middle school and high school students had never smoked regular cigarettes but had used e-cigarettes, a 300% increase in vaping among people in that age group in just 2 years.


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