Electronic cigarettes are a new and divisive force in the struggle against tobacco-related morbidity and mortality. Two commentaries published in Annals of Internal Medicine offer opposing views on their use.
Thaddeus Bartter, MD, of the University of Arkansas for Medical Sciences suggests that a lack of regulation and oversight in e-cigarette marketing means that young people may be tempted by the glamorous images portrayed in e-cigarette advertisements. The aggregate harm is that e-cigarette exposure increases the desire to smoke cigarettes, which could lead to a lifetime of addiction for susceptible young people. Dr. Bartter warns that e-cigarettes have the capacity to disrupt a 50-year fight against smoking.
M. Bradley Drummond, MD, MHS, of Johns Hopkins Asthma & Allergy Center argues that e-cigarettes may be beneficial as a tool for helping smokers reduce their use of combustible cigarettes. Dr. Drummond suggests that the all-or-nothing approach to smoking cessation where complete abstinence is the goal may seem insurmountable to some smokers. E-cigarettes offer these smokers a way to reduce the harms of smoking by giving them a less toxic alternative. He argues that there is a tremendous amount of uncertainty about the harms of e-cigarettes, but the probability of harm from combustible cigarettes is certain.