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Terry Dwelle: E-cigarette cons currently outweigh the pros

Terry Dwelle

In a recent editorial, the Herald raises interesting points about e-cigarettes and their possible benefits to public health ("E-cigs bring benefits in smoking reduction," Page F1, March 15).

Dr. Eric Johnson provided a thoughtful response in his column ("No data to prove e-cigs reduce smoking," Page A4, March 19).

As state health officer, I feel it is important for the public to understand the position of the North Dakota Department of Health with regard to e-cigarettes. As Johnson indicated, much research is still needed in this area to further define the risks and any potential benefits of these devices.

The public has a common assumption that for current smokers, it would be less risky to switch to e-cigarettes versus continuing to smoke conventional cigarettes. The vapor of e-cigarettes is presumed to be less risky than smoke, yet the long-term health risks of e-cigarette vapors for the user and secondhand inhalation of vapors by others have not been defined by current research.

Also, since e-cigarettes have not been regulated, the ingredients and concentrations of components vary significantly from manufacturer to manufacturer, which obviously can influence risks.

For current smokers, the department recommends using proven tools to quit smoking. Many effective support services are available in North Dakota to help people quit, such as NDQuits (1-800-QUIT-NOW or

In addition, the FDA has approved seven medications to assist with quitting tobacco, and these can be obtained over the counter (patches, gum and lozenges) or prescribed by a primary physician.

NDQuits has more information about these medications as well.

More than 30 percent of people who use these services have, when asked about their status seven months after enrollment, reported that they have been able to quit smoking. That is an excellent success rate proven by statistics.

The role of e-cigarettes in helping people quit is unknown at this point, but deserves more research. Some studies demonstrated that smokers who choose to use e-cigarettes also continue to smoke, thereby becoming dual users instead of quitting or switching over to only e-cigarettes.

For current non-smokers, the use of e-cigarettes carries risks. Nicotine is a known, strongly addictive substance, and it is associated with cardiovascular complications of the heart and blood vessels.

Of great concern is the increased use of e-cigarettes in non-smoking youth. In North Dakota, youth e-cigarette use tripled from 2011 to 2013. This not only exposes them to known risks of nicotine, but also may increase their likelihood of trying conventional smoking.

Young people who have used e-cigarettes are twice as likely to admit an intention to smoke conventional cigarettes as youth who have not used e-cigarettes.

Additional known risks associated with e-cigarettes include the accidental poisoning of children. From 2012 to 2013, poison control centers in the United States reported a 219 percent increase in calls regarding exposures to e-cigarettes and their liquid components.

In summary, we need more research to fully understand whether e-cigarettes will provide any benefit to public health. As Johnson indicates, public health needs more quit tools that have proven their effectiveness; but e-cigs are not known to be a good tool for this purpose.

For now, we support legislation that will treat and regulate e-cigarettes like tobacco, particularly when it comes to minors. We encourage anyone who smokes to contact NDQuits.

And we encourage anyone who currently does not smoke to avoid using e-cigarettes, because we know they present serious risks of addiction and they may cause other serious health problems. They are simply not worth the risk.