How do e-cigarettes affect public health? Skeptics and adherents of vaping abound while regulators, healthcare professionals, and smoking cessation professionals remain cautious. In a feature story by a Wisconsin Dells news outlet about the topic, Amy Skora, outreach specialist, General Internal Medicine and UW Center for Tobacco Research and Intervention (UW CTRI), discussed the statewide impact of vaping and e-cigarettes. 

UW CTRI researchers have conducted studies concluding that substances in e-cigarettes are associated with increased risk of cardiovascular disease, and is continuing to investigate the impact of e-cigarettes. 

“Our stance is to go with what we know to be approved for smoking cessation,” said Skora. 

“We see e-cigarettes as more of a harm reduction. We don’t want anyone on nicotine for the long term.”

Concerns about e-cigarettes and advice about what healthcare professionals should tell patients were outlined in a 2014 editorial in the New England Journal of Medicine authored by UW CTRI director Michael Fiore, MD, MPH, MBA, UW CTRI director of research Timothy Baker, PhD, and Steven Schroeder, MD of the Smoking Cessation Leadership Center at the University of California - San Francisco. 

In the editorial, authors wrote, "Evidence shows that all the noncombustible delivery vehicles are substantially less dangerous than combustible tobacco products, though that’s not to say that they are all totally safe." 

Dr. Fiore and others at UW CTRI are concerned about an increase in use of e-cigarettes among youth, levels of secondhand exposure to nicotine in e-cigarette vapor, and unanswered questions about the long-term health effects of e-cigarettes and whether they are effective as a smoking cessation aid.

The Wisconsin Dells news article mentioned a 2016 report from the US Surgeon General documenting a 900 percent increase among e-cigarette use among high school students from 2011 to 2015. 

Researchers with UW CTRI are continuing to conduct clinical studies on smoking and vaping to gain more information about the effect of the products on dual users (people who both smoke and vape), youth who turn to vaping at an early age, and long-term smokers who are seeking to quit combustible cigarettes. 

Resources: 

• "As vaping grows in Wisconsin, adherents and skeptics abound," Wisconsin Dells Events, August 29, 2017
• Fiore MC, Schroeder SA, Baker TB. 2014. Smoke, the Chief Killer — Strategies for Targeting Combustible Tobacco Use. New Eng J Med. 370:297-300.
• Electronic Cigarettes (E-cigs) and Vaping - UW Center for Tobacco Research and Intervention