CONCLUSION
Clinicians are ethically obligated to promote
smoking cessation using evidence-based
treatment strategies. Smokers will ask about
e-cigarettes, and we must be prepared to offer
appropriate counseling. With the evidence available
to date, clinicians must be circumspect in
recommending e-cigarettes for use by cigarette
smokers interested in quitting smoking for the
following reasons:
1. They are not demonstrably superior to
FDA-approved medications for smoking
cessation.
2. They may not be effective for smoking cessation
and dual use (ie, using e-cigarettes and
continuing to smoke) will prolong exposure
to tobacco.
3. They are not FDA-approved for the treatment
of tobacco dependence.
4. Short-term safety data suggest they may
cause airway reactivity.
5. The long-term health risk of exposure to
e-cigarette constituent chemicals is unknown.
6. No regulatory oversight, such as requirements
for good manufacturing practices,
is currently in place for e-cigarette devices
or e-juice.
More clinical safety data and increased product
reliability and regulation are needed before
e-cigarettes can assume a place in the standard
clinical approaches to the treatment of tobacco
dependence.