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    Smoking cessation – are electronic cigarettes a good option?

    More and more smokers are now turning to electronic cigarettes when trying to quit smoking. Is this a good idea?

    What is an electronic cigarette?

    Although the first electronic cigarettes (ECs) were designed to look like real cigarettes, nowadays you can find various forms on the market: some look like a large pen, while others look like a cigar or even a pipe.

    ECs are devices equipped with a cartridge that you fill with a liquid (sometimes referred to as “juice”). An atomizer turns the liquid into a vapour that the user inhales. Users are called “vapers” and the act of using an EC is called “to vape.”

    These devices are evolving quickly, with many changes being made to their components in order to provide a better vaping “experience.” Certain models now offer various settings to modify the vapour that is inhaled, for example by letting users adjust the intensity of the flavour.

    What is in the liquid that gets inhaled?

    The main ingredients in vaping liquids are propylene glycol and vegetable glycerin. These organic liquids are colourless and nearly odourless and flavourless.

    Various flavours and/or nicotine are added to the liquid. There is a wide variety of flavours available, including fruit, candy, chocolate, desserts, etc. Some liquids (with or without nicotine) claim to “taste” similar to popular cigarette brands.

    Are ECs legal in Quebec?

    In Quebec and the rest of Canada, tobacco product sales are governed by numerous laws. Currently, no EC manufacturers have applied for an authorization to sell their products in Canada. Therefore, in theory, only nicotine-free liquids can be legally sold here. The reality, however, is that liquids containing nicotine are sold at specialized shops across the country. Online sales of EC liquids are illegal in Quebec, but consumers can easily purchase the liquids from websites elsewhere in Canada or abroad.

    Is it less harmful to vape nicotine than to smoke it?

    With traditional cigarettes, it is the combustion of tobacco that produces very toxic substances. There is no combustion with electronic cigarettes, but the heat required to turn the liquid to vapour is high enough to create potentially harmful substances.

    Very few quality studies have dealt with the effects of ECs on our health, and their results have not always been conclusive. For example, some studies found no sign of adverse effects, while others noted microlesions in the mucous membrane of the mouth.

    The quality of the research is only one obstacle that will have to be addressed in order to get clearer answers. Another is length of time. So far, the duration of the studies is too short to be able to detect any health issues that may stem from long-term use of electronic cigarettes.

    Another issue is the very rapid evolution of the devices, as well as the great variety of liquids. When doing scientific research, all participants must use the same device and liquid, in order to be able to compare results. The problem is that we cannot generalize these results to all EC models, nor to all liquids, because they are all so different (for example, the strength of the atomizers that create the vapour, or the numerous ingredients used to create flavours).

    Did you know that liquid nicotine is a powerful insecticide?

    Liquid nicotine is extremely toxic if ingested orally or if it comes into contact with the skin. Many cases of poisoning have been reported, some even fatal, particularly in children. Since the liquid containers don’t usually have a childproof cap, they must be kept out of the reach of children and animals, because some of the flavours used can be very appealing to them (e.g. chocolate, candy).  Avoid all contact with the liquid and wash your hands after handling it.

    Are non-nicotine liquids perfectly safe, then?

    The truth is that nobody knows for sure. The heat required to create the vapour can still create toxic substances, even in nicotine-free liquids.

    In addition, since the EC industry isn’t regulated, manufacturers don’t need to notify consumers if they change the formulation of a liquid. As a result, you could buy the same product for several months, but each bottle could contain different ingredients. Studies have even found that nicotine can commonly be found in products labelled as nicotine-free, or that nicotine concentrations differ from the amounts indicated on the label (sometimes higher, other times lower).

    Have there been studies on smoking cessation and ECs?

    Yes, some have been conducted, particularly in New Zealand and England. The success rate for EC users was similar to other smoking-cessation aids (e.g. nicotine patches), particularly among participants who used a liquid that contained nicotine. With nicotine-free liquids, the results weren’t as clear.

    However, these studies were all short-term (only a few weeks), and most of them did not include a follow-up to see if the participants who managed to quit had a relapse or if they remained abstinent in the months or years that followed. It is therefore impossible at the moment to say whether ECs are more or less effective than traditional smoking-cessation aids.

    To vape or not to vape?

    For now, due to the contradictory results of the few studies available, along with the absence of regulation, it is best to err on the side of caution.

    If you are considering ECs to help you quit smoking, take the time to consult a healthcare professional first, especially if you have any health issues. This could help you weigh the pros and cons in order to make an informed decision.

    Regardless of the method you choose, plan for success: Choose a good time to quit and surround yourself with people who will encourage you to stay the course.

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