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We are all aware of the ill effects of smoking.  The hazards of long-term smoking including the development of COPD, lung cancer and heart attack and stroke is well-known.  Quitting smoking is not easy. Nicotine is extremely addictive. There are multiple strategies that have been tried for smoking cessation with some success.  Although the prevalence of tobacco smoking In recent years has declined steadily in the United States and has come down to 14%, the number of people using e-cigarettes is steadily rising. We should all be aware that electronic cigarettes have not been approved by the food and drug administration( FDA)  for smoking cessation.

There has been a report Of a new multicenter, randomized trial of thee- cigarettes, compared with nicotine replacement therapy for smoking cessation (1).  In this trial in addition to behavioral support, the participants also received either a three-month supply of the e-cigarettes or standard nicotine replacement products.  The study results are encouraging. After one year, the period of abstinence from smoking was higher in the e-cigarettes group( 18%) compared to the nicotine replacement group( 10 %).  At least in the short-term, these results are encouraging. Also in the short-term, the e-cigarettes were relatively well-tolerated without significant side effects. However, this does not negate the fact that we need long term trials to establish the safety of e-cigarettes.

It’s too early to arrive at any conclusion about the long-term benefits and safety of the e-cigarettes.  One troubling concern, however, has recently emerged. The use of the e-cigarettes amongst the youth is increasing and has been described by US Surgeon General almost to have reached the level of an  “epidemic”.

Recently flavored e-cigarettes have become more popular in the marketplace.  The flavoring is added to enhance the appeal to the first time users. There has been a concern raised about flavored e-cigarettes.  There is a discussion amongst some experts to urge the FDA to ban the use of flavored e-cigarettes.

What’s the bottom line?  

Following is a summary of the CDC guidelines. (2)

  • E-cigarettes have the potential to benefit adult smokers who are not pregnant if used as a complete substitute for regular cigarettes and other smoked tobacco products.
  • E-cigarettes are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products.
  • While e-cigarettes have the potential to benefit some people and harm others, scientists still have a lot to learn about whether e-cigarettes are effective for quitting smoking.
  • If you’ve never smoked or used other tobacco products or e-cigarettes, don’t start.
  • Additional research can help understand long-term health effects.



  1. A randomized trial of E-Cigarettes versus nicotine replacement therapy: Peter Hajek, et al. N Engl J Med 2019;380:629-37.


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