Dr. Seth Bilazarian of theheart.org on Medscape has recently updated a blog that he started 2 years ago. He believes that this update is valuable for others to know about, especially for doctors who need to provide counsel on electronic cigarettes to their patients.
As ecigarette continue to soar in sales and in popularity; as major tobacco companies continue to delve deeper into the category, more questions about the use and safety of ecigs will also be raised.
Ecigs In Smoke Cessation
Dr. Bilazarian said that thre are some reasons why it is sensible to use ecigs as smoke cessation tool.
He explained that smoking is driven by certain cues like when a person eats or answers a ringing phone. These things still cue a former smoker even years after quitting the habit. Ecigarettes mimic the smoking action and the chemical withdrawal aspect. Ecigs are also potential avenues for patients because smokers accept them more than nicotine replacements.
He stated that it is important for clinicians to be responsive to patients asking about electronic cigarettes who are actually asking for help in smoke cessation.
There are a lot of debated topics about vaping and as detractors continue to oppose; as supporters continue to advocate for ecigs, more and more smokers will be interested in trying them.
What Doctors Must Do
Dr. Bilazarian expects that more patients will become aware of ecigarettes and patients will certainly seek counsel from doctors.
Responding to non-smokers is fairly easy. He said that non-smokers should be told not to start. For smokers, however, the doctor has 4 possible sets of responses in mind.
One is to honestly tell the smoking patient that there is no adequate data available concerning ecigarettes so counseling could not be provided. This response would not be appreciated by patients and would leave doctors at a disadvantage.
A second possible response is to admit that ecigs frankly have harm reduction capability. While using ecigarettes might not be absolutely safe, it is safer than smoking cigarettes. Thus, it is only reasonable and acceptable for patients to use them.
A third possible response is to advice on ecigs as a reasonable cessation strategy. Dr. Bilazartan said that he has learned to accept that if patient really want to use ecigs; and are committed to using the devices for 4-6 weeks while weaning off cigarettes, then it might be reasonable although the long term safety of doing so could not be warranted.
Finally, doctors could also tell patients that vaping cannot be considered as a healthy choice. Other people might say that ecig use is as safe as inhaling water vapor. Ecig vapors are different from pure water vapors because they contain ingredients other than water. It is important that doctors remind patients that this is not what they believe about electronic cigarettes kits.
Health care providers need to be more inquisitive about their patients’ habits. They need to ask not just whether or not they smoke cigarettes. Doctors must also ask patients if they use ecigarettes. Patients could say they do not smoke, but they vape or use ecigs.
In the Circulation Journal, Dr. Bilazarian also had another summary paper on ecigs. It contains a list of policy recommendations for those working or interested at healthcare policies. In summary, his recommendation is to treat ecigarettes as conventional cigarettes in terms of taxes, advertising and similar issues.
Bilazarian said that vaping ecigs is totally beneficial from any health standpoint, but said that it is less hazardous than smoking. If it is less hazardous, then it imparts even the slightest improvement on a smoker’s health.
He said that it is reasonable to allow patients to use ecigarettes because of the harm reduction and smoke cessation (possible) capabilities. Yet, he recommends that ecigs to be regulated taxed and advertised as real cigarettes. It this recommendation is followed, incentives from using ecigarettes will be lost. The aim of doctors to help smokers quit the habit would not be attained because the only possible quitting tool that can help numerous smokers have been eliminated even before showing its true life-saving potentials.