In spite of the public campaigns and all the restrictions against smoking in public such as the work place and restaurants, smoking is still the leading preventable cause of death in the United States.  Nearly1 in 5 deaths (among smokers and non-smokers alike) is related to tobacco use.  Of these deaths almost 50,000 deaths from heart attacks and lung cancer occur in nonsmokers who are exposed to second-hand smoke.  In addition to the increase in heart attacks and lung cancer, smokers suffer from a greater percentage of chronic diseases that are directly related to smoking.  In addition to the human suffering it causes, the economics of cigarette smoking is enormous, contributing $100 billion or more to the nation’s health care bill every year.

Obviously, the best way to stop cigarette smoking is to prevent people from taking their first puff.  For the most part, people start smoking in their youth or as young adults.  Fortunately, the incidence of cigarette smoking among high school students has decreased.  Unfortunately, the use of other tobacco related products or electronic cigarettes has increased in this age group.  (CDC, MMWR, November 14, 2014 / 63(45);1021-1026 )Unfortunately, there are no studies that document the safety or harmfulness of these devices when used over many years.

 

A recent article in the New England Journal of Medicine (N Engl J Med 2014; 370:293-295 ) concluded that “states should ban the sale of e-cigarettes to minors and the FDA should move swiftly to regulate them so that their potential harms are better understood – and so that they can contribute to the goal of harm reduction.”