Many of my patients ask me about e-cigarette(e-cig) use or vaping, as it is commonly known.

Vaping overall is on the rise, with over 500 brands and 7,700 flavors on the market, including nicotine-free versions.

With this gain in popularity have come many questions about the safety and possible benefits of e-cigs, including concerns about impacts on teenage tobacco use.

While the data is limited, I thought it would be interesting to review what is currently known, including a brief history of the e-cigarette.

Modern e-cigs were invented in 2003 by Hon Lik, a Chinese pharmacist who smoked three packs per day, after his father died of smoking-related lung cancer.

They became widely marketed in the US and Europe by 2007, but came under scrutiny by the World Health Organization in 2008 for unsubstantiated advertising claims that e-cigs are a “safe and effective smoking cessation aid.”

By 2010, they were no longer available for purchase on Amazon.com or on websites using PayPal.

On May 5 of this year, the FDA announced it will begin oversight of e-cigs (and similar devices) in August 2016.

Basically, e-cigs making claims to have therapeutic benefit (such as usefulnessfor smoking cessation) will be subject to drug safety and efficacy clinical trial standards.

The rest will be regulated as tobacco products, based on a 2010 court ruling. All manufacturers must register by Aug. 8, but have two additional years to complete applications before they will be evaluated by the FDA.

Until then, it is difficult to know what exactlyis in each product, aside from the manufacturer’s statements.

The main chemical in most e-cigs is nicotine. Trace amounts of nicotine have been found even in “nicotine-free” e-cigs by the FDA in 2009 in lab tests, and two studies in 2014 showed significant variability of nicotine levels in the same products batch-to-batch.

The nicotine amounts also often differed significantly from what the product labels stated. Nicotine dose also varied with vaporizer used and user technique.

Next week we will examine the effects that nicotine and other substances in e-cigarettes can have on users.

Dr. Jacob MINOR is board-certified by the American Board of Otolaryngology. He practices at Seton Medical Center Harker Heights.

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