I felt as though I walked into the interrogation scene of the movie "Basic Instinct" when my patient asked me, "What are you going to do, charge me with smoking?" He was "vaping" on an electronic cigarette while he smirked at me, obviously sensing my discomfort and enjoying it.

But unlike Sharon Stone, he was a 68-year-old man, dressed in a hospital gown, and awaiting surgery. He was dodging the "pesky" restriction of a smoke-free hospital environment and the need for an ashtray. On second thought, I felt as though I was on "The Twilight Zone."

Until that day, I knew little about electronic cigarettes, also referred to as e-cigarettes. Could puffing (a.k.a. vaping) on an e-cigarette be the greatest thing to come along since sliced bread? Or are they just a wolf dressed in sheep's clothing? Let's take a look at what I found:

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What are e-cigarettes?

If it looks like a duck, but does not function like a duck or smell like a duck, is it a duck? In many ways e-cigarettes mimic traditional cigarettes - the shape, the deliverance of nicotine into the lungs, the appearance of smoke. When the user inhales, it triggers a sensor that switches on a small, battery-powered heater. The heater functions to vaporize liquid nicotine in a small cartridge, activate a light at the "lit" end of the device, and vaporize propylene glycol in the cartridge (the same stuff that theatrical smoke is made of).

Are e-cigarettes safe?

Safer does not mean safe. Less dangerous does not mean not dangerous. The fact is e-cigarettes do not contain many toxic compounds found in traditional cigarettes. Additionally, because the vapor quickly dissipates, it does not pose the same harm to bystanders as second-hand smoke.

However, e-cigarettes still contain nicotine which is a highly addictive,  compound that increases the "vaper's" heart rate and blood pressure. Some studies suggest other components in some e-cigarettes such as formaldehyde cause cancer.

Do e-cigarettes help you quit?

Depends on whom you ask. The truth of the matter is smokers are addicted to nicotine and e-cigarettes continue to feed into the addiction. Nicotine patches and gum slowly release small amounts into the body. However, e-cigarettes create a freebase form of nicotine that goes quickly from the lungs to the heart and brain. There is the potential of putting people in "limbo" of wanting to quit and having this hope, but allowing them to continue utilizing nicotine and the ritual of smoking (even in places where traditional cigarettes are banned).

Can they get kids hooked?

Although e-cigarettes are being marketed as devices to help smokers quit, one of the biggest concerns is their appeal to children. Each day in the US, nearly 4,000 people younger than age 18 smoke their first cigarette. Kids may be more inclined to start reaching for e-cigarettes because they come in several yummy flavors. The concern is we may be creating a new generation of nicotine addicts.

It's bad for you, right?

The general perception is if something is not regulated, it is not harmful. Efforts are currently underway to change this notion. Over the next few years, e-cigarettes will likely be included under the definition of a "tobacco product" and face the same set of rules.

Although the jury is out on the future of e-cigarettes, I have a pretty good idea of what the verdict will be. The marketing for these devices eerily mimics that of traditional cigarettes - freedom, sophistication, rebellion - which appeals to youth. This makes me ask myself, do other smoking cessation methods utilize similar cool and breezy ads? Things that make you go hmmmm. Although I applaud those who have utilized them to successfully quit smoking, I worry about creating a new generation of vapers.

Dr. Nina Radcliff, of Galloway Township, is a physician anesthesiologist, television medical contributor and textbook author. Email questions on general medical topics to her at drninaradcliff@aol.com


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