When I think of positive behavioral shifts that have occurred in recent years to improve health, it's easy to point to smoking. This habit, which came into popular use in the 1920s, has been the cause of more deaths in America than all the wars the United States has ever fought. Since the 1960s, when roughly half of men and a third of women were smokers, the ranks have been slowly but steadily declining as the dangers have become better-known to the public. Today about 18 percent of American adults are smokers.
According to the latest report by the surgeon general on the health effects of smoking, despite the great gains we have made in thinning the ranks and reducing the risks associated with smoking over the past half-century, emerging evidence is showing that the ways smoking harms both smokers and nonsmokers have been largely underestimated. Though fewer in number, today's smokers face a much higher risk for lung cancer and chronic obstructive pulmonary disease than heavy smokers of 50 years ago, despite smoking fewer cigarettes. The report also identifies, for the first time, exposure to secondhand smoke as a cause of strokes.
Cigarette smoking is still the single largest cause of preventable death in the United States. The report estimates that smoking costs the United States between $289 billion and $333 billion a year for medical care and lost productivity, well above the previous estimates. The report also reveals that cigarette smoking kills even more Americans than previously reported — about 480,000 a year. It calls for more vigorous efforts to control tobacco, setting a goal of reducing the smoking rate from the current 18 percent to less than 10 percent in the next 10 years.
So is it electronic cigarettes to the rescue?
The emergence of e-cigarettes, a technological innovation introduced some half-dozen years ago, is being viewed by many as a means to help achieve that objective. E-cigarettes come in many shapes and forms and were created as a way of mirroring the act of smoking and feeding nicotine addiction — but without the toxic tar of conventional cigarettes. Some health experts even see e-cigarettes as a device that could make cigarettes obsolete. Sales of e-cigarettes more than doubled last year compared with those in 2012, to $1.7 billion. Consumption of e-cigarettes could outstrip that of conventional cigarettes as early as the end of the decade, some say.
But are e-cigarettes a path away from tobacco or to it? On this question, public health experts are split.
One thing that can be agreed upon is that the skyrocketing popularity of the product is far outpacing our knowledge about its long-term impacts on health. The science that might resolve this question is still in the developmental phase. Meanwhile, there are troubling reports, such as one from the Centers for Disease Control and Prevention, which found that 10 percent of high-school students it surveyed in 2012 said they had tried an e-cigarette, double the percentage from the previous year. Seven percent of those who had tried e-cigarettes said they had never smoked a traditional cigarette. That big tobacco is now selling e-cigarettes has also contributed to skepticism and concern among experts and advocates.
Along with a lack of scientific evidence is a shocking lack of regulations of this product.
E-cigarettes were originally developed by a Chinese pharmacist whose father died of lung cancer, and China produces 90 percent of the world's supply. This year, Chinese manufacturers are expected to ship more than 300 million e-cigarettes to the United States and Europe — all produced with manufacturing processes and materials that are virtually unregulated.
According to a front-page story in this past Sunday's New York Times — the latest in a series of articles examining the multibillion-dollar market for e-cigarettes and the consequences for public health — flawed or sloppy manufacturing could account for hazardous materials that are being detected in some e-cigarettes. Among them are heavy metals, carcinogens and other dangerous compounds, including lead, tin and zinc.
One study found e-vapor that contained hazardous nickel and chromium at four times the level they appear in traditional cigarette smoke; another found that half the e-cigarettes sampled malfunctioned, and some released vapor tainted with silicon fibers.
Another study of nearly two dozen e-cigarettes bought in the United States also found large amounts of nickel and chromium, which probably came from the heating element, another suggestion that poorly manufactured e-cigarettes may allow the metals to enter into the e-liquids.
Such findings are not new. In 2009, the Food and Drug Administration issued a warning about the potential health risks associated with e-cigarettes, saying laboratory studies of some samples found the presence of toxic chemicals. The samples included diethylene glycol, which is used in antifreeze. Though some major manufacturers in China were found to have clean factories and be implementing quality control standards, the ease with which small, shoddy operations counterfeit these bands should give little assurance to consumers about the product they receive.
Caught off guard by a product that is neither a food nor a drug and perhaps not necessarily even a tobacco product, the FDA has only begun to move toward regulating e-cigarettes. Setting those needed rules and new manufacturing guidelines could take years.
In the meantime, let the buyer beware.
Write to Chuck Norris ([email protected]) with your questions about health and fitness. Follow Chuck Norris through his official social media sites, on Twitter @chucknorris and Facebook's "Official Chuck Norris Page." He blogs at http://chucknorrisnews.blogspot.com. To find out more about Chuck Norris and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.