Electronic Cigarettes, Working Psychologically and Physically

Since many of my patients have reported using electronic cigarettes to successfully stop smoking, I now recommend the devices to anyone who has tried to quit smoking cold turkey and failed.

And I think it is time that other doctors do, too.

Electronic cigarettes combine a mouthpiece, which contains liquid (including nicotine), an atomizer (which heats the liquid and turns it into vapor), a battery and an LED tip that glows like the tip of a lighted cigarette.

While early versions of the electronic cigarette date back to 1963, with a patent awarded to inventor Herbert Gilbert, the modern versions of electronic cigarettes—the basis for big brands in the industry, such as LOGIC and Blu—were introduced at the beginning of this century.

The reason my patients tell me electronic cigarettes work better than the patch or nicotine gum is that they simulate the act of smoking, but not perfectly. They are good enough to substitute for real cigarettes, but they aren’t good enough to become an addiction, in and of themselves. An analogy in the arena of food addiction would be something low calorie that fills you up enough to prevent bingeing on sweets, gives you some distance from that addiction, but then becomes forgettable, because it isn’t really all that compelling.

It is, of course, imperative that the electronic cigarette be a good-enough fake. And, on this count, LOGIC seems to have a slight psychological advantage, given what patients tell me is a very realistic smoking experience—but not too realistic, as noted above. Interestingly enough, the LOGIC brand seems to be the best-selling one in New York City, perhaps because of these factors.

There is certainly controversy about whether electronic cigarettes are harmless. Critics note that they do, of course, contain nicotine (which is the whole idea, after all). And critics have also found other substances in the vapor released by electronic cigarettes—even cancer-causing substances, but in tiny, tiny amounts that proponents of the devices claim would have no negative effect on well-being at all.

What no one seems to argue about is that electronic cigarettes—from LOGIC or Blu or any leading brand—are not nearly as dangerous as smoking real cigarettes. LOGIC claims its device avoids 4,000 toxins that are found in cigarettes.

Given my experiences and those of numerous clinicians I have spoken with, it would seem to be a good time to conduct large scale clinical trials in which patients who smoke are given electronic cigarettes by their doctors, encouraged to use them and then quizzed on their use of real tobacco weeks and months and years later. If the data generated support the product, then it may be wise for medical insurance companies to offer electronic cigarettes to smokers for free. My bet is they would save lots of money—from the costs of treating heart disease and cancer—down the road.