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Richard D. Hurt, MD; Joseph G. Murphy, MD, FCCP; William F. Dunn, MD, FCCP
Author and Funding Information

From the Nicotine Dependence Center (Dr Hurt), Division of Cardiovascular Diseases (Dr Murphy), and Division of Pulmonary and Critical Care Medicine (Dr Dunn), Mayo Clinic.

CORRESPONDENCE TO: Richard D. Hurt, MD, Nicotine Dependence Center, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail: rhurt@mayo.edu


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST the following conflicts of interest: Dr Hurt has received a medical education grant from Pfizer Medical Education Group 2010-2014. Drs Murphy and Dunn have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(1):e30. doi:10.1378/chest.15-0830
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To the Editor:

Although the focus of our article in CHEST1 was on the history of the current cigarette epidemic, we also included a brief section on electronic nicotine-delivery devices (electronic cigarettes [e-cigarettes]) because of their place in the continuum of the epidemic. We very much appreciate the concern expressed by Mr Chausse and colleagues about the safety of e-cigarettes because we, too, are concerned about the long-term safety of these products, which were not subject to adequate long-term scientific safety studies before public availability.

From a medical perspective, the only possible rationale for advocating use of e-cigarettes is as an adjunct to helping smokers to stop smoking. Even this argument is now flawed, because, since our earlier article was accepted for publication, numerous articles and a meta-analysis have shown that e-cigarettes do not help smokers to stop smoking.2,3

We support the clarion calls for the regulation of e-cigarette products to protect our children and fully inform smokers of both their risks and potential benefits, if any.4,5 Long-term studies are needed to validate the safety and efficacy, if any, of e-cigarettes in the treatment of tobacco dependence. The current over-the-counter availability of e-cigarettes in the absence of long-term safety and efficacy studies should be strongly condemned by learned medical societies, and we should advocate for reversal of this flawed public policy of widespread availability of a new nicotine-delivery product known to be potentially addictive and likely to be biologically harmful in the long term.

Acknowledgments

Other contributions: Editing, proofreading, and reference verification were provided by the Section of Scientific Publications, Mayo Clinic.

Hurt RD, Murphy JG, Dunn WF. Did we finally slay the evil dragon of cigarette smoking in the late 20th century? Unfortunately, the answer is no—the dragon is still alive and well in the 21st century and living in the third world. Shame on us! Chest. 2014;146(6):1438-1443. [CrossRef] [PubMed]
 
Shi Y, Pierce J, White M, et al. E-cigarette use, smoking cessation and change in smoking intensity in the 2010/2011 TUS-CPS longitudinal cohort [abstract]. Paper presented at: SRNT 21st Annual Meeting; February 25-28, 2015; Philadelphia, PA.
 
Pavlov D, Ivanova A, Hussain S, Selby P, Zawertailo L. Adoption of e-cigarettes during tobacco dependence treatment is associated with poorer quit outcomes [abstract]. Paper presented at: SRNT 21st Annual Meeting; February 25-28, 2015; Philadelphia, PA.
 
Colditz GA. Smoke alarm—tobacco control remains paramount. N Engl J Med. 2015;372(7):665-666. [CrossRef] [PubMed]
 
Carter BD, Abnet CC, Feskanich D, et al. Smoking and mortality—beyond established causes. N Engl J Med. 2015;372(7):631-640. [CrossRef] [PubMed]
 

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References

Hurt RD, Murphy JG, Dunn WF. Did we finally slay the evil dragon of cigarette smoking in the late 20th century? Unfortunately, the answer is no—the dragon is still alive and well in the 21st century and living in the third world. Shame on us! Chest. 2014;146(6):1438-1443. [CrossRef] [PubMed]
 
Shi Y, Pierce J, White M, et al. E-cigarette use, smoking cessation and change in smoking intensity in the 2010/2011 TUS-CPS longitudinal cohort [abstract]. Paper presented at: SRNT 21st Annual Meeting; February 25-28, 2015; Philadelphia, PA.
 
Pavlov D, Ivanova A, Hussain S, Selby P, Zawertailo L. Adoption of e-cigarettes during tobacco dependence treatment is associated with poorer quit outcomes [abstract]. Paper presented at: SRNT 21st Annual Meeting; February 25-28, 2015; Philadelphia, PA.
 
Colditz GA. Smoke alarm—tobacco control remains paramount. N Engl J Med. 2015;372(7):665-666. [CrossRef] [PubMed]
 
Carter BD, Abnet CC, Feskanich D, et al. Smoking and mortality—beyond established causes. N Engl J Med. 2015;372(7):631-640. [CrossRef] [PubMed]
 
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