Electronic Cigarettes: Nicotine Comes Around Again

Are we trading one addiction for another?


The next issue of The Medical Letter includes an article on electronic cigarettes, which have lately received considerable space in the popular press. With LED bulbs at their tips and flavors like chocolate, it becomes easy to forget that what they bring to the table is nicotine, which has caused a lot of trouble in its day.

Researching our article led us to an excellent old (1998) book called Nicotine Safety and Toxicity, edited by Neal L. Benowitz, which does a fine job of teasing out the toxicity of nicotine, particularly its cardiovascular toxicity, from that of all the other toxins found in cigarette smoke. The increased incidence of cardiovascular disease in smokers, including myocardial infarction, stroke, and peripheral vascular disease, is well documented, but the exact cause is unclear.

Benowitz points out that carbon monoxide and oxidant gases are plausible contributors, in addition to nicotine. But he goes on…

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