Across the Czech Republic, electronic cigarettes, or e-cigarettes, have become something of a phenomenon in the last year or so. Stores are opening up on streets in the country’s towns and cities selling these nicotine replacement devices. The rise of the e-cigarette in the Czech Republic mirrors its growing popularity for smokers seeking to kick the habit across much of the world. But questions persist. Are they safe? Do they work? The Czech government is currently debating new regulations to ban them from places where smoking is already prohibited. Doctor Eva Králíková runs the Prague-based Czech Centre for Tobacco Addiction. Her organization has just undertaken a study, which found that more than one-third of Czech smokers have tried e-cigarettes. I asked her for the medical perspective:
“Their safety or even efficacy as a smoking cessation aid has yet to be proven. But on the other side, it is important to point out that they do not produce any smoke. Nothing is burning in them and so there are definitely not thousands of chemicals there, which are present in tobacco smoke. So the risk is incomparable with classic cigarettes and I wouldn’t be afraid of them. But as a doctor I cannot recommend e-cigarettes because I don’t know the exact composition of what is in them, but on the other side, it is almost zero risk.”
Almost zero risk. So tell me a little bit more about the fact that both the medical profession and also governments have yet to officially certify e-cigarettes as smoking cessation devices. Do they exist in something of a legal black hole?
“Concerning the legal question, in the Czech Republic, they are currently categorized among tobacco products, so you cannot sell them to minors and so on. One thing that remains unclear is the amount of nicotine which is contained in the liquid that is absorbed. And several times we’ve heard that someone overdosed because it is easier to do than from classic cigarettes.”
So you believe that that is the main danger? Because there haven’t been any studies of the long-term effects of inhaling the glycerin and the flavorings in the liquid in the e-cigarettes. Could there be any risks there?
“It’s true that there are no long-term studies. There was one study by the US Food and Drug Administration, which did find some traces of [carcinogenic] nitrosamines in one sample, but this is really something close to zero danger.”
So tell me the statistics of the number of Czechs that are smoking, the numbers that have tried e-cigarettes and the impact that they could possibly have.
“We have to point out that to quit smoking is not easy – that tobacco dependency is a drug dependency with a very low success rate. In the Czech Republic, we have around 30% of the population over the age of fifteen smoking. And of these, around 35% have tried e-cigarettes for two reasons: one is to find a less dangerous way of smoking, which is definitely true. And the second reason is to stop smoking and also to be able to get nicotine in places where smoking is forbidden. But as a doctor I can only recommend nicotine replacement therapy as pure nicotine, available without prescription over the counter in pharmacies, in the form of patches, gum or inhalers.”
And finally, the government is apparently preparing some new legislation that will regulate e-cigarettes. What might this, to your knowledge, change?
“As far as I’ve heard, it will ban the use of e-cigarettes where smoking is already forbidden. This doesn’t make sense to me because in my opinion, it is smoke that should not be present in any indoor environment. So it is far more important to ban smoking in restaurants and other indoor public places. To point out the dangers of e-cigarettes seems crazy compared to the dangers of classic cigarettes.”