Indication of a Propensity for Addiction
Any form of smoking is harmful, and not smoking is the ultimate sociopolitical and medical objective. This is not what is being discussed. Morgenstern et al. (1) in their article interpreted the consumption of e-cigarettes as a gateway to cigarette consumption in the following six months, with a relative risk of 2.2. The question is whether this is a legitimate position or whether experimenting with e-cigarettes is already a manifestation of a propensity for addictive behavior. Binge drinking—which has the second highest relative risk—is similar. It is therefore not the e-cigarette as such but the fact of the consumption of an e-cigarette, in the same way as a prior drinking binge, that shows the already existing propensity of a person to develop an addiction.
The e-cigarette per se does not create later cigarette smokers. This is reflected in the comment in an article by Kotz et al. (2), that consumption of e-cigarettes in persons who had never smoked tobacco was low, at 0.3%. The fact that people with addiction potential and lower willingness to take risks at first try out another product seems logical. On this background it would have been important to differentiate between the different e-products and the societal phenomenon of hookah/shisha smoking. As Dr. Ute Mons, director of the cancer prevention office at the German Cancer Research Center (DKFZ) said at the 2017 annual meeting of the Austrian Society of Pneumology (quote): “Whereas for shishas it has been proved that they are associated with a similar risk to health as cigarette smoking, according to current research evidence the potential for harm of e-cigarettes is notably lower than that of conventional cigarettes” (3).
Prof. Dr. med. Knut Kröger
Klinik für Gefäßmedizin
- Angiologie -
HELIOS Klinikum Krefeld GmbH
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Morgenstern M, Nies A, Goecke M, Hanewinkel R: E-cigarettes and the use of conventional cigarettes—a cohort study in 10th grade students in Germany. Dtsch Arztebl Int 2018; 115: 243–8 VOLLTEXT|
|2.||Kotz D, Böckmann M, Kastaun S: The use of tobacco, e-cigarettes, and methods to quit smoking in Germany—a representative study using 6 waves of data over 12 months (the DEBRA study). Dtsch Arztebl Int 2018; 115: 235–42 VOLLTEXT|
|3.||Mons U: Shishas & E-Zigaretten, ein Update. Wiener Medizinische Wochenzeitschrift (Skriptum) 2017; 8: 4–5|