Like conventional cigarettes, electronic cigarettes may function as a
"gateway drug" that can prime the brain to be more receptive to harder
drugs, US researchers said on Wednesday.
The findings, published in the New England Journal of Medicine, add to
the debate about the risks and benefits of electronic cigarettes, the
increasingly popular devices that deliver nicotine directly without
burning tobacco.
E-cigarettes have the same physiological effects on the brain and may
pose the same risk of addiction to other drugs
"With e-cigarettes, we get rid of the danger to the lungs and to the
heart, but no one has mentioned the brain," coauthor Dr. Eric Kandel of
Columbia University, whose findings were published in the New England
Journal of Medicine, said in a telephone interview.
In laboratory studies, the researchers showed that "once mice and rats
are on nicotine, they are more addicted to cocaine" after being
introduced to that drug, said Dr. Aruni Bhatnagar of the University
of Louisville, who was not involved in the study but chaired a 10-member
American Heart Association panel on the impact of e-cigarettes.
That was true even when the mice received nicotine without burning
tobacco, Kandel, a 2000 Nobel laureate for his work on memory, told
Reuters Health in a telephone interview. The findings by Kandel and his
wife, Columbia University researcher Denise Kandel, expand on her
earlier work on nicotine as a "gateway drug," a theory she first
reported on in 1975.
"E-cigarettes have the same physiological effects on the brain and may
pose the same risk of addiction to other drugs as regular cigarettes,
especially in adolescence during a critical period of brain
development," they wrote.
Although it is not yet clear whether e-cigarettes will prove to be a
gateway to the use of conventional cigarettes and illicit drugs, they
said "that's certainly a possibility." "Nicotine clearly acts as a
gateway drug on the brain, and this effect is likely to occur whether
the exposure comes from smoking cigarettes, passive tobacco smoke, or
e-cigarettes," they wrote.
Electronic cigarettes are now a $3 billion business with 466 brands that
include candy flavoring and are increasingly popular among children,
according to the World Health Organization.
Using 2004 epidemiologic data from a large, longitudinal sample, Denise
Kandel found that the rate of cocaine dependence was highest among users
who started using cocaine after having smoked cigarettes.
Dr. Shanta Rishi Dube of the Georgia State University School of Public
Health, who was not involved in the research, said the results "appear
valid based on prior studies that have looked at nicotine as a potential
gateway (drug)."
Bhatnagar said the findings strengthen the case for regulation of
e-cigarettes by the US Food and Drug Administration. "If we don't have
strict laws on youth access and marketing for e-cigarettes, we may fuel
an entire new generation of people on nicotine, and that will be a
gateway drug for the use of other drugs," Bhatnagar said.
