My conversation with Jonathan Whiteson M.D.

[pbusardo]

I thought you would very much enjoy this conversation I've been having with Jonathan Whiteson M.D. He is the director of cardiac and pulmonary rehabilitation at the Rusk Institute, NYU Langone Medical Center. For those of you who don't know, he has been quoted as saying.

"Electronic cigarettes should be absolutely avoided because they clearly have toxic elements," said Dr. Jonathan Whiteson, a pulmonologist at New York University Langone Medical Center. "It is proven now that electronic cigarettes contain toxic elements. Electronic cigarettes play no role in smoking cessation and don’t add to a healthier lifestyle."I edited the email thread to make it a bit easier to read. The contents have not been edited at all.

I invite you to make your own conclusion. I will enjoy reading the comments.

----------------------

[FONT="]Hello Dr. Whiteson.[/FONT]
[FONT="] [/FONT]
[FONT="]I’ve recently begun using electronic cigarettes. After 23 years of smoking a pack and a half per day, I now smoke NO real cigarettes. [/FONT]
[FONT="] [/FONT]
[FONT="]I’m concerned about your concern with these devices. Would you be willing to tell me more?[/FONT]
[FONT="] [/FONT]
[FONT="]Thank you.[/FONT]
[FONT="] [/FONT]
[FONT="]Phil J. Busardo[/FONT][/COLOR][FONT="]

[/FONT]


[FONT="]Phil,[/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]
[FONT="]Congratulations on quitting smoking.[/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]
[FONT="]Electronic cigarettes contain toxins that are known carcinogens including elements contained in anti –freeze.[/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]
[FONT="]All Physician groups and the FDA consider them toxic and of no benefit in the smoking cessation arena. [/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]
[FONT="]There are other products with a known and acceptable side effect profile that used under medical guidance are approved for smoking cessation. Electronic cigarettes are not a part of this.[/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]
[FONT="]Stay well,[/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]
[FONT="]Jonathan Whiteson M.D.[/FONT][/COLOR]
[COLOR=navy][FONT="]Director, Cardiac and Pulmonary Rehabilitation [/FONT]
[FONT="]Rusk Institute, NYU Langone Medical Center. [/FONT][/COLOR]



[B][FONT="]From:[/FONT][/B][FONT="] Busardo, Phil [mailto:xxx]
[B]Sent:[/B] Wednesday, August 12, 2009 8:54 AM
[B]To:[/B] Whiteson, Jonathan
[B]Subject:[/B] RE: Electronic Cigarettes[/FONT]

[COLOR=blue][FONT="]Thank you for your reply![/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="]Please see my comments below…[/FONT]
[FONT="] [/FONT][/COLOR]

[COLOR=navy][FONT="]Phil,[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]Congratulations on quitting smoking.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="][Busardo, Phil [HUMB:9562:EXCH]] Thank you!! I’m feeling much better![/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]Electronic cigarettes contain toxins that are known carcinogens including elements contained in anti –freeze.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="][Busardo, Phil [HUMB:9562:EXCH]] I was under the impression that FDA approved nicotine delivery systems also contain known carcinogens as well. As far as the toxic elements contained in anti-freeze, I thought that was only found in a single cartridge at a single strength by a single company. Is that not the case?[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]All Physician groups and the FDA consider them toxic and of no benefit in the smoking cessation arena. [/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="][Busardo, Phil [HUMB:9562:EXCH]] The use of the word “all” here surprises and concerns me. Is it really ALL physician groups that consider them toxic?[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]There are other products with a known and acceptable side effect profile that used under medical guidance are approved for smoking cessation. Electronic cigarettes are not a part of this.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="][Busardo, Phil [HUMB:9562:EXCH]] I understand that there are products available, but this is the first product that has worked for me. If risk reduction is what I’m after, would an electronic cigarette not be safer than a real one? [/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="]The following chart suggests that they are MUCH safer than a traditional cigarette. Please note that I’m not trying to be an advocate, I just want to understand if using them is safer than a real cigarette as I’m concerned with what I’m putting in my body.[/FONT]
[FONT="] [/FONT][/COLOR]
[B]Maximum tobacco-Specific Nitrosamine Levels in Various [/B]
[B]Cigarettes and Nicotine-Delivery Products [/B]
[B](ng/g, except for nicotine gum and patch which are ng/patch or ng/gum piece)[/B]
[B]Product[/B]
[B]NNN[/B]
[B]NNK[/B]
[B]NAT[/B]
[B]NAB[/B]
[B]Total[/B]
Electronic cigarettes
3.87
1.46
2.16
0.693
8.183
Nicotine gum
2.00
Not detected
Not detected
Not detected
2.000
Nicotine patch
Not detected
8.00
Not detected
Not detected
8.000
Swedish snus
[FONT="] [/FONT]
[FONT="] [/FONT]
[FONT="] [/FONT]
[FONT="] [/FONT]
2400
Winston
2200
580
560
25
3365
Newport
1100
830
1900
55
3885
Marlboro
[FONT="] [/FONT]
[FONT="] [/FONT]
[FONT="] [/FONT]
[FONT="] [/FONT]
6600
Camel
3100
1400
2800
150
7450
Skoal
4500
470
4100
220
9290
Marlboro
4300
1800
4900
190
11,190
[COLOR=blue][FONT="] [/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="]I’m not interested in using this product forever. I’ve already gone from a strong nicotine liquid to a medium and now I’m using a low. My goal is zero and then to stop using the product.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="]Again, thank you very much for your guidance.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]Stay well,[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]Jonathan Whiteson M.D.[/FONT]
[FONT="]Director, Cardiac and Pulmonary Rehabilitation [/FONT][/COLOR]
[COLOR=navy][FONT="]Rusk Institute, NYU Langone Medical Center. [/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]


[FONT="]From:[/FONT][/B][FONT="] Whiteson, Jonathan [mailto:Jonathan.Whiteson@nyumc.org]
Sent: Wednesday, August 12, 2009 9:44 AM
To: Busardo, Phil
Subject: RE: Electronic Cigarettes[/FONT]

[FONT="]Noted. Thanks. [/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]
[FONT="]Stay well.[/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]Jonathan Whiteson M.D.[/FONT]
[FONT="]Director, Cardiac and Pulmonary Rehabilitation[/FONT][/COLOR]
[COLOR=navy][FONT="]Rusk Institute, NYU Langone Medical Center[/FONT]



[FONT="]From:[/FONT][/B][FONT="] Busardo, Phil [mailto:xxx]
Sent: Wednesday, August 12, 2009 9:45 AM
To: Whiteson, Jonathan
Subject: RE: Electronic Cigarettes[/FONT]

[FONT="]Thanks for your response. Could you please respond to the additional questions and comments?[/FONT][/COLOR]
[COLOR=blue][FONT="] [/FONT]
[FONT="]Phil J. Busardo[/FONT][/COLOR][COLOR=blue][FONT="]

[/FONT]



[FONT="]From:[/FONT][/B][FONT="] Whiteson, Jonathan [mailto:Jonathan.Whiteson@nyumc.org]
Sent: Wednesday, August 12, 2009 9:48 AM
To: Busardo, Phil
Subject: RE: Electronic Cigarettes[/FONT]

[FONT="]This is not a forum to discuss this issue further. [/FONT][/COLOR]
[COLOR=navy][FONT="]
Regards.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]Jonathan Whiteson M.D.[/FONT]
[FONT="]Director, Cardiac and Pulmonary Rehabilitation[/FONT][/COLOR]
[COLOR=navy][FONT="]Rusk Institute, NYU Langone Medical Center[/FONT]



[FONT="]From:[/FONT][/B][FONT="] Busardo, Phil [mailto:xxx]
Sent: Wednesday, August 12, 2009 9:53 AM
To: Whiteson, Jonathan
Subject: RE: Electronic Cigarettes[/FONT]

[FONT="]What would be the correct forum Doctor?[/FONT][/COLOR]
[COLOR=blue][FONT="] [/FONT]
[FONT="]Why won’t anyone answer the question, “If risk reduction is what I’m after, based on current research and testing, is an electronic cigarette safer than a real one.”[/FONT][/COLOR]
[COLOR=blue][FONT="] [/FONT]
[FONT="]It really is a simple yes or no answer.[/FONT][/COLOR]
[COLOR=blue][FONT="] [/FONT]
[FONT="]Phil J. Busardo[/FONT][/COLOR][COLOR=blue][FONT="]

[/FONT]



[FONT="]From:[/FONT][/B][FONT="] Whiteson, Jonathan [mailto:Jonathan.Whiteson@nyumc.org]
Sent: Wednesday, August 12, 2009 9:55 AM
To: Busardo, Phil
Subject: RE: Electronic Cigarettes[/FONT]

[FONT="]No![/FONT][/COLOR]
[COLOR=navy][FONT="] [/FONT]

[FONT="] [/FONT][/COLOR]

[B][FONT="]From:[/FONT][FONT="] Busardo, Phil [mailto:xxx]
[B]Sent:[/B] Wednesday, August 12, 2009 10:04 AM
[B]To:[/B] Whiteson, Jonathan
[B]Subject:[/B] RE: Electronic Cigarettes[/FONT]

[COLOR=blue][FONT="]I apologize, but the response of ‘No!’ is based on what information? [/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="]Even with the trace amounts of Diethylene glycol found in that one cartridge how can you say based on this chart that an electronic cigarette is not safer than a real one. I’m not saying it’s 100% safe. I’m not saying it’s safer than just breathing air. I’m saying that it’s safer than a pack-and-a-half a day habit of smoking Marlboro reds.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="] [/FONT]
Product
NNN
NNK
NAT
NAB
Total
Electronic cigarettes
3.87
1.46
2.16
0.693
8.183
Nicotine gum
2.00
Not detected
Not detected
Not detected
2.000
Nicotine patch
Not detected
8.00
Not detected
Not detected
8.000
Swedish snus
[FONT="] [/FONT]
[FONT="] [/FONT]
[FONT="] [/FONT]
[FONT="] [/FONT]
2400
Winston
2200
580
560
25
3365
Newport
1100
830
1900
55
3885
Marlboro
[FONT="] [/FONT]
[FONT="] [/FONT]
[FONT="] [/FONT]
[FONT="] [/FONT]
6600
Camel
3100
1400
2800
150
7450
Skoal
4500
470
4100
220
9290
Marlboro
4300
1800
4900
190
11,190
[FONT="] [/FONT][/COLOR]
[COLOR=blue][FONT="]Again, I’m really not trying to give you a hard time. I’m just trying to understand all the facts that are currently known.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=black][FONT="]Phil J. Busardo[/FONT][FONT="]

[/FONT][/COLOR]
[COLOR=blue][FONT="] [/FONT]

[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]I thank you for your interest. [/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]With respect to my patients and the work I do, I cannot maintain this dialogue.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]You have my opinion based on available data.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]Regards.[/FONT]
[FONT="] [/FONT][/COLOR]
[COLOR=navy][FONT="]Jonathan Whiteson M.D.[/FONT]
[FONT="]Director, Cardiac and Pulmonary Rehabilitation[/FONT][/COLOR]
[COLOR=navy][FONT="]Rusk Institute, NYU Langone Medical Center[/FONT]
[FONT="] [/FONT]

 

[sherid]

Would you please either paste this on The Rest of the Story: Tobacco News Analysis and Commentary or grant me permission to do so?

 

[GrimmGreen]

wow , just.... wow... "NO!" so effing bureaucratic it's amazes me

 

[JustJulie]

Not that I agree at all with Dr. Whiteson, but in all fairness, it's unrealistic to expect him to have an extended "conversation" with a non-patient, especially a non-paying one.

I don't know that much can be fairly inferred from his curt "No" other than he simply didn't want to bother with the conversation any further.

No great loss to us, though. In my opinion, his use of the word "all" is pretty damning . . . shows a lack of thoroughness and thoughtful consideration. Glad he's not my doctor.

 

[Angela]

Reminds me of someone talking to a child without having any answers:-

Parent: "Don't do that"
Child: "Why"
Parent: "Because it's bad for you"
Child: "But why?"
Parent: "Because it is"
Child: "Why?"
Parent: "Because I said so"


LOL... talk about being unable to back up his opinion!!!!! It clearly shows that YOU know more about the FDA report than he does!!!!!

pbusardo, would you have any objection to my copying and pasting this into another forum I frequent?

 

[pbusardo]

To all requests to repost -

I have no problem with this. Just PLEASE send me your email so I can send you a copy with the table formats intact. Looks like the format got hosed on my post.

Thanks!!

 

[Adverb]

At least he responded. You can't really expect the guy to have a debate with you.

 

[pbusardo]

At least he responded. You can't really expect the guy to have a debate with you.

Wasn't looking for a debate, just some facts and data to support, "No!"

 

[SudokuGal]

Unless the doc agreed to you posting his responses here, I'm wondering if it is a good idea to keep this post.

 

[Ryle]

LOL I think the doc sounded a bit infantile. "No!".. reminds me of my little brother (3) ..

Me: "Quit trying to kick the TV"
Bro: "No!"
Me: "Sit down and behave"
Bro: "No"
Me: "Do you want to be in trouble"
Bro: "No!" *insert pouty face here*
Me: "Then sit down and behave"
Bro: "No!" *sits on the couch anyway*

I would think that someone "smart" enough to be a Doctor would have a bit more skill in the usage of the English language to respond with something a little more intellectual than "No!" as the entire body of an email.

 

[AVITWeb]

Sounds like someone had poop in his diaper....Great to know that DOCTORs are just as bad as the rest of the sheep...believe everything you read!
I explained it to the wife like this:
If you were given the choice between jumping down a 20 foot well where you would almost certain not survive or jumping down a 3 foot well and perhaps get some broken bones, which would you choose...

I really would like to see some REAL evidence as to what happens to VG or PG and glycerin when it it burned.!

 

[surich]

Another closed mind. As soon as you started quoting hard data, he shut down. Wonder which Pharma he gets kick backs from? We all know that a lot of doctors get a "bonus" for writing prescriptions of certain brands. Maybe he's one of them?

No bashing please. Just my .02 cents.

 

[The Wrong Man]

The first email does just seem like the same old sh**e we see everywhere but in his later responses, this is the first doctor (as far as I have seen) who has 100% said 'smoke real cigs, not e-cigs'. I wonder if he tells his patients to smoke real cigs? I wonder if he is the only doctor in the world to encourage his patients to smoke cigarettes? I wonder many more things, too, but I probably shouldn't post them....
TWM.

 

[Houdini]

This doctor knows nothing about e-cigarettes. NOTHING AT ALL. He probably never even heard of them until he read that bs report from the FDA. He's just quoting almost exactly what was said in that report. He can't answer any logical questions because he has nothing to base his argument on except what he read in the report.

 

[ProtoType]

This Doctor is not well educated on the matter or subject. He has not done any research on the topic at hand nor looked at unbiased data. Trust me, not all Doctors are like him. He does not represent the council.

 

[Luke15_7]

Excellent work, Phil! Seems to me that if he steps out into the public spotlight, as an expert, to condemn a product that he should be able to defend his position - also with hard evidence.

A true scientist examines all data and then makes their determinations based on the results... not make a determination and then not be able to back it up with the data. A true scientist would also look objectively at "new" information (that table laid it out plain and clear to me!) and re-evaluate their position without personal bias to what the results say.

...then again, I also learned about 11 years ago that everyone has an agenda (personal bias), and I tend to believe the best of people.

Kudos, Phil!

 

[pbusardo]

Excellent work, Phil! Seems to me that if he steps out into the public spotlight, as an expert, to condemn a product that he should be able to defend his position - also with hard evidence.

A true scientist examines all data and then makes their determinations based on the results... not make a determination and then not be able to back it up with the data. A true scientist would also look objectively at "new" information (that table laid it out plain and clear to me!) and re-evaluate their position without personal bias to what the results say.

...then again, I also learned about 11 years ago that everyone has an agenda (personal bias), and I tend to believe the best of people.

Kudos, Phil!

Thanks Luke.

I agree with you. He couldn't back up his position and when pushed, put his tail between his legs and ran.

 

[Calfun58]

Interesting - I have been over this with my personal physician, an ENT who's a close friend and my dentist. All of whom have encouraged me over the years to stop smoking. In these three cases they had heard of but knew nothing of E-Cigs. Physicians go through rigorous education and training but its all based on well tested (and regulated)data and the medical system. You will rarely get positive reviews from any physician on alternative or holistic medicine or even a chiropactor. All this said, the AMA is no ttaking a stand on e-cigs and the FDA is somewhere between big tobacco who missed the boat so far on e-cigs, pressures through the political machine supported by the tobacco farming lobby and pressures to stamp out nicotine use - not replace it with a safer healtier delivery alternative.

So back to the Doc's. All three of the medical professionals I work with support the e-cig for this patient. I have no "health issues" but they believe that for me the e-cig may be a lifesaver.

 

[Luke15_7]

My nearly 80-year old mother, who's been a smoker for well over 60 years and now has COPD, asked her new doctor (she just relocated closer to us) if ecigs would be a good alternative to try. Granted, my mom lied to her and said that she had quite smoking, and later said she only smoked about 5 cigs a week (but only on weekends)... ok, she's in denial, but she's my Mom.
Anyway, without looking into it further, familiarizing herself with the pros and cons and making an informed choice - she just came out and said, "No." Now we can't get Mom interested at all...

 

[Angela]

Well, in fairness, if the doctor was under the impression that your mum had given up (or just about given up) then no - vaping isn't a good alternative to not smoking at all!