E-Cigarettes: Are They Safer?


What is an e-cigarette, and are they safer than the regular variety?

An e-cigarette is a cigarette-shaped, battery-powered tube containing a cartridge with a liquid solution of propylene glycol and/or vegetable glycerin plus nicotine inside. Puffing (called “vaping”) on an e-cig, activates a heating device, which warms the nicotine-containing liquid inside the cartridge, which produces the vapor.  The e-cigs contain far less nicotine than regular cigarettes, although the doses may be different between e-cigarette brands.  The nicotine from e-cigs goes to the brain quickly, producing a brief relaxation and slight mood elevation. The nicotine is metabolized or excreted, but because the influx of nicotine causes elevated production of nicotinic receptors, the body demands another cigarette.

How does this differ from regular tobacco cigarettes?

Five million deaths a year are attributed to tobacco use worldwide. Nicotine has been conclusively linked to a higher risk of heart disease.  Until the advent of e-cigarettes, cigarettes were traditionally just tobacco rolled in paper. If it were still possible to smoke pure tobacco, probably this dismal mortality rate would not be so huge.  What makes them so deadly are the estimated 4,000 chemicals they give off when lit. As of April 1994, the five major tobacco companies had reported 599 chemical additives to the tobacco. Additives such as lead, arsenic, and formaldehyde have been blamed for cancer, and a host of other diseases.  In November of 1998 the four largest US tobacco companies reached a settlement with the Attorneys Generals of 46 states, ultimately paying out upwards of $206 billion for health-care costs associated with cigarette use.

According to Michael B. Siegel, MD, a professor at Boston University’s School of Public Health, available data indicates that e-cigarettes are safer than traditional tobacco.  Smokers trying to quit cigarettes may have better luck by switching to e-cigarettes. Unfortunately, the e-cigs haven’t been on the market for long enough to make data available on the long-term health effects.  And the jury is still out as to whether or not they do help people kick the habit.

Research into possible health effects is still in the preliminary phases. However, concerns about the safety of the e-cigs have caused the FDA to consider regulations. Propylene glycol has been extensively tested, and the FDA considers it safe for use in food and medicinal use. It’s also an element in cough syrups, food flavorings, and toothpastes, despite a link to minor skin or lung irritation. Vegetable glycerin has also been okayed by the FDA, although not much research exists on its health effects.

What about second-hand smoke?

There is not a lot of research into the chemicals produced when one smokes an e-cig.  The heat apparently creates harmful chemicals, with indeterminate effects, although considerably fewer than regular cigarettes. Also of concern is the artificial flavors added to the e-cigs; these flavor-producing chemicals have been cleared to be eaten as food, but the risk from inhaling them has not yet been assessed, according to Maciej Goniewicz, PhD, PharmD of Roswell Park Cancer Institute in Buffalo, New York. Compounding the complexity of the safety studies is the sheer number of available e-cig varieties and the variety of the chemicals they contain.

Secondhand cigarette smoke is linked to many serious diseases, including cancer and heart disease. Dr. Goniewicz has performed research on the amount of chemicals in the e-cig vapors; the investigations turned up nicotine in the vapor, but non-worrisomely low levels of other toxins. The researchers called for follow-up studies on long-term exposure, especially with children; also for studies to measure levels of vapors outside the lab, such as in restaurants and bars. Because of the possible health concerns associated with e-cigarettes, the FDA is looking into regulation of these products although there is no definite deadline for the proposed regulations. Dr. Siegel is in favor of the regulation, as it encourages more studies into the possible health repercussions of the e-cigarettes.

Ethical considerations:

Picking up a cigarette for teens is often a rite of passage: nowadays, however they are more likely to pick up the electronic variety. The number of youngsters who have reportedly tried the flavored e-cigs has doubled between 2011 and 2012.  A recent study indicated that middle and high school students smoking e-cigs are also more likely to smoke the traditional tobacco cigarettes, suggesting a strong link between these habits. Other research suggests that 70 percent of adult smokers picked up cigarettes before age 18. Health officials worry that e-cigarettes may be a gateway to regular tobacco use for young smokers.

The economic impact of e-cigarettes:

Although a number of questions remain unanswered about the safety of e-cigarettes, researchers suggest they are a safer option than regular cigarettes. At this time, due to their popularity among adults seeking to quit and among youths seeking rebellious pleasures, e-cigarettes are pulling in $1.5 billion yearly for the manufacturers, and are projected to produce $3 billion in revenue within five years.

By Laura Prendergast


NY Times

Roswell Park Cancer Institute