If you’re like me, when you first heard of the electronic cigarette you immediately wondered what was wrong with it. In fact, it was a fortunate comment left by a researcher, now a good friend, in the very very early days of this blog which reassured me (and lead to our Interviews with Scientists series).
I think I have learnt a lot about the safety of electronic cigarette since then. Most of this information is on our website or blog somewhere, but I’ve tried to bring it together in one post. If you are new to e-cigarettes, hopefully this will answer your questions and fears – and if you’re not new, let me know if I am missing anything!
Oh – you also want to what the shocking truth is? You’ll have to read on to find out…
What’s Wrong With Smoking?
Anti-smoking activists like to highlight the dramatic use of ingredients found in tobacco cigarette smoke.
Hydrogen cyanide, for example, was used in Nazi death camps, while another, formaldehyde, has been used to preserve corpses).
However, it is the way you use tobacco cigarettes which cause the problem.
When you burn tobacco, you produce smoke. As the smoke cools down, it produces both tar and hundreds of chemicals. Indeed, according to tobacco harm reduction experts, we have yet to identify many of the chemicals in cigarette smoke.
We do know that dozens of them are carcinogenic.
Electronic Cigarette Safety
In contrast, and after a number of analyses, we know exactly what is in electronic cigarettes. The principal ingredient is propylene glycol, which is used in dozens of applications, including medicine, asthma inhalers, cosmetics, foods, to sterilise drinking water, in air-conditioners – and to produce stage smoke!
Propylene glycol has been used since the mid-20th century, and is generally considered safe for inhalation. It’s even been used to sterilise the air in children’s wards. However, a small minority of people may be allergic to it. (If you are allergic to propylene glycol, try using vegetable glycerine instead.)
Vegetable Glycerine has also been analysed by scientists, and considered safe for inhalation.
Most e-cigarettes also contain nicotine. While not entirely healthy (its effects are similar to caffeine), nicotine is not carcinogenic, and carries a fraction of the risk of burning tobacco. (For more information see: Nicotine: 10 facts all users should know.)
In a study summarising the analyses of the electronic cigarette, Professor Siegel concluded:
none of the more than 10,000 chemicals present in tobacco smoke, including over 40 known carcinogens, has been shown to be present in the cartridge or vapor of electronic cigarettes in anything greater than trace quality … they [electronic cigarettes] are undoubtedly safer than tobacco cigarettes
Source: Electronic Cigarettes as a harm reduction strategy for tobacco control: A step forward or a repeat of past mistakes?
What Do Scientists Think About The Electric Cigarette?
Perhaps the most dramatically expressed opinion of an expert is that of David Sweanor, who told me:
Rather than the unattainable standard of ‘safe’ we should be thinking in terms of ‘safer’…. Despite the risks associated with soccer, I would, for instance, prefer my children play soccer rather than play with live hand grenades.
There’s no doubt it can save many lives and hundreds of millions of pounds.
Professor John Britton, chair of the Tobacco Advisory Group of the Royal College of Physicians Source, believes:
If all the smokers in Britain stopped smoking cigarettes and started smoking e-cigarettes we would save 5 million deaths in people who are alive today. It’s a massive potential public health prize.
And here is what Professor Carl Phillips told us:
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Are There Short Term Health Benefits With Electronic Cigarettes?
What we know about electronic cigarettes is based on science, and analyses of the ingredients. As the devices have been used for less than 10 years, we don’t have empirical evidence of the longer term effect of e-cigarettes.
It’s a different matter for short term effects, though.
In 2009, we carried out a survey with the University of Alberta asking how smokers felt after switching to the electronic cigarette. The results seemed clear:
You can read an academic summary of the survey here: E Cigarettes as Potential Tobacco Harm Reduction Projects.
What Other Studies Say
While we are not able to watch a control group for 40 years to see what the effect of e-cigarettes has over the long term, there is a large and growing body of studies which suggests that e-cigarettes are vastly safer than tobacco cigarettes.
One study focussed on nicotine inhalation. A 1996 study saw scientists putting rats in a chamber and pumping in nicotine for 20 hours a day, 5 days a week.
After two years, the rats were still perfectly healthy. The only side effect noticed was some slight weight loss.
Effect on Blood
One World Health Organisation expert wanted to test the effect of vaping on bystanders.
He did so by testing the white blood cells in in their blood.
Smoking causes an increase in white blood cells, which are produced to counter the damage caused by cigarette smoke.
The expert found that there was no increase in white blood cells in either smokers OR in vaper’s blood streams.
Effect on Heart
A 2012 study by expert Konstantinos Farsalinos found that vaping had no acute effects on cardiac function, and only very slight effects on blood pressure and heart rate.
Dr Farsalinos discussed these results with us here.
Effect on Lungs
Dr Murray Laugesen, who conducted one of the first analysis of electronic cigarettes, found that in contrast to smoking, people vaping absorb nicotine in the airway passages rather than the lungs. Studies into the effect of vaping on lungs so far have only found a slight increase in airway resistance (an effect which can also be caused by humid air.)
We also conducted our own survey of a thousand vapers to see how vaping effected their lungs. Check out the results here!
So Are E-Cigarettes Safe or Dangerous?
No, e-cigarettes are not safe or healthy. At least, not in absolute terms. Scientists estimate that they carry around 1-2% of the risk of smoking, which is about the same health risk you get from drinking a cup of coffee.
They are, however, an awful lot safer for you than regular cigarettes.
So what’s the shocking truth?
The shocking truth is that despite the fact that e-cigarettes have the ability to save your life – as well as millions of others – they do not have the support they deserve.
In New Zealand e-cigarettes containing nicotine are banned. Although the government admits they are safer than cigarettes, they worry it could affect their official policy of ‘denormalising’ smokers.
In the Middle East the device is banned, with press stories claiming the device contains 100 or more times as much nicotine as a regular cigarette.
While the device is legal in the US, anti-smoking organisations are financed by pharmaceutical companies selling competing nicotine products to campaign against the device.
And the EU commission is currently trying to ban the e-cigarette, with one MEP highlighting the loss of tax revenue caused by the popularity of the e-cigarette.
Shocking, isn’t it?
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Cahn Z. and Siegel M. Electronic Cigarettes as a harm reduction strategy for tobacco control: A step forward or a repeat of past mistakes? 2010, Journal of Public Health Policy pp. 16-29.,
Farsalinos et al, Electronic cigarettes do not damage the heart,2012, European Society of Cardiology,
Flouris A, Poulianiti K, Acute effects of electronic and tobacco cigarette smoking on complete blood count, PubMed, 50(10):3600-3 · July 2012, DOI: 10.1016/j.fct.2012.07.025
Heavner K, Electronic cigarettes (e-cigarettes) as potential tobacco harm reduction products: Results of an online survey of e-cigarette users Nov 2009, TobaccoHarmReduction.org
Laugesen M. Safety Report on the Ruyan® e-Cigarette and Inhaled Aerosol. 2008, Christchurch: Health New Zealand Ltd .
Waldum H.L. et al, Long-term effects of inhaled nicotine, Life Sci. 1996;58(16):1339-46, PMID: 8614291