What Do We Know about E-Cigarette!

As a pulmonologist with the San Diego Veteran’s Affairs hospital, Laura Crotty Alexander has probably answered every possible question about smoking. Whether her patients were trying to find ways to quit or just wondering whether their current health problems could be associated with smoking, Crotty Alexander provided answers.

A couple of years ago, however, her patients began asking new questions: Are electronic cigarettes safer than conventional cigarettes, and will they switch? “I did not have the answers. As a physician and a researcher, that was very frustrating,” Crotty Alexander says.

Physicianeverywhere the country are encountering an equivalent questions from their patients. Out of nowhere, it seems, e-cigarettes–or electronic nicotine delivery systems, as they’re formally known–are appearing at gas stations, convenience stores, and anywhere else cigarettes are sold. Advertisements claim e-cigarettes offer health benefits by helping smokers quit. All e-cigarette users inhale is “harmless water vapour .” (1) The e-cigarette, it might seem, takes all the danger out of smoking.

Many environmental health scientists aren’t so sure. Maciej Goniewicz, a toxicologist at the Roswell Park Cancer Institute in Buffalo, New York, says, “This is vapor, but only alittle proportion of it’s water.” Mostly, he says, it’s made from propanediol and/or glycerin, the most ingredients within the “e-liquid” (or “e-juice”) that’s vaporized inside e-cigarettes. When heated, these solvents produce an aerosol resembling cigarette smoke. (2) Most e-liquids also contain flavorings and preservatives. (3,4)

“Most of what we all know about e-cigarettes is from lab studies,” Goniewicz says. “We do not know about the important health effects on the users of this product, especially on long-term users.”


The newness of e-cigarettes means longitudinal studies about potential health dangers are still within the distant future. Meanwhile, the prevailing literature about the security of the devices consists of small studies on e-liquids and e-cigarette emissions. It remains unknown exactly how e-cigarettes and their related secondhand smoke compare with conventional cigarettes.

Despite the shortage of health data, many researchers assume e-cigarettes are less dangerous than conventional cigarettes. Gerry Stimson, a public health scientist at Imperial College London, explains, “When you burn substance , you inhale many nasty things into your lungs.” Because e-cigarettes only heat a liquid instead of burning tobacco leaves, he says, it creates fewer hazardous particles which will be inhaled.

“The vapor doesn’t appear to be benign, but it does seem to be the lesser of two evils in comparison to cigarettes,” Crotty Alexander says.

Stimson adds, “At issue may be a matter of weighing up potential risks against potential health benefits. Small and sometimes not so small risks are related to all kinds of pharmacological and other health and social interventions, but the required precautionary principle must be weighed against potential benefits.”

Of course, saying something is safer than smoking cigarettes isn’t exactly setting a horizontal bar . The Centers for Disease Control and Prevention estimates that cigarette smoking causes one in five U.S. deaths annually , including deaths resulting from secondhand smoke exposure. (5) Smoking may be a leading risk think about chronic obstructive pulmonary disease, carcinoma , and disorder . (6) it is the leading preventable explanation for premature death within the us and one among the leading causes round the world. (6)

A Boom in Popularity

Against a backdrop of accelerating awareness of the health dangers of cigarettes and legal crackdowns on public smoking, Chinese pharmacist Hon Lik first developed an electronic alternative to traditional cigarettes in 2003. (7) E-cigarettes entered the U.S. market in 2007. (8)

The devices are available a spread of shapes and sizes, but all are variations on an equivalent general theme: A component at one end aerosolizes a liquid nicotine solution, and therefore the vapor is inhaled through a mouthpiece. …

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