Are E-cigarettes safe?

While anything containing nicotine cannot be called 100% safe, evidence from numerous studies strongly suggests that they are magnitudes safer than tobacco cigarettes.

Due to the fact that nothing is burned, e-cigarettes don’t deliver the things that cause smoking-related disease and death. Vapor contains no tar, no carbon monoxide, no particulates, and none of the thousands of chemicals that are created by combustion. Harm reduction experts can point to research supporting that switching from cigarettes to a smoke free product will reduce health risks to less than 1% of smoking traditional cigarettes - nearly the same as non-smokers.

Electronic cigarettes offer another option for the committed smoker who enjoys smoking but who seeks a viable alternative to traditional tobacco smoking. In the five years that electronic cigarettes have been on the market, there have been no known adverse health reactions or complaints. On the other hand, approximately 440,000 people die every year from traditional tobacco smoking.

Here's what the experts say:

Professor Carl Phillips:

"The health benefits of switching are almost exactly the same as the health benefits of quitting..."

Siegel and Cahn (in a conclusion to an analysis is 19 different studies into e-cigarettes:)

“They [electronic cigarettes] are undoubtedly safer than tobacco cigarettes.”

Dr Nitzkin, Chair of the Tobacco Control Task Force for the American Association of Public Health Physicians:

"...we have every reason to believe that the hazard posed by e-cigarettes would be much lower than one percent of the hazard posed by cigarettes."

David Sweanor, former advisor to the WHO on tobacco control:

"If there is anyone who believes cigarettes are no more hazardous than e-cigarettes I’d recommend a remedial course in basic sciences."


What is Propylene Glycol?


What are the health effects?

In multiple surveys, over 90% of users report that their health has improved since they completely or even partially switched from inhaling smoke to inhaling vapor. The most frequently reported health improvement is in lung function, with coughing and wheezing reduced or eliminated.


Do e-cigarettes cause cancer just like tobacco cigarettes?

Though testing by the FDA and other labs have discovered trace amounts of tobacco-specific nitrosamines, which are known to cause cancer with high exposure, the amounts found were extremely low and unlikely to cause cancer. To put it in perspective, an e-cigarette contains nearly the exact same trace levels of nitrosamines as the FDA-approved nicotine patch and about 1,200 times less nitrosamines than a traditional tobacco cigarette.

"An independent study by Dr. Murray Laugesen showed that, on average, the electronic cigarette contained 8.18ng nitrosamines per 1g of liquid. 8 ng in 1g = eight parts per trillion, an extremely tiny amount.

By comparision, nicotine gum tested at 2ng, the nicotine patch tested at 8ng and traditional tobacco cigarettes tested at a staggering 11,190ng. That translates to electronic cigarettes containing 1,200 times LESS of these cancer‐causing nitrosamines than tobacco cigarettes and about the same as the FDA‐approved nicotine patch."


UCLA Santa Monica Hospital Chief of Staff, Dr. David Baron talks about e-cigarettes and their safety. 

Part 1

Part 2


Can e-cigarettes help me quit smoking?

There is a lot of anecdotal evidence and even some scientific research surveys that strongly indicate that e-cigarettes are an effective alternative to smoking. Surveys show that up to 80% of e-cigarette users quit smoking traditional cigarettes while using e-cigarettes.

The United Health Organization concluded that, "In the short time that electronic cigarettes have become popular, the number of people that have been able to quit smoking and stay cigarette free have risen by an estimated 300%; No other methodology has proven as successful in such a short period of time"

However, while some users have gradually reduced the nicotine levels down to zero, the majority of e-cigarette users treat the devices as an alternate source of nicotine and not as a nicotine cessation program. So there is not as much scientific evidence yet that show how effective e-cigarettes are when used to treat or cure nicotine addiction. Yet, anecdotal reports by users who have used e-cigarettes as a way to wean from nicotine also indicates they seem to be very effective way to break smoking triggers and dramatically reduce nicotine levels. As with pharmaceutical NRTs, it depends upon the smoker and the strength of his or her addiction and resolve to quit. E-cigarettes also appear to be a much safer option for short-term use in the event of relapse.

The good news is, nicotine by itself has very low health risks, so switching to e-cigarettes can be nearly as good as quitting altogether. The most important thing for those who cannot or will not quit nicotine to do is to stop the exposure to the harmful chemicals in cigarette smoke and e-cigarettes can help them do it.


About Nicotine

Experts, non-experts, and organizations have been debating the effects of nicotine long before electronic cigarettes entered the market, and the pharmaceutical answer was to create Nicotine Replacement Therapies (NRTs). However, these products have yet to yield a large decrease in smokers and fail to provide committed smokers a comparable alternative to the daily function they enjoy. Moreover, it is a well-known fact that these cessation products fail 95 percent of the time.


Additional Facts About Nicotine

Nicotine is believed to be addictive because people have a great deal of difficulty giving up smoking. But there are major differences between nicotine and drugs such as alcohol, heroin, cocaine, and methamphetamines that people use to "get high". For one thing, nicotine does not cause intoxication. It does not impair judgement, motor skills, or the ability to get along with others. In fact, it improves these abilities.

Nicotine Benefits

Nicotine is being considered as a therapeutic agent to treat such conditions as attention deficit disorder, Alzheimer's Disease, Parkinson's Disease, Tourette syndrome, sleep apnea, obesity, ulcerative colitis, and inflammatory skin disorders.

Nicotine has the following benefits:

  • Relieves depression
  • Reduces anxiety
  • Improves ability to concentrate and long term memory
  • Protects against developing high blood pressure
  • Protects against weight gain
  • Protects against developing Parkinson's Disease

Nicotine Abstinence

Theoretically, the healthiest thing a smoker can do is to totally give up using nicotine in any form. But does reality conform to the theory?

The official list of nicotine withdrawal symptoms in the Diagnostic and Statistical Manual (DSM-IV) includes depressed mood, sleep disturbance, irritability, anxiety, difficulty concentrating, restlessness, decreased heart rate, and increased appetite or weight gain. These symptoms are supposed to peak within a day or so and disappear altogether after a couple of weeks. However, researchers have found that in some groups of quitters, symptoms do not dissipate and can, in fact, worsen as time goes on.

The problems with concentration, memory, and mood make it difficult to fulfil responsibilities of daily living. How many employers are willing to overlook impaired job performance for weeks or months at a time? What effect does prolonged irritability that sometimes escalates into anger have on relationships with family, co-workers, and friends?

For many would-be abstainers, the Catch 22 is that some improvements in physical health, for example, better lung function must be paid for with possibly permanent declines in cognitive and emotional health. Is it any wonder that so many relapse to smoking within a few days of quitting?

For those who do manage long-term nicotine abstinence, the picture is not 100% better in terms of physical health. For years the medical community claimed that smokers only gained 5 pounds after quitting. More recent studies reveal that the average weight gain is closer to 5 kilograms, accompanied by an average increase in waist circumference of 3.88 cm. In 13% of women and 10% of men, weight gain exceeds 12.7kg. The weight gained with smoking cessation is very resistant to weight loss interventions.

Smokers who become nicotine abstinent develop hypertension at a higher rate than continuing smokers and those who are at risk for diabetes develop that disease 26% more often than continuing smokers.

Conclusion

Those at risk of long-term cognitive and/or mood impairments, hypertension, and diabetes, should be allowed to pursue smoking cessation through permanent replacement of adequate amounts of nicotine using a reduced-harm smoking alternative. In view of the fact that alternatives that are reduced-harm to a smoker are totally without harm to general society, there is no compelling reason to deny reduced-harm alternatives to anyone who wants to take advantage of the beneficial effects of nicotine.

Source


Do E‐cigarettes give off second-hand smoke?

The e‐cigarette generates no side‐stream smoke. (Laugesen, 2008)

After the user inhales, the residual aerosol, or vapor, is exhaled into the surrounding air. (Trtchounian, Williams, & Talbot, 2010)

The exhaled vapor of the e‐cigarette is composed of propylene glycol, and contains almost no nicotine; and no carbon monoxide. (Laugesen, 2008)


Is second-hand vapor from e‐cigarettes harmful?

E‐cigarette vapor was tested for over 50 cigarette smoke toxicants and none were found. (Laugesen 2009)

“Lacking any active ingredient or any gaseous products of combustion, the PG mist or ‘smoke’ is not harmful to bystanders.” (Laugesen, 2008)

Electronic cigarettes tested did not expose users to “measurable levels of nicotine or carbon monoxide, although both suppressed nicotine/tobacco abstinence symptom ratings.” (Eissenberg, 2010)


Are there other facts or concerns about the use of e‐cigarettes?

They are proving acceptable as a complete replacement for smoking for up to 79% of consumers. (Heavner, Dunworth, Bergen, Nissen, & Phillips, 2008)

Over 90% of users report that their health has improved. (Heavner, Dunworth, Bergen, Nissen, & Phillips, 2008)

Smokers with a documented history of recurring relapses were able to quit and to remain abstinent for at least six months after taking up an e-cigarette. (Polosa, 2011)

E-Cigarettes can substantially decrease cigarette consumption without causing significant side effects in smokers not intending to quit. (Polosa, 2011)

Surveys of e-cigarette users strongly indicate that the devices do not have a strong appeal for young adults and youth. High start-up costs and maintenance requirements for e-cigarettes discourage youth from choosing e-cigarettes over traditional cigarettes. (CASAA, 2010)

The vast majority of e-cigarette users surveyed are current and former long-time smokers between the ages of 30 to 65. (CASAA, 2010)

A great number of e-cigarette users report that traditional cigarettes to taste extremely foul after switching to e-cigarettes, further reducing the urge to return to smoking. This effect would greatly minimize the risk of e-cigarettes becoming a “gateway product” and initiating youth to smoking traditional cigarettes. (CASAA, 2010)

E-cigarettes are easily distinguishable from traditional cigarettes. There is no lingering smoke, no unpleasant odor, no ashes, no embers, and no side stream smoke from the tip and no butts. Many e-cigarette brands are available in colors and shapes which further distinguish them from traditional cigarettes. (CASAA, 2011)


Tests Conducted Using Electronic Cigarettes As A Cessation Tool

Siegel MB, Tanwar KL, Wood KS. Electronic cigarettes as smoking cessation tool: Results from an Online Survey. American Journal of Preventive Medicine 2011 Apr; 40(4):472-5.

"This study aimed to examine the effectiveness of e-cigarettes for smoking cessation using a survey of smokers who had tried e-cigarettes. Using as a sampling frame a cohort of all first-time purchasers of a particular brand of e-cigarettes during a 2-week period, a cross-sectional, online survey was conducted. The primary finding was that the 6-month point prevalence of smoking abstinence among the e-cigarette users in the sample was 31.0% (95% CI=24.8%, 37.2%). A large percentage of respondents reported a reduction in the number of cigarettes they smoked (66.8%) and almost half reported abstinence from smoking for a period of time (48.8%). Those respondents using e-cigarettes more than 20 times per day had a quit rate of 70.0%. Of respondents who were not smoking at 6 months, 34.3% were not using e-cigarettes or any nicotine-containing products at the time. Findings suggest that e-cigarettes may hold promise as a smoking-cessation method and that they are worthy of further study using more-rigorous research designs."

 Source


Bullen C, et al. Bullen C, et al. Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tobacco Control. 2010 Apr;19(2):98-103.

OBJECTIVES: To measure the short-term effects of an electronic nicotine delivery device ("e cigarette", ENDD) on desire to smoke, withdrawal symptoms, acceptability, pharmacokinetic properties and adverse effects.
PARTICIPANTS: 40 adult dependent smokers of 10 or more cigarettes per day.

INTERVENTIONS: Participants were randomised to use ENDDs containing 16 mg nicotine or 0 mg capsules, Nicorette nicotine inhalator or their usual cigarette on each of four study days 3 days apart, with overnight smoking abstinence before use of each product.

RESULTS: Over 60 min, participants using 16 mg ENDD recorded 0.82 units less desire to smoke than the placebo ENDD (p=0.006). No difference in desire to smoke was found between 16 mg ENDD and inhalator. ENDDs were more pleasant to use than inhalator (p=0.016) and produced less irritation of mouth and throat (p<0.001). On average, the ENDD increased serum nicotine to a peak of 1.3 mg/ml in 19.6 min, the inhalator to 2.1 ng/ml in 32 min and cigarettes to 13.4 ng/ml in 14.3 min.

CONCLUSIONS: The 16 mg Ruyan V8 ENDD alleviated desire to smoke after overnight abstinence, was well tolerated and had a pharmacokinetic profile more like the Nicorette inhalator than a tobacco cigarette. Evaluation of the ENDD for longer-term safety, potential for long-term use and efficacy as a cessation aid is needed. Trial registration No.12607000587404, Australia and New Zealand Clinical Trials Register."


Source


Caponnetto P, Polosa R, Auditore R, Russo C, Campagna D.
Smoking Cessation with E-Cigarettes in Smokers with a Documented History of Depression and Recurring Relapses.

International Journal of Clinical Medicine, 2011, 2, 281-284.

This is the first time that objective measures of smoking cessation are reported for smokers who quit successfully after using an E-cigarette. This was accomplished in smokers who repeatedly failed in previous attempts with professional smoking cessation assistance using the usual nicotine dependence treatments and smoking cessation counselling.


Source


Safety Assessment of Electronic Cigarettes (Effects)

Miura K, Kikukawa Y, Nakao T, Tokai H, Izumi Y, Fujii H, Taisuke Hojo, T.
Safety Assessment of Electronic Cigarettes in Smokers.
SEIKATSU EISEI (Journal of Urban Living and Health Association). Vol. 55 (2011) , No. 1 p.59-64.

In order to assess the safety of electronic cigarettes, 32 smokers who consume more than 20 tobacco cigarettes daily were enrolled in the present study. Each participant was asked to consume one filter cartridge per day (more than 150 puffs per day) for 4 weeks. Following the treatment, no abnormal changes in blood pressure, hematological data, or blood chemistry and no severe adverse events were observed. During the use of the electronic cigarette, the daily consumption of tobacco cigarettes decreased significantly. This electronic cigarette containing glycerin aqueous solution may be a safe alternative to cigarette smoking.


Source


References And Links To Articles And Journals That Validate Electronic Cigarettes As A Safer Alternative

Link: E-Cigarettes ; Harmless inhaled or exhaled ; No second hand smoke

Link: Harm Reduction Journal - Debunking the claim that abstinence is usually healthier for smokers than switching to a low-risk alternative, and other observations about anti-tobacco-harm-reduction arguments; Carl V Phillips

Link: National Institute of Health - Long-term effects of inhaled nicotine.

Link: Comparison of Carcinogen Levels Shows that Electronic Cigarettes are Much Safer Than Conventional Ones

Link: Professor Carl Phillips-Interview with ecigarettedirect.co.uk

Link: Professor Michael Siegel-Interview with ecigarettedirect.co.uk

Link: Dr Joel Nitzkin-Interview with ecigarettedirect.co.uk

Link: David Sweanor-Interview with ecigarettedirect.co.uk 

 

For additional information regarding the safety of electronic cigarettes, kindly visit CASAA.org for more information.


 

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