Are e-cigarettes a safer bet than tobacco cigarettes?

Electronic cigarettes (or e-cigarettes) are becoming increasingly popular as an alternative way of smoking or for smokers wishing to quit. The devices do not burn tobacco, but instead heat up a liquid to produce an aerosol or vapour that the user inhales. The liquids are commonly a combination of propylene glycol (which produces the artificial smoke) and glycerol; however, the ingredients of products available on the market vary wildly with some containing nicotine as well as various other flavour additives. Despite a rapid increase in the use of e-cigarettes, the health risks of these devices are not fully understood. In our review, we assessed the safety of these devices in terms of the short-term and long-term health risks associated with their usage, from damage to individual cells to changes in overall organ function.

We found that in the short term (studies ranging from a few hours to a few days), the aerosols produced by e-cigarettes cause less severe health problems compared to conventional cigarettes. These devices can therefore represent a viable option for smokers of conventional cigarettes wishing to quit. E-cigarette aerosol is not, however, free from harm.

First, e-cigarette aerosol can contain just as much nicotine as a puff of a conventional cigarette. Nicotine and flavourings present in e-cigarettes may lead to similar levels of addiction when compared to conventional cigarettes. Second, although the liquids and flavourings are considered harmless on their own, when heated they produce toxic chemicals not found in conventional cigarettes. In particular, glyoxals can cause DNA mutations, and metal particles (such as nickel or copper) can cause lung inflammation and DNA damage. Finally, research on the health effects of using e-cigarettes over months or years is still very limited and there are few studies available on possible long-term health consequences of their use.

Nicotine-containing liquids are not approved for sale by Health Canada. In the United States, e-cigarette products are regulated in the same fashion as with the tobacco industry. However, current regulations in North America are still lagging when it comes to the manufacturing process of both the flavoured and unflavoured liquids and the e-cigarette devices themselves. Users should therefore use these products with caution.

Read the full paper — Electronic Cigarettes — A Review of the Physiological Health Effects by Alyssa Zucchet, and Grégory Schmaltz on the FACETS website.