E-cigarettes – What’s the harm?

Portrait of woman smoking with electronic cigaretteI’ve recently noticed a wealth of articles exploring the potential for harm associated with ‘smoking’ E-Cigarettes (also known as vaping) – for a few examples see here, here and here. But, with vaping steadily on the rise* what is the bigger picture?

One thing we can all agree on is that smoking cigarettes is pretty dam bad for you; certainly, the facts and figures associated with this habit don’t make for pleasant reading…

In brief:

  • There are about one billion smokers worldwide, of whom about half will die prematurely as a direct consequence of smoking.
  • Smoking currently accounts for around 100,000, or about one in six, deaths each year in the UK.
  • Smoking causes around 85% of the approximately 40,000 cases of (and deaths from) lung cancer in the UK each year. What’s more, smoking also contributes to the development of many other cancers, including oral cavity cancer, oesophageal and gastric cancer, kidney and bladder cancers, and pancreatic cancer.

…for more startling stats see here.

With this in mind, it’s worth noting that electronic cigarettes have traditionally been marketed as a ‘less harmful’ alternative to smoking and, in some cases, a stepping stone on the path to quitting the habit entirely. But what are they, what are the associated risks and are they really safer than conventional cigarettes?

image2Electronic cigarettes are designed to provide a measured dose of inhaled nicotine, whilst also mimicking the experience of smoking a conventional cigarette. Early models looked almost identical to normal cigarettes, with most even incorporating a realistic glowing tip. However, newer products come in all kinds of shape and sizes.

The most important difference between e-cigarettes and the real deal is the method of nicotine delivery. A regular cigarette burns tobacco and the user inhales the resulting nicotine-rich smoke, along with any associated nasties. E-cigarettes, however, produce a vapour by heating a solution of nicotine mixed with propylene glycol or glycerine. This method of nicotine delivery means that users still get the desired effect from the vapour but, without many of the toxic side effects associated with cigarette smoke.

It is now widely accepted that nicotine itself carries no serious health implications and is likely to be no more harmful than caffeine (for studies see here, here and here). The main problem with cigarettes is that they deliver their nicotine hit alongside a staggering array of carcinogens and toxins. These include: nitrosamines, acetone, acetylene, DDT, lead, radioactive polonium, hydrogen cyanide, methanol, arsenic and cadmium and vapour phase toxins such as carbon monoxide.

Since e-cigarettes do not burn tobacco, they do not deliver such a large doses of associated nasties. However, this does not mean that they’re harmless. Studies reveal that e-cigarettes contain small amounts of formaldehyde and acetaldehyde (both known human carcinogens); they can also deliver trace levels of carcinogenic nitrosamines, and some toxic metals such as cadmium, nickel and lead. A quick scan of the literature suggests that levels of these substances can vary hugely between e-cig brands, however, most studies agree that levels are generally low and are almost always significantly below those delivered by traditional cigarettes. Also, unlike traditional cigarette smoke, there appears to be little harm in the passive inhalation of vapour.

So at this point the case for e-cigarettes looks pretty strong. We know that smoking kills and that, without intervention, millions of smokers alive today will die of smoking-related illnesses. Despite being new to the market and lacking the long term research which can only come from an established product, e-cigarettes certainly seem significantly safer than their conventional cousins. Therefore, it is likely that making the switch from smoke to vapour is going to be pretty beneficial for your health.

This said, I don’t think we should be complacent with vaping and it certainly shouldn’t be marketed as ‘harmless’. It is important that legislations be formulated to standardise the mechanics of vaporisers and the content of e-liquids – particularly since studies have found products to vary widely in both their toxicity and nicotine delivery. Advertising must also be approached with caution. Critics of e-cigarettes have suggested that vaping may become a gateway for youngsters into smoking. Although there is currently no grounding to these fears, it is important that vaping is not glamorized in the media – it is not a harmless practice and should only be used by those already addicted to nicotine who want to improve their health by quitting smoking.

So, although we may have discovered smoke without fire there is no guarantee we won’t still get burned…

Post by: Sarah Fox

* Action on Smoking and Health (ASH) has estimated that currently about 1.3 million people in the UK use electronic cigarettes, and around 400,000 people have completely replaced smoking with electronic cigarettes (for link see here).

20 thoughts on “E-cigarettes – What’s the harm?”

  1. Okay, let’s put the findings into context. Formaldehyde only was found after taking a four second long ‘puff’ at 5.0 volts. Now, for contextual purposes, I will explain that I am what’s known as an ‘advanced vaper’ (the type of guy with a big collection of devices, lots of experience, who ‘vapes’ frequently, and who blows out big clouds).

    Currently, I’m holding a Sigelei 100 watt with a 28mm Plume Veil RDA. I have used 28g kanthal wire to build what is a 0.2ohm quad coil. I use organic cotton for wicking, and currently have a 60/40 (VG to PG) Tiramisu e liquid with 6mg of nicotine.

    Right now, I have my wattage setting at 39.1 watts and am more than comfortable. I’m usually between 38 and 46 watts. That all equates about 3.3 volts, which is also displayed on the screen of my device.

    If I double my output, to 65 Watts, that puts us at 4.3 volts and it’s really too harsh, I can’t really take a single full second puff, let alone a four second puff. At 80 watts, we’re at 4.7 volts. You can imagine, I am not capable of taking a puff at this wattage. I tried anyway, and regretted it.

    To get to 5.0 volts, I have to crank this thing up to 90 Watts, and with my current build, that’s impossible for any human being to use. The device goes up to 5.2 Volts max, and it is a high-end, high powered vaporizer.

    5.0 volts is not what anyone is going to be using at all, and frankly, you would have to go out of your way to take a four second long puff at any of these settings. My average puff is below three seconds long at 39 watts and I exhale a big cloud. No regular user of a little stick battery, or even a big double battery box mod is ever going to subject themselves to the conditions that were necessary to produce formaldehyde.

    They said themselves that it didn’t exist within the practical range. The only people that believe this stuff are people that have no idea what I just said. If you don’t understand any of this, then you should not be issuing any opinion until you do.

    • Of course there have been a range of studies performed using different vaping parameters and a range of e-cig/e-liquid brands (many of which use different parameters than those you mention above – often more realistic ones).

      But, I think the take-home message here is really that we need more structured research on this topic – I don’t believe that there is any grounding for a knee-jerk reaction against vaping (as some scaremongering articles may have you believe). However, on the flip side, I also don’t think enough research has been done to fly the flag and say that it is 100% safe.

      This may sound very non-committal, but we can only go by what studies tell us… and so far it’s still a complicated picture (you find some work stating that it’s perfectly safe, others suggesting that it’s really not…and many more falling somewhere in the middle).

      That said, one thing I do believe is that, whatever way you look at it, vaping is significantly less damaging to your health than smoking – so any smoker who switches to vaping is almost certainly doing their body a favour!

      I’m going to keep my ear to the ground on this one and hopefully post more articles as new research becomes available since this is a very interesting topic!

  2. Finally, an intelligent article about electronic cigarettes!

    You’re 100% right – no one should be saying they are perfectly safe. But everyone pretty much agrees that they are far safer than cigarettes. I smoked 1.5 packs/day for 30 years and fully switched to e-cigs the day I tried them. That’s over two years ago. As far as I’m concerned, they’re the best invention of the past five years.

  3. E-cig are pretty safer than tobacco your explanation is perfect but with the help of e-cigs in the market there is less consumption of tobacco now a days which is good, thanks for your important note on Electronic cigarettes.

  4. You mentioned that “Since e-cigarettes do not burn tobacco, they do not deliver such a large doses of associated nasties” and they contain small amounts of carcinogens which are cancer causing agents and exposure to this (thou im not sure which amount of this actually cause cancer) leads to cancer.

    Is it safe to assume that because they are not 100% safe they will eventually kill you or damage your lungs and possibly lead to cancer like traditional cigarettes but at a lower rate?


  5. Many great points have been highlighted and it is well emphasized that although e-cigarettes are a far better alternative they are not the complete solution to all the negatives of smoking. While they do lure smokers away from cigarettes for a while, many do however reverse back to their cancer-causing cousins. A reason for this may be because even though they are known to be the healthier option they are not quite as satisfactory as the real thing.

  6. I want to respond to the last two postings.

    First, regarding the “100% safe”. No one is saying they are 100% safe – but *nothing* is 100% safe. None of the ingredients in eliquid (nicotine, flavorings, vegetable glycerin, and propylene glycol) are considered carcinogenic by the FDA. There aren’t a lot of studies on inhaled PG and VG because they have been considered extremely safe for decades. Heck, PG is used in asthma inhalers – it ‘carries’ the medication to the lungs (just like in eliquid, it ‘carries’ the nicotine).

    Second, I’m sure some smokers do try vaping and then revert back to smoking. But I’m convinced the majority of them do so because they haven’t found the right ecigarette for them. The little cheap ones you buy at convenience stores (the ones put out by Big Tobacco) are pretty bad. I know several people who tried them and went back to smoking (myself included). But then I tried a better system and quit cigarettes that same day. The trick is 1) finding a flavor you like and 2) starting out at a nicotine level high enough for *you* to quit and 3) having a powerful and reliable enough system to give you the ‘smoking’ experience you’re used to.

  7. I do not agree with this e-cigarette system. I think people are not fully informed about these e-cigarettes. I believe more teenagers actually get addicted to smoking now,because they think if there is no tobacco or tar that causes direct damage to your lungs,it is not that dangerous.

  8. I was also refering to this “Studies reveal that e-cigarettes contain small amounts of formaldehyde and acetaldehyde (both known human carcinogens); they can also deliver trace levels of carcinogenic nitrosamines, and some toxic metals such as cadmium, nickel and lead.”
    And studies have shown that propylene gycol leads to dehydration and this may be because it has the ability to trap water but people with ill-effects to it can optout for e-liquid that uses vegetable oil.

    And i also agree with the last post as far as a lot of people know e-cig is safe and there are no real dangers to it, there are considered to cure smoking habits forever but like you also said you have to find an e-cig that works for you but if you do not know that there are different kinds of e-cig and the first one you try is bad for you that takes you back to smoking traditional cigarettes.


    • Not to be picky but no vegetable *oil* is used – it’s vegetable glycerin (VG), a completely different substance. No oil is used in eLiquid because it can lead to a form of pneumonia. And it’s the VG that can cause dehydration because it attracts water. (It’s the same thing used in fog machines to make the ‘fog’.)

  9. I’ve been vaping since 2008. I smoked a lot of cigarettes up until 2012, when the 510 became standard threading. I believe the ecig is one of the greatest inventions in healthcare. Smokers can get serious benefits switching to vapor. It is truly a cheaper and healthier alternative, but not cheap and healthy.

    • No you can’t because over zealous anti smokers will call attention to your smoking and you will most likely be asked to stop. I purchased a vape just over 3 weeks ago when I unfortunately was suddenly called back to The States to bury my mother (Live in Spain which is still a country with many smokers). Spurred on by my teenage daughter who had been researching one to get me as a birthday gift, I looked forward to not being relegated to smoking out doors as my whole family and friends are non smokers. But I still felt like a leper when the looks and questions began, and only 2 of the approximate 7 restaurants I dined at were tolerant enough (and only probably due to my being one of the few who had ever requested permission), to allow me to vape ‘discreetly’. 1 restaurant which wouldn’t allow vaping said they had a no ecig or vaping nationwide policy!! And I only saw 1 other person vaping during that entire 15 day trip. I’ve given up the 1.5 pack a day habit I’ve had on and off for 38 years, and use VG only and 0% nicotine (cigarettes I smoked were Silk Cut Silver which were ultra light with only 0.1mg of nicotine).

      • Kat – I’m curious as to where you were in the U.S.??

        As to the ‘2 out of 7 restaurants’ that allowed vaping, I’m not really surprised. Most places just don’t know enough about it and it does ‘look’ like smoking (which is generally forbidden in restaurants). I’m an avid vaper (after a former 30 year, pack-and-a-half/day cigarette habit) but most vapers I know don’t vape in restaurants.

        • Tallaassee, FL which is a 2 college town although it was in the summer this time as well as last year when we visited. Also was in Chicago for a couple of weeks last year as well as Auburn, Alabama and then did a road trip down to Miami and stopped off for a week at Highland Beach/Palm Beach and saw no ecigs or vapers. Only first heard of it the week before we left for our flights last month when my daughters research was revealed. None of my friends or family members stateside knew anything about this new fad. However my daughter recently reports having seen vapors in London when she visits her father. Restaurants and bars are sadly where I would most want to vape when I’m out as my cigarette smoking was always paired with the enjoyment of a nice dry red.

  10. One of the nasties you mention in tobacco is radioactive polonium. From Der Spiegel: “Tiny airborne particles of the radioactive metal commonly settle on tobacco leaves. This explains why cigarettes can contain significant quantities of polonium. Heavy smokers are exposed to an annual dose of radiation from polonium equal to about 250 lung x-rays.” It is thought that 1% of all smoking related lung cancers can be attributed to polonium and there is no way of removing polonium from tobacco leaves. This has been on my mind recently as a vaper because my favoured liquids are Naturally Extracted Tobacco liquids – actual tobacco leaves are processed to flavour the eliquid. I wonder if polonium is present in such liquids and if so could the quantity be as harmful as in cigarettes? Further reading about polonium in tobacco here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2509609/

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