E-cigarettes: Are they really safer?

November 1, 2013 | by

Are electronic cigarettes safer than regular cigarettes? That’s the burning question from some smokers who wouldn’t mind getting their nicotine fix without harming their lungs.

Are e-cigarettes a safe alternative to smoking traditional tobacco cigarettes? With no studies available, no regulation of the products, it's too soon to tell, say doctors.

Are e-cigarettes a safe alternative to smoking traditional tobacco cigarettes? With no studies available and no FDA regulation of the products, it's too soon to tell, say doctors.

The short answer from lung experts: It’s too soon to tell. There have been no scientific studies to determine whether e-cigarettes are safe – or if they're an effective tool to help smokers kick the habit as some claim. Despite this, the federal Centers for Disease Control and Prevention reported that use of e-cigarettes among middle school and high school students doubled from 2011 to 2012.

"While they might be safer, I personally believe that e-cigarettes are also delivery devices for an addicting drug: nicotine," said Brian Tiep, M.D., director of Pulmonary Rehabilitation at City of Hope. "If they are used as a recreational drug, they should be regulated as a tobacco product, including bans in public places. Definitely, they should not be made attractive for kids."

Health concerns top the list of reasons people give for wanting to break their smoking addiction. According to the American Cancer Society, about 8.6 million people suffer from smoking-related lung and heart diseases. In addition to lung cancer, smoking is linked to a litany of other cancers including cancer of the mouth, nose, sinus, esophagus, bladder, kidney, pancreas, ovary, cervix, stomach and colon as well as acute myeloid leukemia.

Although a product that claims to offer all the enjoyable aspects of smoking without the risk of developing serious diseases is enticing, those claims are not substantiated.

Electronic cigarettes, or e-cigarettes, are battery-operated and many of them look like regular cigarettes. Many contain nicotine, just like tobacco cigarettes. Inside the e-cigarette is a liquid that, when heated, turns into a vapor that the smoker inhales.

The liquid in many of these is propylene glycol, used in cosmetics, antifreeze and fog machines. It also often includes vegetable glycerin, and sometimes, flavors. Even e-cigarettes with nicotine are not currently regulated as a tobacco product, meaning there’s no Food and Drug Administration (FDA) oversight of the products.

The FDA has, however, questioned the safety of e-cigarettes. An analysis of two popular brands found traces of carcinogens and various amounts of nicotine in the products, and the FDA has issued a warning about potential health effects even though it doesn't regulate their use or manufacturing standards.

In the absence of any safety data, experts are not recommending e-cigarettes to smokers or anyone else.

Tiep points to the guidelines on e-cigarettes from the American Thoracic Society, whose recommendations indicate the organization is skeptical that the products have any benefit. The organization is calling for restrictions similar to those placed on traditional tobacco products. The recommendations include:

  • States should regulate e-cigarettes as tobacco products; e-cigarettes should not be sold to people younger than 18;  and identification and proof-of-age should be required at time of purchase.
  • Internet sales should be strictly regulated.
  • E-cigarettes should be taxed at rates equivalent to tobacco products, and subject to the same restrictions regarding public use.
  • The FDA should have regulatory authority over e-cigarettes.
  • Candy and menthol flavors should not be allowed in e-cigarettes.
  • E-cigarettes should include warning labels. Known risks should be disclosed in clear, direct language. If data regarding risk is unavailable or inconclusive, consumers should be informed of the lack of reliable safety testing data.
  • The FDA should regulate advertising for e-cigarettes.
  • Direct and implied health and safety claims by e-cigarette manufacturers should be subject to the same review process currently required for other products making such claims.
  • Researchers and clinicians, as well as scientific societies and publications, receiving funding from e-cigarette manufacturers should disclose this relationship and the potential for conflict of interest in a manner equivalent to disclosures required for funding from the tobacco industry.

Experts recommend that smokers looking to give up cigarettes should instead turn to one of the tried-and-true methods found to be both safe and effective, such as a nicotine inhaler. These inhalers are classified as nicotine replacement therapy drugs. They give the patient a small and controlled dose of nicotine when they’re puffed, they do not contain other ingredients – and they're regulated.

That means you know exactly what you're getting.