The electronic cigarette is a device that can deliver nicotine to the lung in the form of a vapour. The vapour is produced when the e-liquid is heated but there is no burning so the combustion and pyrolysis effects of traditional tobacco cigarettes is avoided.
A compilation of studies, reports and professional analysis related to vaping
The majority of nicotine solutions are imported from countries where good manufacturing practices (GMP) are not currently in place, and can lead to the incorporation of unwanted and dangerous substances into the ‘raw’ nicotine solutions. Importers may find batch-to-batch variations that are unacceptable and have an urgent requirement to do ongoing due diligence analysis work.
The GC-MS (Gas Chromatography – Mass Spectrometry) technique ... can screen the nicotine solutions for unwanted chemicals present such as diethylene glycol, phthalates, and other unwanted chemicals present in the raw nicotine solutions.
Such GC-MS analysis can also give the ‘nominal area percentage’ of each chemical which may or may not be regarded as an accurate reflection of the true percentages of each component.
Carbonyls in E-cigarettes: Uchijama (2010) describes a new method to measure carbonyls and demonstrates this with analyses of cigarette smoke and electronic cigarettes. Analysis by Dr Laugesen
On balance, the nicotine solution cartridges appears to offer a much safer alternative to the traditional cigarette. Apart from the required toxic Nicotine, the samples tested appear to be fairly clean and free
from other potentially toxic chemicals.
Electronic cigarettes are intended as an alternative to smoking tobacco cigarettes. They are not designed to treat nicotine addiction, only provide nicotine in a safer manner. However, many experts agree that switching to electronic cigarettes is almost as good as quitting smoking. Additionally, some people have reportedly used the reduced nicotine levels available to wean themselves off of nicotine altogether and now use 0mg nicotine liquid.
What is in the liquid?
Most contain propylene glycol (a non-toxic, liquid base), nicotine, glycerin and food flavoring.
Is it safe?
While nothing is 100% safe and further testing needs to be done regarding long-term use, based on the fact that they contain only ingredients already shown to be safe for human consumption and research studies show that they do not contain most of the toxins or levels of carcinogens that are found in tobacco cigarettes, we are reasonably certain they are considerably safer than tobacco cigarette smoking.
The American Association of Public Health Physicians (AAPHP) supports the use of electronic cigarettes as a reduced harm tobacco product. The AAPHP released a statement that electronic cigarettes “could save the lives of 4 million of the 8 million current adult American smokers who will otherwise die of a tobacco-related illness over the next 20 years."
Doesn’t nicotine cause cancer?
Nicotine is an addictive stimulant, similar to caffeine and is not shown to cause cancer. Although nicotine use carries other possible health risks, without the tobacco smoke, it is relatively low risk.
Didn’t the FDA say electronic cigarettes are dangerous and banned them?
The FDA tested 18 samples and found that a few had trace amounts of possible cancer-causing nitrosamines, which were found only at parts-per-billion. The FDA allows certain levels of nitrosamines in products. Independent testing showed that the levels of nitrosamines were nearly identical to those found in FDA-approved nicotine patches. They also found that one cartridge was contaminated with “about 1% diethylene glycol,” however subsequent tests have found no other contaminated cartridges to date.
Because consumers have reported that switching to e-cigarettes have allowed them to refrain from smoking, the FDA asserts that electronic cigarettes are a nicotine cessation treatment and therefore drugs. While the FDA has been confiscating e-cigarette shipments, they have not been legally banned. A federal judge recently ruled that the FDA is overstepping its authority and agreed with the AAPHP that they are a reduced-harm tobacco product. The case is pending in appeals court. The AAPHP has also petitioned the FDA to retract their misleading statements about electronic cigarettes and allow them to be marketed as reduced harm tobacco products.
... “Subsequent analyses found that there is no diethylene glycol in any e-cigarettes, but that the vaporant is polyethylene glycol, which is as safe as rain water and is used in asthma inhalers. The ‘carcinogens’ they are referring to are present in such minute quantities that they can’t possibly harm a flea. Besides, the alternative to these so-called carcinogens in e-cigarettes are the known carcinogens found in traditional tobacco smoke...
It is almost certain that e-cigarette use (also called vaping) is vastly safer than cigarette smoking, but this is based on limited scientific evidence. Some questions remain unanswered.
The health effects of long-term exposure of the respiratory tract to propylene glycol vapor are unknown, and unknowable. As a health professional, I am more comfortable recommending a product with a defined risk profile, where a clear risk-benefit analysis can be evaluated. That is why I have been a strong supporter of smokeless tobacco products as cigarette substitutes. I recommend these products knowing that we have 50 years of epidemiology documenting the extremely low level of health risks. E-cigarette consumers must understand that the safety of e-cigarettes can not be guaranteed, despite the likelihood that they pose but a tiny fraction of the health risks of regular cigarettes. But given the paucity of legitimate research, specific safety claims for e-cigarettes can not be made.
Dr. Nitzkin, Tobacco Control Task Force, American Association of Public Health Physicians
AAPHP favors a permissive approach to E-cigarettes because the possibility exists to save the lives of four million of the eight million current adult American smokers who will otherwise die of a tobacco-related illness over the next twenty years.
The only feasible way to achieve this remarkable public health benefit will be to inform smokers of the differences in risk posed by different categories of nicotine-delivery products. Conventional cigarettes account for about 80% of nicotine consumption in the United States, but more than 98% of the illness and death. This harm is not caused by the nicotine, but by toxic products of combustion. A cigarette smoker can reduce his or her risk of future tobacco-related death by 98% or better by switching to a low risk smokeless tobacco product. He or she could cut that risk by 99.9% or better by switching to a nicotine-only delivery product like one of the pharmaceutical products or E-cigarettes.
Experience suggests that E-cigarettes may be more acceptable to smokers than the currently available pharmaceutical alternatives. A smoker can secure almost all the health benefits of quitting if he or she transitions to an E-cigarette.
E-cigarettes deliver the same nicotine found in the pharmaceutical products, with no more contamination by toxic substances than the pharmaceutical products already approved by FDA.
Ruyan® V8 nicotine e-cigarette users do not inhale smoke or smoke toxicants. The modest reductions recommended in 2008 by WHO’s Tobacco Regulation committee for 9 major toxicants in cigarette smoke, in line with Articles 9 and 10 of the FCTC (WHO Framework Convention Tobacco Control treaty), are already far exceeded by the Ruyan® e-cigarette, as it is free of all accompanying smoke toxicants. Absolute safety does not exist for any drug, but relative to lethal tobacco smoke emissions, Ruyan e-cigarette emissions appear to be several magnitudes safer. E-cigarettes are akin to a medicinal nicotine inhalator in safety, dose, and addiction potential.
... Because no combustion process takes place, there is no exposure to tobacco smoke or toxic and carcinogenic contaminants in particular. The health risk is therefore significantly lower than with the consumption of tobacco products. Apart from nicotine the "electrical cigarette" is toxicologically harmless...
The detection of trace and non-measurable levels of TSNAs and tobacco-associated impurities in the liquid, rather than the vapor phase of NJOY’s products, at levels that are many orders of magnitude below conventional cigarettes, and at or below FDA-approved nicotine containing products, should be considered as indicators of the regulatory acceptability of the NJOY products rather than reason for concern. When considering the relative potential health risks posed by these trace levels, it is worth noting that the approved NRTs, which have been shown to contain these substances, were not judged to contain levels sufficient to warrant toxicity information or reference to these substances in their own product literature.
... While we will not advocate the use of any product, nor certify that a product is totally safe, the nJoy device appears to limit a consumer's exposure to a few compounds of low toxicity, while delivering a metered dose of nicotine and flavor additives. Because combustion by-products, nitrosamines, and microbial toxins were not found in the aerosol of the e-cigarette, the risks associated with the use of the nJoy product appear to be low in comparison to the risks of traditional cigarettes.
By Exponent Health Sciences
This is Dr. Phillips who is a respected tobacco harm reduction advocate:
The health benefits of switching are almost exactly the same as the health benefits of quitting, and this applies to electronic cigarettes, smokeless tobacco and pharmaceutical nicotine. If a smoker can manage to switch from smoking to one of those other products the benefits are approximately the same as quitting - they lower their cancer risk, they lower their cardiovascular disease risk, they get rid of acute symptoms of lung and airway problems, a risk that comes from smoking for pulmonary diseases and so forth. Switching is so close as good as quitting that from a health point of view there is no point in worrying about the difference...
Dr. Siegel, another respected harm reduction specialist
... It doesn't take a rocket toxicologist to recognize that electronic cigarettes have to be a safer alternative to cigarette smoking. Based on the laboratory testing that has been conducted, the presence of the product on the market for more than 3 years without any recognized adverse effects, the demonstrated absence (or presence at only trace levels) of carcinogens present in high concentration in cigarettes, and the absence in of any suspected toxin or carcinogen that has been identified and thought to cause disease, how could it be opined that switching back to traditional cigarettes from this product is a reasonable decision?...
... So far, anti-smoking groups which want electronic cigarettes removed from the market have pointed to just two potential hazards from these products: (1) carcinogenic exposure from tobacco-specific nitrosamines; and (2) exposure to diethylene glycol. This testing of inLife and other electronic cigarettes is significant because it demonstrates that for at least some of the e-cigarette products on the market, neither of these two alleged health hazards is a problem...
Dr. Laugesen says he'd recommend ecigs to anyone trying to quit smoking.
During 2008-9 I have coordinated rigorous safety tests by 8 laboratories on the Ruyan e-cigarette, funded by Ruyan. Of over 50 priority tobacco smoke toxicants, none was found in any but trace quantity. Nicotine is safe used as medicine. Propylene glycol has been used on bedfast children in 1942-43 as an aerosol germicide by University of Chicago researchers, without adverse effect. All up, we find the Ruyan e-cigarette safe in the common meaning of that word, and much safer than smoking tobacco. The FDA and other drug regulators will hopefully keep the e-cigarettes on sale (as in the UK), while further research can be conducted and suitable approvals applied for. Simply banning e-cigarettes will simply consign thousands of e-smokers back to smoking tobacco and an early death. That would be crazy.
Murray Laugesen public health physician, Christchurch, New Zealand
No second hand smoke ... Second hand mist from an e-cigarette is not smoke at all, and does not contain any substance known to cause death, short or long term, in the quantities found. It becomes invisible within a few seconds, and is not detectable by smell...
Exhaled breath after e-cigarette use has been tested for CO only. No increase in CO was found...
Exhaled breath after e-smoking contains even less nicotine per puff, as much of the nicotine inhaled is absorbed. Similarly, propylene glycol is largely absorbed and little is exhaled...
The e-cigarette does not create side-stream smoke...
Propylene glycol is harmless – it is used in making theatrical fog and as an ingredient in soaps, personal lubricants and intravenous medicines.
E-cigarette use reduces risk of cancer by supplanting the smoking of tobacco cigarettes.
Using e-cigarettes INSTEAD of smoking tobacco cigarettes is bound to reduce the risks of lung cancer, because the cancer-causing gases such as 1,3 butadiene found in the smoke of all cigarette brands, are no longer inhaled...
Switching to e-cigarettes with nicotine continued, can be expected to reduce lung cancer risk the same as altogether quitting cigarettes without e-cigarettes...
ASH Scotland conducted a recent YouGov survey, finding that approximately 7% of adult smokers surveyed have used e-cigarettes (with around 3% still using them)*
*Based on sub-sample of 221 adult smokers in Scotland (daily or less often). All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 1206 adults. Fieldwork was undertaken between 17th and 22nd March 2010.
Awareness and use of e-cigarettes was measured as part of the ASH/YouGov national survey 2010 (sample size 12,597). Focus groups with smokers who had used e-cigarettes and separately with smokers who had not, informed the development of an on-line survey of 1,380 smokers including 486 smokers who had used e-cigarettes. In the national survey 9% reported having tried e-cigarettes of whom 3% were still using them at the time of the survey
All respondents previously smoked and 91% had attempted to stop smoking before trying ecigarettes. Most respondents resided in the USA (72%) and 21% were in Europe. About half (55%) were 31-50, while 32% were >50 years old. Most (79%) of the respondents had been using e-cigarettes for <6 months and reported using them as a complete (79%) or partial (17%) replacement for, rather than in addition to (4%), cigarettes. The majority of respondents reported that their general health (91%), smoker’s cough (97%), ability to exercise (84%), and sense of smell (80%) and taste (73%) were better since using e-cigarettes and none reported that these were worse. Although people whose e-cigarette use completely replaced smoking were more likely to experience improvements in health and smoking caused symptoms, most people who
substituted e-cigarettes for even some of their cigarettes experienced improvements.
These are highly motivated and passionate e-cigarette users who may have different experiences than average e-cigarette users or smokers, and thus the estimates cannot be extrapolated to all smokers or e-cigarette users. However, the results still suggest that very few e-cigarette users are not using them to replace cigarettes and there are many switchers and current smokers who could have the reported experience. Unfortunately e-cigarettes have been banned in some jurisdictions (e.g., Canada, Victoria (Australia)) where switching from cigarettes to e-cigarettes was documented. The lack of available and legal e-cigarettes may cause some users to resume smoking.
An internet survey of 81 ever-users of e cigarettes in 2009. Participants answered open-ended questions on use of, and opinions about, e cigarettes.
Results
Respondents (73 current and 8 former users) lived in France, Canada, Belgium or Switzerland. Most respondents (77%) were men; 63% were former smokers and 37% were current smokers. They had used e-cigarettes for 100 days (median) and drew 175 puffs per day (median). Participants used the e cigarette either to quit smoking (53 comments), to reduce their cigarette consumption (14 comments), in order not to disturb other people with smoke (20 comments), or in smoke-free places (21 comments). Positive effects reported with e cigarettes included their usefulness to quit smoking, and the benefits of abstinence from smoking (less coughing, improved breathing, better physical fitness). Respondents also enjoyed the flavour of e cigarettes and the sensation of inhalation. Side effects included dryness of the mouth and throat. Respondents complained about the frequent technical failures of e-cigarettes and had some concerns about the possible toxicity of the devices and about their future legal status.
The correlation between length of time since quitting smoking and length of time the person had been vaping suggests that most respondents quit smoking within 30-60 days after beginning use of the NV. (Quitting smoking was a condition for participation.) (See Fig.1)
Results suggest that many of the respondents use the device as a replacement for cigarette smoking and use it in a similar manner to the way they smoked tobacco cigarettes.
Respondents who said they use the NV "much more" than they used tobacco cigarettes, as a whole, use substantially lower levels of nicotine than those who use it less or the same as tobacco cigarettes. Presumably, those using the device "much more" do so to increase nicotine intake.
Average nicotine consumption is around 30-40 mg per day, although at this time we cannot confirm how much nicotine is absorbed by the body through this method of delivery.
Smoking Survey: Public Not As Stupid As The Government Thinks!
An E Cigarette Direct survey suggests that the public are sceptical of claims that the electronic cigarette is more dangerous than cigarettes.
Electronic cigarettes are devices that deliver nicotine in a propylene glycol solution - a solution also used for sterilising the air in children's wards.
In a survey of more than 250 electronic cigarette smokers, smokers and non-smokers, only 28% of respondents believed that smoking electronic cigarettes was more unhealthy than electronic cigarettes.
58% gave an emphatic no, while just under 30% remained unsure.
The numbers were rather different for non-smokers only, with 32.6% agreeing that the electronic cigarette was more dangerous than cigarettes. A minority (15.1%) did not believe the claim, while more than 50% were unsure. Smokers were more sceptical, with only 10.9% believe it was more dangerous, although again more than 50% were uncertain.
Perhaps unsurprisingly, those who had already converted to the electronic cigarette had a different story to tell, with all 89 respondents agreeing that the electronic cigarette was safer than cigarettes.
"These and other questions asked show that a majority of people do not yet believe claims that the e-cigarette is more dangerous than regular cigarettes."
This paper seems to be missing one major point: it is the toxicity of what you are smoking or vaping that makes it harmful, not simply how hard you are puffing.
Increased intensity of puffing on electronic cigarettes compared to conventional cigarettes would only make vaping more harmful if the constituents of electronic cigarette vapor were harmful to begin with. The abstract omits any mention of the fact that conventional cigarettes contain perhaps tens of thousands of chemicals and more than 40 carcinogens while electronic cigarettes contain none of the above, other than the nicotine. It also omits mention of the fact that there are no hazardous chemicals that have been identified in electronic cigarette vapor at anything other than trace levels that are known to have significant adverse health effects.
Intellicig research on speed of nicotine delivery to the blood suggests similar speed of absorption as combustible tobacco. No details disclosed about effectiveness of delivery.
Comparison of the Cmax [peak serum concentration] of Intellicig® NDD [nicotine delivery device] and a 0.5mg cigarette show similarities in time with only a 12 second time difference in time taken to reach Cmax. Comparison of these results with published data on marketed NRT products suggests the Intellicig® NDD can deliver nicotine at a much quicker rate than that of currently marketed NRT products.
16 smokers inexperienced at vaping, using Crown Seven Hydros with 16mg cartridges or nJoy nPros and 18 mg nicotine cartridges found that after 10 puffs "... there was no significant increase in nicotine levels or heart rate, and little reduction in craving..."
Relative to a tobacco cigarette, 10 puffs from either of these electronic nicotine delivery devices (E-cigarettes) with a 16 mg nicotine cartridge delivered little to no nicotine and suppressed craving less effectively.
The 16mg EC delivered nicotine more rapidly (mean tmax 19.4 minutes) than Nicorette® inhalator (30 minutes) but not as rapidly as cigarettes (14.3 min), which also gave the highest cmax of nicotine (13.4 ng/ml), almost ten-fold that of the 16mg EC (0.9 ng/ml), and Nicorette® inhalator (1.8 ng/ml).
CONCLUSIONS The Ruyan V8 16 mg ENDD reduced desire to smoke more than the placebo ENDD and during 9 h of use was well tolerated, acceptable to most users, rated significantly more pleasant to use than the inhalator, and in the first hour exhibited a pharmacokinetic profile more like the inhalator than a tobacco cigarette, without excess adverse events.
Statistics
Number of deaths worldwide, from 2004, primary suspect electronic cigarette - zero
Number of deaths in the US, from 2004, primary suspect Chantix - 334
Number of deaths in the US, from 2004, primary suspect NRT - 42
Number of deaths in the US, from 2004, primary suspect Zyban - 64
Number of deaths in the US, from 2004, primary suspect Buproprion - 2
Deaths caused by medical error in the US per year - approximately 200,000
Please help us to keep track of important vaping health and safety issues by reporting your experiences here
This isn't a scientific study, it is intended simply to record adverse effects and events that may be related to inhaling vapour and using vaping equipment.
Our collected experiences should serve as an early warning system about potential long term problems that the community needs to monitor. Hopefully we can highlight where there is a need to reassess and improve specific liquid formulas or hardware designs.
Known Issues:
Some people believe they are sensitive to propylene glycol and experience allergy type reactions. PG is also reported to cause dry mouth and sore throat.
Some battery combinations can become unstable and dangerous. This has caused overheating in a small number of cases with devices using two unprotected 3v lithium ion batteries.
There is a possibility that small amounts of acrolein are being produced with glycerine based liquids and certain vaping techniques at high voltage.
Signs of nicotine level changes - overdose or underdose are also common.
Please use the comment facility at the bottom of this page to report adverse events. If you prefer to report privately you are welcome to use our contact form.
Details you might want to include for added context:
Don't worry about reporting things that you think might be trivial, it does no harm and will give a fuller picture of our symptoms and experiences with vaping.
Thanks for your help.
If you are experiencing health problems please consult a professional medic
For anyone wishing to discuss symptoms or events with other vapers, forums often have discussions of this nature.
Please note: there is no scientific credibility in anonymous anecdotes here and there is no screening process to detect hoaxes. Reports should be read critically.
An E Cigarette Direct survey suggests that the public are sceptical of claims that the electronic cigarette is more dangerous than cigarettes.
