The truth about the safety of e-cigarettes

By Christopher Wanjek, Columnist
Published 11/22/2013 08 44 AM EST on LiveScience

At first, electronic cigarettes were a novelty something a braggart in a bar might puff to challenge the established no smoking policy, marveling bystanders with the fact that the smoke released from the device was merely harmless vapor.

Now, e cigarettes are poised to be a billion dollar industry, claimed as the solution to bring in smokers from out of the cold, both figuratively and literally, as e cigarettes promise to lift the stigma of smoking and are increasingly permitted at indoor facilities where smoking is banned.

So, are e cigarettes safe? Well, they’re not great for you, doctors say. What’s being debated is the degree to which they are less dangerous than traditional cigarettes.

1940 revisited

E cigarettes are battery powered devices, often shaped like traditional cigarettes, with a heating element that vaporizes a liquid nicotine solution, which must be replaced every few hundred puffs. Nicotine is inhaled into the lungs, and a largely odorless water vapor comes out of the device. Puffing an e cigarette is called vaping. Vaping How E cigs Work (Infographic)

Yet the industry’s duplicity is clear to medical experts E cigarettes are marketed to smokers as a means to wean them off of tobacco (although studies show they don’t help much) yet the same devices, some with fruity flavors, are marketed to young people who don’t smoke, which could get them hooked.

Hooked? Yes, e cigarettes are a nicotine delivery system, highly addictive and ultimately harmful because of their nicotine.

Cancer and respiratory experts see the same ploy being played out today with e cigarettes as was done in the 1940s with cigarettes, when America started smoking en masse. They often are distributed for free and pitched by celebrities and even doctors as cool, liberating and safe.

In an ad for a product called blu eCigs, celebrity Jenny McCarthy, infamous for encouraging parents not to vaccinate their children, encourages young adults to vape, enlisting words such as «freedom» and the promise of sex. In another ad, for V2 Cigs, a medical doctor named Matthew Huebner who is presented without affiliation but is associated with a Cleveland Clinic facility in Weston, Fla. implies that vaping is as harmless as boiling water.

As for the notion of e cigs as liberating, the cost of a year’s worth of e cigarette nicotine cartridges is about $600, compared with $1,000 yearly for a half pack a day of regular cigarettes.

As for whether they’re safe, it’s a matter of comparing the advantages of one addiction over another.

E cigarettes not a patch

One would think that vaping has to be safer than smoking real cigarettes. Experts say they are probably safer, but safer doesn’t mean safe.

«Cigarettes have their risk profile,» said Dr. Frank Leone, a pulmonary expert at the University of Pennsylvania Medical Center in Philadelphia. And just about everyone who breathes understands the risks circulatory disease and myriad cancers, for starters. «E cigarettes might be better off compared to that profile. But that doesn’t mean they don’t have their own risk profile.»

A top concern is the nicotine delivery rate, Leone said. With nicotine patches and gum, the nicotine delivery is regulated, with small amounts of nicotine released slowly into the bloodstream. But with traditional cigarettes and now e cigarettes, heat creates a freebase form of nicotine that is more addictive or what smokers would call more satisfying. The nicotine goes right into the lungs, where it is quickly channeled into the heart and then pumped into the brain.

Once addicted, the body will crave nicotine. And although nicotine isn’t the most dangerous toxin in tobacco’s arsenal, this chemical nevertheless is a cancer promoting agent, and is associated with birth defects and developmental disorders.

A study published in 2006 in the journal Obstetrics and Gynecology, for example, found that women who chewed nicotine gum during pregnancy had a higher risk of birth defects compared to other nonsmokers.

Great unknowns

This great unknown of possible negative health effects, along with the lack of regulation of e cigarettes, scares experts like Leone. The products come bereft of health warnings. How many pregnant women will vape following McCarthy’s promotion?

As for their merits in smoking cessation, e cigarettes don’t appear very helpful. A study published last month in the journal Addictive Behaviors found that most smokers who used them while they tried to quit either became hooked on vaping, or reverted back to smoking cigarettes. A study published Nov. 16 in the journal The Lancet found no statistically significant difference in the merits of the e cigarette over the nicotine patch in terms of helping people quit.

Leone said that e cigarettes might not help people quit smoking because the device keeps addicts in a state of ambivalence the illusion of doing something positive to mitigate the guilt that comes from smoking, but all the while maintaining the ritual of smoking.

The Jenny McCarthy blu eCigs ad hints at this notion, with such phrases as «smarter alternative to cigarettes,» «without the guilt» and «now that I switched…I feel better about myself.»

Editors of The Lancet called promotion of e cigarettes «a moral quandary» because of this potential to replace harmful cigarettes with something slightly less harmful yet just as addictive. Other researchers agree that e cigarettes might help some people quit, but at a population level, converting millions of smokers into vapers still addicted to nicotine might not lead to the cleaner, greener, healthier world implied by e cigarette manufacturers.

And then there’s the issue of not knowing what’s in the e cigarette nicotine cartridge.

«It’s an amazing thing to watch a new product like that just kind of appear there’s no quality control,» said Dr. Richard Hurt, director of the Mayo Clinic’s Nicotine Dependence Center in Rochester, Minn. «Many of them are manufactured in China under no control conditions, so the story is yet to be completely told.»

The authors of The Lancet study, all based in New Zealand, called for countries to regulate the manufacturing and sale of e cigarettes. The U.S. Food and Drug Administration, which does not approve any e cigarettes for therapeutic purpose, said it plans to propose a regulation to extend the definition of «tobacco product» under the Tobacco Control Act to gain more authority to regulate products such as e cigarettes.

Follow Christopher Wanjek wanjekfor daily tweets on health and science with a humorous edge. Wanjek is the author of «Food at Work» and «Bad Medicine.» His column, Bad Medicine, appears regularly on LiveScience.

  • Never Too Late 5 Bad Habits You Should Still Quit
  • 9 Healthy Habits You Can Do in 1 Minute (Or Less)
  • 10 Easy Paths to Self Destruction

Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. >

Selena gomez pictured buying cigarettes morning after justin bieber’s dui arrest

  • Mellow in yellow for sunny Sydney Crowds greet William, Kate and baby Prince George as they arrive in Australia for ten day tour
  • ‘William said I look like a banana’ Kate shines in bright yellow gold Roksanda Ilincic dress but not everyone is a fan
  • He takes after his dad! Prince George models traditional royal romper his father Prince William also wore as a baby
  • Missing mummy, George? Prince looks less than impressed as he’s pictured in arms of his nanny for first time
  • Mother of two who has never worked encouraged her daughter to get pregnant so she could get a council house and have an ‘easy life on benefits’
  • The supermarket mind games that make us spend more Array of tricks stores use to make shoppers bust budget exposed
  • Tesco posts falling profits for the second year running as shoppers head to rivals
  • ‘It was like an instant amputation’ Oscar Pistorius cowers in the dock as forensic expert describes horrific gunshot injury to Reeva Steenkamp’s arm
  • Britain’s youngest parents Mother, 12, gives birth to 7lb baby girl after falling pregnant at primary school to a boy aged 13
  • Drugs mule caught after he complained that his luggage containing 200k of opium had been lost
  • Wife of ‘fit and healthy’ runner who collapsed and died at finish line of London Marathon saw him fall at the end of the race
  • At least two dead and 300 people missing as massive ferry sinks off South Korea with 470 passengers on board including hundreds of high school children
  • Taking statins could prevent prostate cancer from spreading to the bones in a finding that could benefit thousands
  • White babies just 15 months old show racial bias when picking playmates
  • ‘Ice cream for breakfast? Of course, poppet! Draw on the walls and swear? How creative!’ Brace yourself to meet the mother who NEVER says ‘No’ to her children
  • Britain’s hospital bed crisis is second worst in Europe. . . and we are only marginally better than China
  • Children are battling for best primary school places from age of TWO as record numbers of youngsters are denied chosen schools
  • Tanks bearing Russian flag roll into eastern Ukraine as Vladimir Putin warns that country is on the brink of civil war
  • EDWARD LUCAS I hope I’m wrong but historians may look back and say this was the start of World War III
  • Former defence secretary Liam Fox says whistleblower Edward Snowden is guilty of treason and put British spies and their families lives at risk
  • Newborn boy died in father’s arms as he slept on sofa as actress mother was on her first night out since the birth
  • Squirming of the Lib Dems Clegg and Co’s claims that they knew nothing about Cyril Smith’s paedophilia crumble
  • Brave boys the fat man branded liars How Cyril Smith’s victims were ignored when they tried to expose the abuse they suffered at his hands
  • How the position couples sleep in reveals the strength of their relationship