A lot of websites have published articles recently urging readers to be wary of the risks of using e-cigarettes. However, I’ve found that many of these articles merely cite the FDA — an organization clearly not in favor of e-cigarettes — as a reference. Those that don’t cite the FDA seem to think that vendors are still pushing e-cigarettes as smoking cessation tools, which is a practice that stopped long ago. Vendors now market e-cigarettes as what they are: an alternative for people who will smoke either way. However, are e-cigarettes safe for smokers to use? There have been no studies on the effects of long-term e-cigarette use because the product hasn’t been around long enough.
To make matters more complicated, one of the challenges associated with researching whether e-cigarettes are safe is determining which sources are reliable. A lot of the positive information regarding the safety of e-cigarettes comes from vendors and affiliates — people who stand to benefit from a sale. Much of the negative information seems to come from governmental organizations who may be under pressure from Big Tobacco and Big Pharma to stifle competition.
In this article, I’ll attempt to examine the most recent information regarding whether e-cigarettes are safe and let you come to your own conclusion.
The Bottom Line: Are E-Cigarettes Safe?
I don’t think it can be said that e-cigarettes are absolutely safe because there are still some unknowns associated with e-smoking. In addition, we know that nicotine itself isn’t safe to consume. A lot of experts seem to have very positive opinions about the safety of e-cigarettes, but the safer option by far is to stop smoking completely. If you’re able to do that — or you haven’t started smoking yet — don’t use e-cigarettes. If you won’t or can’t stop smoking and are considering e-cigarettes as an alternative, this article presents some e-cigarette safety information to consider. As always, I recommend asking your doctor if you need advice; I’m not a health expert and am only presenting the information I have found.
E-Cigarette Chemicals and Carcinogens
No one questions the fact that cigarette smoke is loaded with thousands of dangerous chemicals, many of which are known carcinogens. Others, such as tar and carbon monoxide, impede your body’s ability to use air effectively and deliver oxygen to your cells. E-cigarettes, by comparison, have no tar or carbon monoxide and consist of just a few primary ingredients — generally propylene glycol, vegetable glycerin, flavors and nicotine. The Smoker’s Angel has an interesting collection of interviews in which health experts discuss the safety of e-cigarettes. I highly recommend reading the interviews for yourself, but the primary bit of information I took from them is that many experts seem to agree e-cigarettes can be as much as 99 percent less harmful than cigarettes due to the elimination of the harmful substances contained in cigarette smoke. In fact, many experts seem to believe that the health effects of e-cigarettes are similar to those of nicotine replacement products such as gum and lozenges.
To my knowledge, however, no one knows the possible long-term health effects of inhaling propylene glycol or vegetable glycerin. These substances are already found in foods and cosmetic products, and because propylene glycol is used in smoke machines, you’ve probably already inhaled it if you’ve ever been to a rock concert. However, prior to the invention of the e-cigarette, no one had ever inhaled these substances in the concentration now inhaled by e-smokers. So that’s an unknown that prospective e-smokers should think about.
Risks of Using Nicotine
If we know that nicotine is the substance in e-cigarettes that should cause the most concern, then what exactly are the risks of using nicotine? In 2007, the University of Medicine and Dentistry of New Jersey published a press release stating that using nicotine replacement is far safer than continuing to smoke — even if the former smoker has to continue using the nicotine long-term to keep from smoking. According to Dr. Jonathan Foulds, one of the experts cited in the press release, “Nicotine patches, gum and lozenges do not cause cancer, emphysema or heart attacks, even for smokers who already have had heart attacks or heart disease.” That being said, it is my understanding that nicotine is always contraindicated for pregnant or nursing women, diabetics and people who are immune-deficient or undergoing chemotherapy. If you fall into any of these categories, again, you need to speak to your doctor about whether e-cigarettes are safe for you.
One of the most important things to keep in mind, though, is the fact that nicotine is highly addictive in a way that no non-smoker could possibly comprehend. E-cigarettes with nicotine are just as addictive as cigarettes, and if you don’t smoke, there’s no reason for you to ever consider buying an e-cigarette.
E-Cigarette Effect on Airways
In early 2012, CHEST — the official publication of the American College of Chest Physicians — published a study indicating that e-cigarette vapor begins to affect the user’s airways, causing inflammation and restricting pulmonary function, after as little as five minutes. What, if anything, this would indicate about whether e-cigarettes are safe for long-term use is unknown. In addition, the study used subjects who didn’t smoke and failed to compare the respiratory effects of e-cigarettes to that of tobacco cigarettes. It also failed to compare e-cigarette vapor to something known to be benign, like pure water vapor.
Chemicals in Atomizers and Cartomizers
Another unknown of e-cigarettes that few people seem to talk about is the potential of vaporizing and inhaling chemicals in atomizers and cartomizers. Some of the materials used to construct these devices may include steel, aluminum, cotton, and potentially even fiberglass, glue and solder. No one seems to have yet examined the potential effects that atomizers and cartomizers could have on whether e-cigarettes are safe. In addition, all of these accessories are made in China, a nation that doesn’t exactly have the best reputation for manufacturing safe consumer products. Having no information about this, I advocate replacing atomizers and cartomizers as soon as vapor production declines rather than cleaning them in an attempt to prolong their life. Repeated use stresses the heating coil, causing it to break down. That’s what leads to decreased vapor production. I would imagine that if there is any risk of vaporizing and inhaling the materials used to create the atomizer or cartomizer, that’s when the risk would be at its greatest.
E-Liquid Safety Standards
Other potential unknowns in the matter of whether e-cigarettes are safe are the ingredients of e-liquids and the safety standards used to manufacture them. I published an article a while back containing one company’s list of the ingredients in its e-cigarettes, and although many of the items seemed pretty benign, there were a few that I had some minor concerns about. I would like to see a lot more transparency about the ingredients that companies put into their e-liquids, although some e-liquid suppliers such as Virgin Vapor and Intellicig have already begun to move in that direction. Many e-cigarette companies are still getting their e-liquids from China, though, and that causes some concern for me because of the lack of safety oversight. For example, a while back some e-liquids with buttery flavor notes were found to have diacetyl, the chemical used to give microwave popcorn its buttery flavor. While diacetyl is approved for consumption, it isn’t safe to inhale concentrated doses over a long period of time. For maximum e-cigarette safety, I suggest buying your e-liquids from a company that adheres to the strictest safety regulations and is very transparent about the ingredients in its e-liquids so you know exactly what you are consuming.
E-Cigarette Battery Explosions
The last potential e-cigarette safety concern is the battery used to operate the atomizer or cartomizer. If a battery overheats, it can cause a violent explosion that’s dangerous to both people and property. This happened to a man in Florida this year and caused a severe injury to his mouth. Although the brand of e-cigarette he was using was never revealed to my knowledge, it’s been suggested that he was using a six-volt “mod” containing two three-volt batteries stacked in series. All of the information I’ve seen indicates that stacking batteries in an e-cigarette can potentially be quite dangerous, which is why I don’t discuss these types of “mods” in my e-cigarette reviews. For people who don’t need the extra vapor that a large “mod” provides, the best that you can do is buy from an established vendor that has proven itself to be reliable. There’s a certain amount of risk any time you use a portable device with a battery, whether it’s an e-cigarette, a computer or a mobile phone. To date, I’ve never seen a specific brand implicated in an e-cigarette battery explosion, which makes me wonder whether some of the reports are true.
Top photo courtesy of Mike Licht, Flickr.